Prevalence and associated factors of secondary hyperparathyroidism after Roux‐en‐Y gastric bypass: A meta‐analysis

Summary This study aimed to investigate the prevalence and factors associated with secondary hyperparathyroidism (SHPT) after Roux‐en‐Y gastric bypass (RYGB). We searched PubMed, EMBASE, and CENTRAL for relevant studies using search terms gastric bypass, RYGB and hyperparathyroidism. Thirty‐four cohort studies with 4331 patients were incorporated into the final meta‐analysis. Overall estimates of the prevalence of SHPT following RYGB were 39%. Subgroup analyses indicated the pooled prevalences of SHPT were 25%, 42%, 48%, and 54% for ≤1 year, >1 and ≤5 years, >5 and ≤10 years, and >10 years, respectively, after RYGB. Meta‐regression showed that SHPT occurred was positively related to follow‐up durations ( p = 0.001). Additionally, SHPT prevalence was higher in studies in which calcium and vitamin D supplementation were considered inadequate than in those which were adequate ( p = 0.002). SHPT is highly prevalent in individuals with obesity after RYGB. It seems to progress with time after surgery. Routine calcium and vitamin D supplementation post‐RYGB together with targeted treatment of vitamin D deficiency, reasonable adjustment of the doses of supplementation with regular follow‐up, and improved patient compliance, as well as long‐term screening, are necessary to prevent the development of SHPT.