Effect of gastric bypass surgery on vitamin D nutritional status

Carlin, Arthur M.; Rao, D. Sudhaker; Yager, Kelli M.; Genaw, Jeffrey A.; Parikh, Nayana; Szymanski, Wanda

doi:10.1016/j.soard.2006.09.003

Cited by 61 publications

(68 citation statements)

References 15 publications

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“…One hypothesis is that vitamin D is stored by the fatty tissue of obese patients and that it may be gradually released into the circulation during weight loss (11). However, contrary to common belief, there is no significant improvement in 25OHD status after bariatric surgery, as illustrated by several longitudinal studies (16,17,(33)(34)(35)(36). This was confirmed by the present study, in which no significant differences in the serum 25OHD levels were recorded in patients submitted to bariatric surgery.…”

Section: Discussionsupporting

confidence: 72%

Factors associated with secondary hyperparathyroidism in premenopausal women undergoing Roux-en-Y gastric bypass for the treatment of obesity

Vasconcelos

Viégas

Marques

et al. 2010

Arq Bras Endocrinol Metab

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OBJECTIVE: To evaluate bone metabolism, bone density (BMD) and vertebral fractures in morbidly obese individuals. SUBJECTS AND METHODS: Case series of 29 premenopausal obese patients, 15 of whom had been submitted to bariatric surgery. Serum calcium, albumin, PTH and 25-hydroxy vitamin D (25OHD) were measured as well as bone densitometry of the lumbar spine and proximal femur, and lateral spine x-rays. RESULTS: High parathyroid hormone (PTH) levels were recorded in 46.6% of the surgical patients and in 21.4% of the non-surgical patients (p = 0.245); 26.7% of the former and 28.6% of the latter revealed levels 25OHD < 30 ng/mL (p = 1.000). Calcium intake was higher in the surgical group (p = 0.004) along with lower serum calcium concentrations (p = 0.019). There were no significant differences in bone mineral density (BMD) or in the prevalence of vertebral fractures between groups. CONCLUSION: In premenopausal women undergoing Roux-en-Y gastric bypass there is important intestinal calcium mal absorption which seems to be the main factor causing secondary hyperparathyroidism.

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Section: Discussionsupporting

confidence: 72%

Factors associated with secondary hyperparathyroidism in premenopausal women undergoing Roux-en-Y gastric bypass for the treatment of obesity

Vasconcelos

Viégas

Marques

et al. 2010

Arq Bras Endocrinol Metab

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“…Also, although some studies have mentioned a significant increase in 25(OH)D, levels have remained at suboptimum values, which may contribute to maintaining a state of SHPT (33). Vitamin D deficient people need supplementation of 2000 UI per day; however, patients after bariatric surgery need more than that for efficient restoration.…”

Section: Discussionmentioning

confidence: 99%

Bariatric surgery and bone metabolism: a systematic review

Viégas

Vasconcelos

Neves

et al. 2010

Arq Bras Endocrinol Metab

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SUMMARYFew studies have demonstrated the risk of metabolic bone disease and a reduction in bone mineral density (BMD) after bariatric surgery. A systematic review was conducted of case-control and cohort studies with the aim of evaluating the relationship between bariatric surgery and bone metabolism. The search was undertaken in MedLine, covering the period from January 1997 to August 2009, using the keywords: "bariatric surgery" AND "osteoporosis" , "fracture" , "bone diseases" , "metabolic" . Six studies were included, comprising four cohort and two casecontrol studies. Three studies evaluated bone metabolism and BMD, and the other evaluated bone metabolism only. Based on this review, bariatric surgery is associated with alterations in bone metabolism, loss of bone mass and an increased risk of fracture. However, the maximum evaluation period covered by these studies was two years after surgery, hence the need to undertake further studies of longer duration in order to achieve a more thorough understanding of this association. Arq Bras Endocrinol Metab. 2010;54(2):158-63 Keywords Osteoporosis; fracture; bariatric surgery; bone diseases SUMÁRIO Alguns estudos têm demonstrado aumento do risco de doença osteometabólica e redução de densidade mineral óssea (DMO) após a cirurgia bariátrica. Realizou-se uma revisão sistemática de estudos de caso-controle e coorte com o objetivo de avaliar a relação entre cirurgia bariátri-ca e o metabolismo ósseo. A procura foi realizada na MedLine de janeiro 1997 a agosto 2009, utilizando os descritores: "bariatric surgery" e "osteoporosis" , "fracture" , "bone diseases" , "metabolic" . Foram incluídos seis estudos, sendo quatro coortes e dois casos-controle. Três desses estudos avaliaram metabolismo ósseo e DMO e os demais avaliaram apenas o metabolismo ósseo. Com base nesta revisão, a cirurgia bariátrica está associada com alterações no metabolismo ósseo, perda de massa óssea e aumento no risco de fraturas. Entretanto, os estudos tiveram acompanhamento máximo de dois anos após a cirurgia, havendo necessidade de estudos de maior seguimento para melhor conhecimento dessa associação. Arq Bras Endocrinol Metab. 2010;54(2):158-63

