Impact of Vitamin D and Calcium Deficiency in the Bones of Patients Undergoing Bariatric Surgery: A Systematic Review

Abstract

Introduction: Bariatric surgery is considered the most effective tool in the control and treatment of severe obesity, but patients undergoing this procedure are at increased risk of developing nutritional deficiencies by limiting the intake and absorption of many nutrients.Objective: To assess the impact of vitamin D deficiency and calcium in bone in patients after gastric bypass in Roux-en-Y, pointing directly at the type of administration, doses and effects after surgery.Method: Was conducted a systematic review with articles related to the topic of the last 10 years searched in PubMed (US National Library of Medicine National Institutes of Health, Medline, Lilacs, Scielo and Cochrane using the headings "bariatric surgery", "bone", "obesity", "vitamin D '', "calcium" AND "absorption". Exclusion criteria to research on animals, smokers, pregnant women and patient treated with bisphosphonates.Results: Five articles were included in this review. All refer that bariatric surgery can lead to nutritional deficiencies and poor absorption of fats and fat-soluble vitamins and other micronutrients such as calcium.Conclusion: Patients submitted to RYGB should make use of multivitamins and minerals especially vitamin D and calcium to prevent bone fractures. Monitoring, treatment and control of risk factors are essential to prevent complications after this operation.

Problems in bariatric patient care – challenges for dieticians

“…The patients’ diet should be carefully planned to prevent nutritional deficiencies, and bisphosphonate treatment may be required in some cases. According to a meta-analysis of recent studies, bariatric surgery may contribute to a deficiency of calcium and fat-soluble vitamins, mainly vitamin D, which is a risk factor for osteopenia and osteoporosis [ 61 ].…”

Vitamin D Deficiency and Paratohommonium Increase in Late Postoperative Gastric Bypass in Roux-en-Y

“…The results are related to sustained weight loss and the improvement or resolution of comorbidities associated with morbid obesity 5 , 29 . However, nutritional deficiencies stemming from food restriction associated with poor nutrient absorption are important issues to consider in the follow-up of these patients 6 , 16 , 19 , 25 .…”

Estudo de coorte prospectivo do padrão ósseo alveolar em mulheres eutróficas e obesas antes e após a cirurgia bariátrica

“…Os resultados mostraram uma diminuição da densidade óssea mineral do colo femoral (9,2%) e no quadril (8,0%) associado à extensão da perda de peso (FLEISCHER et al, 2008). Quanto à saúde bucal, se o tecido ósseo da maxila e mandíbula for afetado, poderá levar à perda dentária por comprometimento do periodonto de sustentação (CABRAL et al, 2016).…”

“…Isto poderia levar ao fracasso de tratamentos reabilitadores com implantes dentários osseointegrados, comprometendo a qualidade de vida destes indivíduos. Recomenda-se acompanhamento, tratamento, monitoramento e controle dos fatores de risco, a fim de prevenir complicações após a cirurgia bariátrica, evitando assim perdas de implantes dentários em futuros tratamentos reabilitadores (CABRAL et al, 2016). Entretanto, futuras pesquisas longitudinais de longa duração deverão ser conduzidas, para que estas evidências sejam mais bem esclarecidas.…”

“…Outros fatores como o socioeconômico, genético e psicológico influenciam indiretamente nas alterações ósseas. Monitoramento, tratamento e controle dos fatores de risco nessa população são essenciais para prevenir complicações após a cirurgia, a fim de evitar perdas de implantes dentários em futuros tratamentos reabilitadores(CABRAL et al, 2016).…”