271 Effects of Bariatric Surgery on Metabolic and Hormonal Balance: A 10-Year Retrospective Study

Abstract

Abstract Background The increasing demand on Gastric bypass and other weight-loss surgeries known collectively as bariatric surgery is well documented but the long-term effects on some parameters have not been satisfactorily analysed over the years. Surgeons are dealing with a level of uncertainty regarding the most likely reason behind this metabolic derangement following such procedures in the follow up clinics. Aim To study the long-term effects of bariatric surgery and weight reduction procedures on Parathyroid function, calcium levels, Vitamin D and determinants of bone health. Method 10-year retrospective study looking at patients underwent bariatric surgery between the years 2006 – 2008 within the Yorkshire area and their follow up data. Results We found that the median calcium levels have decreased significantly compared to its level prior to the operation, even though the absolute value of calcium remained within the normal reference range, it was lower than that of the baseline for each individual, resulting in an increased PTH and ALP levels to a low statistical significance and important clinical significance. Conclusions Calcium levels being lower than the baseline but still within the normal reference range is affecting both PTH and ALP leaving the patient at increased risk of bone weakness complications and other hormonal disturbances. Recommendation During the post-operative follow up plan, calcium levels should be adjusted to mimic the levels of the individuals’ pre-operative values, and the baseline should be the reference range rather than the actual lab reference assuming Calcium levels preoperatively were within the normal range.