Thin bones: Vitamin D and calcium handling after bariatric surgery

Corbeels, Katrien; Verlinden, Lieve; Lannoo, Matthias; Simoens, Caroline; Matthys, Christophe; Verstuyf, Annemieke; Meulemans, Ann; Carmeliet, Geert; Schueren, Bart Van der

doi:10.1016/j.bonr.2018.02.002

Cited by 43 publications

(58 citation statements)

References 94 publications

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“…Therefore, less contact between fat, fat-soluble molecules, and bile exists before food bolus passes to the ileum [141]. Following VSG, vitamin D malabsorption might result from less exposure of the nutrients to the digestive mucosa [142]. Hypovitaminosis D following BS can also be precipitated by SIBO [105].…”

Section: Vitamin D and Calciummentioning

confidence: 99%

“…Vitamin D deficiency and impaired absorption of calcium in the gut contribute to bone loss because of secondary hyperparathyroidism (sPTH) [142]. Elevated levels of PTH are associated with bone calcium resorption, higher vitamin D synthesis, osteomalacia, or loss of bone mineral density (BMD) that cause hip and column osteoporotic fractures [149].…”

Section: Vitamin D and Calciummentioning

confidence: 99%

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Bariatric Surgery in Obesity: Effects on Gut Microbiota and Micronutrient Status

et al. 2020

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Obesity is associated with reduced gut microbial diversity and a high rate of micronutrient deficiency. Bariatric surgery, the therapy of choice for severe obesity, produces sustained weight loss and improvements in obesity-related comorbidities. Also, it significantly alters the gut microbiota (GM) composition and function, which might have an important impact on the micronutrient status as GM is able to synthesize certain vitamins, such as riboflavin, folate, B12, or vitamin K2. However, recent data have reported that GM is not fully restored after bariatric surgery; therefore, manipulation of GM through probiotics represents a promising therapeutic approach in bariatric patients. In this review, we discuss the latest evidence concerning the relationship between obesity, GM and micronutrients, the impact of bariatric surgery on GM in relation with micronutrients equilibrium, and the importance of the probiotics’ supplementation in obese patients submitted to surgical treatment.

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Section: Vitamin D and Calciummentioning

confidence: 99%

Section: Vitamin D and Calciummentioning

confidence: 99%

Bariatric Surgery in Obesity: Effects on Gut Microbiota and Micronutrient Status

et al. 2020

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“…The mechanism of secondary hyperparathyroidism post‐operatively is not completely understood, but appears to be partially attributed to 25 OHD deficiency and calcium malabsorption. This results in osteoclast differentiation and survival, ultimately leading to reabsorption of the bone matrix and reduced bone mass 9 …”

Section: Introductionmentioning

confidence: 99%

The effects of adolescent laparoscopic adjustable gastric band and sleeve gastrectomy on markers of bone health and bone turnover

et al. 2020

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Summary 25‐hydroxy vitamin D (25 OHD) deficiency and secondary hyperparathyroidism have been seen after metabolic and bariatric surgery, but data are lacking on the bone health outcomes of adolescent sleeve gastrectomy (SG). The purpose of this study was to examine bone‐related nutrition after SG, compared to laparoscopic adjustable gastric band (LAGB), and trend bone turnover markers following SG. This is an observational study of 197 adolescents who underwent LAGB (n = 98) or SG (n = 99). Bone health labs were collected at baseline and 6 and/or 12 months after LAGB or SG, with additional analysis of bone turnover markers in the SG group. Calcium and 25 OHD levels increased at 6 and 12 months after LAGB and SG, with no difference between the surgeries. Parathyroid hormone levels decreased only in the SG group. SG patients had increased osteocalcin and carboxy‐terminal cross‐linking telopeptide of type 1 collagen (CTX) at 6 and 12 months post‐SG, although CTX decreased between 6 and 12 months. Excess weight loss at 6 months predicted the rise in CTX, but the changes in osteocalcin and CTX could not be attributed to 25 OHD deficiency, hypocalcemia or hyperparathyroidism. Patients had improved 25 OHD levels post‐surgery, which may be secondary to stringent vitamin supplementation guidelines. However, there were marked increases in bone turnover markers following SG. More studies are needed to evaluate the effects of SG on adolescent bone health and to correlate the early changes in bone turnover with bone mineral density and fracture risk.

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“…Several factors may affect bone health after BS such as local effect of wnt signaling, and the effect of adipokines. 3 Further studies are needed to clarify this issue.…”

Section: Discussionmentioning

confidence: 99%

“…Calcium is transferred from cells to circulation with a mechanism that consists of three steps including TRPV6, kalbindin-D9k, and PMCA1b. 3 Gastric surgery reduces gastric acid therefore calcium may not be effectively absorbed, and may lead to osteoporosis. 4 Hypothalamus-pituitary-parathyroid axis is affected by the changes in gastrointestinal tract, and the secondary hyperparathyroidism (SHPT) caused by the deficiency of vitamin D, is an important issue after bariatric surgery.…”

Section: Introductionmentioning

confidence: 99%

Does Bariatric Surgery Increase the Formation of Parathyroid Adenoma

Keskin

Öztürk²,

Koca

et al. 2020

Bariatric Surgical Practice and Patient Care

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Background: Bariatric surgery is an important treatment option of obesity over the last decade. While bariatric surgery reduces weight and helps maintanence, it significantly reduces the obesity-related comorbidities, as well. Secondary hyperparathyroidism is a common metabolic complication of bariatric surgery, despite the recommended dose of calcium and vitamin D replacement. We have presented in our article that one of the results of bariatric surgery may be parathyroid adenoma (PA), although the long-term results are unknown. Methods: A total of 838 patients who had undergone sleeve gastrectomy (SG) between 2015 and 2018 were screened retrospectively. We analyzed the data of five patients with parathyroidectomy with PA and indicative of operation according to international guideline. Parathormone (PTH), 25-OH vitamin D3 (25OHD), calcium, phosphate (P), albümin, and alkaline phosphatase were evaluated, which were measured before and after parathyroidectomy. Weight changes of patients before and after bariatric surgery were calculated. Results: Mean age of the 838 patients were 38.7 -10.4 (years) with SG. Six hundred and eighty three subjects (81.5%) were women and 155 (18.5%) were men. Mean body weight changed before and after SG was respectively, 45.04 -6.37 kg/m 2 , 35.80 -7.6937 kg/m 2 , ( p = 0.002). All patients with PA were female and the mean age was 41.4 -9.0 (years). The mean time from bariatric surgery to parathyroid surgery was 2 -1 years. In 838 cases, PA was detected in five cases and the prevalence was found to be 0.6%. Conclusion: Long-term hypocalcemia may cause development of PA as a result of parathyroid gland stimulation. Clarification of increased PTH secondary to hypocalcemia, intestinal adaptation mechanisms, local effect of the wnt signaling pathway, change in carrier proteins, and the effect of adipokines on multifactorial conditions are extremely important to prevent bone loss in patients who underwent bariatric surgery. Development of PA after bariatric surgery is a serious complication and should not be overlooked. Therefore, long-term and strict follow-up is very important after surgery.

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Thin bones: Vitamin D and calcium handling after bariatric surgery

Cited by 43 publications

References 94 publications

Bariatric Surgery in Obesity: Effects on Gut Microbiota and Micronutrient Status

Bariatric Surgery in Obesity: Effects on Gut Microbiota and Micronutrient Status

The effects of adolescent laparoscopic adjustable gastric band and sleeve gastrectomy on markers of bone health and bone turnover

Does Bariatric Surgery Increase the Formation of Parathyroid Adenoma

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