Vitamin D Status of Morbidly Obese Bariatric Surgery Patients

Fish, Emily; Beverstein, Gretchen; Olson, Diane L.; Reinhardt, Susan; Garren, Michael; Gould, Jon C.

doi:10.1016/j.jss.2010.06.029

Cited by 80 publications

(68 citation statements)

References 26 publications

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“…4,5,19,[48][49][50][51][52] The high prevalence of low VD levels in obesity is proposed to be due to volumetric dilution in obesity, as the volume of distribution of VD increases with increased body weight. 23 Our study aimed to elucidate whether low plasma 25OHD levels in obesity could be further explained by an altered VD metabolism.…”

Section: Discussionmentioning

confidence: 99%

Expression of vitamin D-metabolizing enzymes in human adipose tissue—the effect of obesity and diet-induced weight loss

et al. 2012

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OBJECTIVE: Low vitamin D (VD) levels are common in obesity. We hypothesized that this may be due to metabolism of VD in adipose tissue (AT). Thus, we studied (1) whether the VD-metabolizing enzymes were expressed differently in AT of lean and obese individuals and in visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), and (2) whether their expression was influenced by weight loss. METHODS: Samples of SAT and VAT were analyzed for expression of the vitamin-D-25-hydroxylases CYP2R1, CYP2J2, CYP27A1 and CYP3A4, the 25-vitamin-D-1a-hydroxylase CYP27B1, the catabolic vitamin-D-24-hydroxylase CYP24A1, and the vitamin D receptor, using reverse transcriptase-PCR. Moreover, plasma 25-hydroxy-vitamin D (25OHD) level was measured and related to the expression of these enzymes. Samples of SAT and VAT from 20 lean women and 20 obese women, and samples of SAT from 17 obese subjects before and after a 10% weight loss were analyzed. RESULTS: A plasma 25OHD level o50 nmol l À 1 was highly prevalent in both lean (45%) and obese (90%) women (Po0.01). Plasma 25OHD increased by 27% after weight loss in the obese individuals (Po0.05). Expression levels of the 25-hydroxylase CYP2J2 and the 1a-hydroxylase CYP27B1 were decreased by 71% (Po0.0001) and 49% (Po0.05), respectively, in SAT of the obese. CYP24A1 did not differ between lean and obese women, but the expression was increased by 79% (Po0.05) after weight loss. CONCLUSION: Obesity is characterized by a decreased expression of the 25-hydroxylase CYP2J2 and the 1a-hydroxylase CYP27B1 in SAT, whereas the catabolic CYP24A1 does not differ between lean and obese women. However, the expression of CYP24A1 is increased after weight loss. Accordingly, AT has the capacity to metabolize VD locally, and this can be dynamically altered during obesity and weight loss. INTRODUCTIONLow levels of circulating 25-hydroxy-vitamin D (25OHD) are associated with increased fat mass and body mass index, 1-5 but the underlying mechanism for this association is not fully elucidated. 6 Vitamin D (VD) is stored in adipose tissue (AT), and release of VD from AT is proposed to serve as an endogenous source of VD during the winter, when cutaneous production is low or absent in several parts of the world. 7 As low circulating levels of 25OHD are common in association with the obese state, 8 several studies have examined the effect of weight loss on circulating levels of 25OHD. However, results are inconsistent. After diet-and exercise-induced weight loss, both increased 9-11 and unaltered 12,13 circulating levels of 25OHD have been reported. Likewise, after major weight loss by bariatric surgery, both temporary 14-16 and long-term increases [16][17][18] in circulating levels of 25OHD have been reported, along with reports of no changes one year after surgery. 13,19 Taken together, these findings indicate that body weight is an important factor for circulating 25OHD levels. Several other explanations for the low levels of 25OHD in obesity have been proposed: a decreased exposure to sun light, 20 ...

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Section: Discussionmentioning

confidence: 99%

Expression of vitamin D-metabolizing enzymes in human adipose tissue—the effect of obesity and diet-induced weight loss

et al. 2012

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“…The observation that obesity is associated with below-normal serum 25-hydroxyvitamin D concentrations and/or overt deficiency is not new; however, as obesity prevalence has grown, so have the number of reports in the literature regarding this phenomenon. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38] Some of the most recent information about low vitamin D status and obesity comes from studies in bariatric surgery patients, reporting low preoperative circulating levels of 25-hydroxyvitamin D. [21][22][23][24][25][26][27][33][34][35][36][37][38] In fact, a recent systematic review of 14 studies with about 1500 patients undergoing bariatric surgical procedures confirmed that obese individuals have serum 25-hydroxyvitamin D levels below 80 nmol l À1 preoperatively. 39 Other investigators have reported that body mass index (BMI) 25,26,[40][41][42][43][44][45][46] and body fat 20,45,…”

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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“…These associations have been described by several authors, both in obese and non-obese patients [8,10,11,16,[18][19][20][21][22][23][24][25][26].…”

Section: Resultsmentioning

confidence: 69%

“…Studies in post-surgery patients have reported vitamin D deficiencies ranging from 42% to 81% [13][14][15]17,18]. However, there are differences in oral vitamin D supplementation (Table 4).…”

Section: Resultsmentioning

confidence: 99%

Vitamin D Levels in an Obese Population, before and after Bariatric Surgery

Tavares¹,

Oliveira²,

Varela³

et al. 2016

Int J Clin Nutr Diet

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Background: Obesity has been associated with vitamin D deficiency. The purpose of this study was to evaluate vitamin D status in obese patients, before and after bariatric surgery, and to examine the relationship of 25(OH)D 3 levels with anthropometric measurements and body fat. Methods: Laboratory values of 25(OH)D 3 , anthropometric measurements, body fat and demographics were retrospectively collected from 239 obese patients, 179 of whom had undergone bariatric surgery. Blood levels of 25(OH)D 3 were correlated with anthropometric measurements, body fat, and with weight loss in patients undergone bariatric surgery. Results:The prevalence of vitamin D deficiency (<15ng/mL) was 50% in the non-operative group and 33% in the bariatric surgery group. A negative association was found between 25(OH)D 3 and anthropometric measurements and body fat in both groups. Body mass index, gender and season were predictors of 25(OH)D 3 . Each body mass index increase of 1 kg/m 2 was associated with a decrease of 0.5 ng/mL in 25(OH)D 3 . In addition, it was found a positive association between 25(OH)D 3 and weight loss after bariatric surgery. Conclusion:The levels of vitamin D seem to be associated with obesity. This finding suggests the need for assessment of vitamin D status and oral vitamin D supplementation in this population.

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Vitamin D Status of Morbidly Obese Bariatric Surgery Patients

Cited by 80 publications

References 26 publications

Expression of vitamin D-metabolizing enzymes in human adipose tissue—the effect of obesity and diet-induced weight loss

Expression of vitamin D-metabolizing enzymes in human adipose tissue—the effect of obesity and diet-induced weight loss

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

Vitamin D Levels in an Obese Population, before and after Bariatric Surgery

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