Background: Morbidly obese patients have been reported to present with vitamin D insufficiency and secondary hyperparathyroidism.
We assessed whether bariatric surgery alters the 25-hydroxyvitamin D (calcidiol) and intact parathyroid hormone (iPTH) levels
in patients presenting with morbid obesity. Methods: A cross-sectional survey was conducted on 144 patients of whom 80 had
not undergone bariatric surgery, while 64 had bariatric surgery at a mean of 36 months previously. Calcidiol levels were defined
as being normal (>50 nmol/L), insufficient (2550 nmol/L) and deficient (<25 nmol/L). Mild secondary hyperparathyroidism was
defined as iPTH >7.3 pmol/L with simultaneous normal values for creatinine, calcium and phosphorus. Results: 80% of the patients
presented low vitamin D levels and mild secondary hyperparathyroidism. Previous surgery or the presence of diabetes did not
influence calcidiol levels. Corrected serum calcium, phosphorus, alkaline phosphatase, iPTH and Calcidiol were similar between
subjects with and without surgery. Conclusions: Vitamin D deficient states with secondary hyperparathyroidism in the morbidly
obese precede and are not significantly affected by bariatric surgery. Hypovitaminosis D with secondary hyperparathyroidism
due to low calcidiol bio-availability should be added to the crowded list of sequelae of morbid obesity. While further studies
are warranted, it seems advisable to support vitamin D supplementation in the morbidly obese population.
MORBID OBESITY - SECONDARY HYPERPARATHYROIDISM - HYPOVITAMINOSIS D - CALCIDIOL BIO-AVAILABILITY - BARIATRIC SURGERY