Effect of gastric bypass surgery on vitamin D nutritional status

Surg Obes Relat Dis. Nov-Dec 2006;2(6):638-42. doi: 10.1016/j.soard.2006.09.003.

Abstract

Background: We previously reported a 60% prevalence of vitamin D (VitD) depletion, defined as a 25-hydroxyvitamin D (25-OHD) level of < or =20 ng/mL, in morbidly obese patients preoperatively. We now report the effect of gastric bypass (GB) on the VitD nutritional status in these patients.

Methods: We prospectively studied 108 morbidly obese patients who had undergone GB. Routine postoperative supplementation consisted of 800 IU VitD and 1500 mg calcium daily. Serum calcium, parathyroid hormone, and 25-OHD were measured before and 1 year after GB.

Results: The mean patient age was 46 +/- 9 years, 93% were women, and 72% were white. Preoperatively and at 1 year postoperatively, the prevalence of VitD depletion and hyperparathyroidism (HPT) and the mean 25-OHD level was 53% and 44%, 47% and 39%, and 20 and 24 ng/mL, respectively. One year after GB, the percentage of excess weight loss was 67% and demonstrated significant correlations both positively with 25-OHD and inversely with parathyroid hormone. At both intervals, blacks had a greater incidence of VitD depletion than did whites, and, at 1 year after GB, HPT was more common in patients with VitD depletion (55% versus 26%, P = .002).

Conclusion: With customary supplementation, VitD nutrition is improved after GB, but VitD depletion persists in almost one half of patients, and blacks are at a significantly greater risk than whites. HPT did not improve, and those with VitD depletion had a significantly greater rate of HPT. Additional prospective studies are needed to determine how to optimize VitD nutrition and avoid potential long-term skeletal complications after GB.

MeSH terms

  • Adult
  • African Continental Ancestry Group / statistics & numerical data*
  • Aged
  • Chi-Square Distribution
  • European Continental Ancestry Group / statistics & numerical data*
  • Female
  • Gastric Bypass / adverse effects*
  • Humans
  • Hyperparathyroidism / epidemiology
  • Hyperparathyroidism / prevention & control
  • Male
  • Middle Aged
  • Obesity, Morbid / blood*
  • Obesity, Morbid / surgery
  • Prevalence
  • Prospective Studies
  • Risk Factors
  • Vitamin D / administration & dosage
  • Vitamin D / analogs & derivatives
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / etiology*
  • Vitamin D Deficiency / prevention & control

Substances

  • Vitamin D
  • 25-hydroxyvitamin D