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“…Other investigators have reported on the effect of supplementation with 800 IU vitamin D (and calcium) on vitamin D status in individuals after gastric bypass. 33,100 Flores et al 33 observed that in 71% of the patients, serum 25-hydroxyvitamin D concentrations remained below 75 nmol l À1 (30 ng ml À1 ) at 1 year after surgery. Carlin et al 100 reported similar findings, with half of the patients remaining vitamin D-deficient (serum 25-hydroxyvitamin D o50 nmol l À1 or 20 ng ml À1 ) at 1 year after surgery.…”

Section: Methodsmentioning

confidence: 99%

“…33,100 Flores et al 33 observed that in 71% of the patients, serum 25-hydroxyvitamin D concentrations remained below 75 nmol l À1 (30 ng ml À1 ) at 1 year after surgery. Carlin et al 100 reported similar findings, with half of the patients remaining vitamin D-deficient (serum 25-hydroxyvitamin D o50 nmol l À1 or 20 ng ml À1 ) at 1 year after surgery. In a particularly notable study, Aasheim et al 65 studied 60 bariatric surgery patients (31 RYGB, 29 duodenal switch) at multiple time points up to 1 year post-operatively and found that, although serum 25-hydroxyvitamin D concentrations increased after RYGB, they remained below normal for most patients even by 1 year after surgery.…”

Section: Methodsmentioning

confidence: 99%

The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications

et al. 2011

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Obesity and vitamin D deficiency have both been recognized as major public health issues worldwide, and there is growing evidence that they are related, although the cause-effect relationship remains unclear. Could obesity be contributing to low circulating 25-hydroxyvitamin D concentrations? Alternatively, could low vitamin D status predispose to obesity? In this review, the relationship between low circulating 25-hydroxyvitamin D and obesity, and possible underlying reasons from both perspectives, is presented. One potential mechanism by which obesity could contribute to low serum 25-hydroxyvitamin D is adipose sequestration of vitamin D. On the other hand, adipose tissue has both the vitamin D receptor and the ability to synthesize 1,25-dihydroxyvitamin D, and there is evidence that vitamin D may regulate adipose tissue mass, differentiation and metabolism in ways that might contribute to obesity. Of particular interest, vitamin D deficiency is common both before and after bariatric surgery, and is often difficult to treat, particularly with the more malabsorptive procedures. Additional research is needed to elucidate the complex and multifaceted factors underlying the association between low circulating 25-hydroxyvitamin D and obesity, and to identify optimal treatment approaches in obese individuals and in bariatric surgical patients both before and after surgery.

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Effect of gastric bypass surgery on vitamin D nutritional status

Cited by 61 publications

References 15 publications

Factors associated with secondary hyperparathyroidism in premenopausal women undergoing Roux-en-Y gastric bypass for the treatment of obesity

Factors associated with secondary hyperparathyroidism in premenopausal women undergoing Roux-en-Y gastric bypass for the treatment of obesity

Bariatric surgery and bone metabolism: a systematic review

The link between obesity and low circulating 25-hydroxyvitamin D concentrations: considerations and implications

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