Vitamin D status and supplementation in morbid obesity before and after bariatric surgery

INTRODUCTION: Long-term results from bariatric surgery amongst individuals with obesity is considered good in general, with regard to weight loss, complications of obesity or quality of life. However, risk of nutrient deficiency might be increased. The aim of the study was to assess vitamin D status of patients before and after metabolic and bariatric surgery at Landspitali. METHODS: Data on 25(OH)D concentration and parathyroid hormone (PTH) was retrieved from medical records for patients undergoing metabolic and bariatric surgery at Landspitali from 2001-2018 (n=539). Insufficient vitamin D status was defined as 25(OH)D concentration <45 nmol/L in 2001-2012 but <50 nnmol/L from 2013-2018, due to changes in analytical method during the study period. Vitamin D deficiency was defined as 25(OH)D <30 nmol/L for both time periods. Guidelines on supplement use are provided before discharge from the hospital and up to 18 months after surgery, RESULTS: Mean concentration of 25(OH)D before surgery was 51 nmol/L (SD 30 nmol/L) and 278 (52%) had insufficient vitamin D status, of which quarter of subjects were defined as being vitamin D deficient. Concentration of 25(OH)D increased after surgery in majority of subjects (85%). However, about third of those defined as having insufficient vitamin D status before surgery still had insufficient status 18 months after surgery. When comparing time periods, 2001-2012 and 2013-2018 it can be seen that insufficient vitamin D status was less common in the second period, although still persistent in about 25% of cases before surgery and 8,5% 18 months after surgery. CONCLUSION: Insufficient vitamin D status is relatively common before metabolic and bariatric surgery at Landspitali. In large majority of subjects, 25(OH)D concentration increased after surgery, following recomendations on supplement intake. The results highlight the need for greater emphasis on correcting possible nutrient deficiencies before surgery.

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Vitamin D Status in Patients with Morbid Obesity Following Bariatric Surgery in Shiraz, Iran: A Retrospective Observational Study

Bariatric Surgical Practice and Patient Care ◽

10.1089/bari.2020.0121 ◽

2021 ◽

Author(s):

Shirin Rajabi ◽

Vahideh Aghamohammadi ◽

Gholamreza Moradpour ◽

Masoud Amini ◽

Seyed Vahid Hosseini ◽

...

Keyword(s):

Bariatric Surgery ◽

Morbid Obesity ◽

Vitamin D ◽

Observational Study ◽

Retrospective Observational Study ◽

Vitamin D Status

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Faculty Opinions recommendation of Vitamin D status and supplementation before and after bariatric surgery: a comprehensive literature review.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726272152.793521863 ◽

2016 ◽

Author(s):

Frank Lammert

Keyword(s):

Bariatric Surgery ◽

Vitamin D ◽

Literature Review ◽

Vitamin D Status ◽

Comprehensive Literature Review ◽

Before And After

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Vitamin D deficiency in morbid obesity before and after bariatric surgery

Endocrine Abstracts ◽

10.1530/endoabs.32.p154 ◽

2013 ◽

Author(s):

Inmaculada Gonzalez-Molero ◽

Montserrat Gonzalo-Marin ◽

Marta Dominguez ◽

Juan Garcia Arnes

Keyword(s):

Bariatric Surgery ◽

Morbid Obesity ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Before And After

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Effects of Bariatric Surgery on Vitamin D Status and Secondary Hyperparathyroidism: A Prospective Study

Obesity Surgery ◽

10.1381/096089205774859182 ◽

2005 ◽

Vol 15 (10) ◽

pp. 1389-1395 ◽

Cited By ~ 47

Author(s):

Joan Sánchez-Hernández ◽

Juan Ybarra ◽

Ignasi Gich ◽

Alberto De Leiva ◽

Xavier Rius ◽

...

Keyword(s):

Bariatric Surgery ◽

Vitamin D ◽

Prospective Study ◽

Secondary Hyperparathyroidism ◽

Vitamin D Status ◽

A Prospective Study

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Serum 25(OH)D3 vitamin status of elderly Finnish women is suboptimal even after summer sunshine but is not associated with bone density or turnover

Acta Endocrinologica ◽

10.1530/eje-09-0739 ◽

2010 ◽

Vol 162 (1) ◽

pp. 183-189 ◽

Cited By ~ 11

Author(s):

Tuula Pekkarinen ◽

Ursula Turpeinen ◽

Esa Hämäläinen ◽

Eliisa Löyttyniemi ◽

Henrik Alfthan ◽

...

Keyword(s):

Vitamin D ◽

Bone Density ◽

Bone Turnover ◽

Population Based ◽

Type I ◽

Vitamin D Status ◽

Mineral Density ◽

Type I Procollagen ◽

Before And After ◽

Before And After Summer

ObjectiveConcentrations of 50 and 75 nmol/l are proposed as serum 25-hydroxyvitamin D (25(OH)D) target for older people from the view of bone health. We evaluated vitamin D status of elderly Finnish women in light of these definitions, its relationship to bone mineral density (BMD) and turnover, and improvement by summer sunshine.DesignPopulation-based study.MethodsA total of 1604 ambulatory women aged 62–79 years were studied; 66% used vitamin D supplements. Serum 25(OH)D3was measured with HPLC before and after summer, and heel BMD in spring. In subgroups, serum parathyroid hormone (PTH) and type I procollagen aminoterminal propeptide (PINP) were analyzed.ResultsIn spring, 60.3% of the women had 25(OH)D3≤50 nmol/l, and the target of 75 nmol/l was reached by 9.1%. For supplement users, the respective numbers were 52.1 and 11.9%. Serum 25(OH)D3did not determine BMD or bone turnover measured by serum PINP. Summer sunshine increased serum 25(OH)D3by 17.4% (P<0.0001), but in autumn 84% of the subjects remained under the target of 75 nmol/l. In supplement users, PTH remained stable but decreased in others during summer (P=0.025).ConclusionsVitamin D status of elderly Finnish women is suboptimal if 25(OH)D3levels of 50 or 75 nmol/l are used as a threshold. It is moderately increased by supplement intake and summer sunshine. However, 25(OH)D3concentrations did not influence bone density in terms of serum PINP and bone turnover rate.

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Vitamin D Status in Patients Operated for Primary Hyperparathyroidism: Comparison of Patients from Southern and Northern Europe

International Journal of Endocrinology ◽

10.1155/2013/164939 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Erik Nordenström ◽

Antonio Sitges-Serra ◽

Joan J. Sancho ◽

Mark Thier ◽

Martin Almquist

Keyword(s):

Vitamin D ◽

Primary Hyperparathyroidism ◽

Disease Activity ◽

Vitamin D Deficiency ◽

Urinary Calcium ◽

Vitamin D Status ◽

Mineral Density ◽

Before And After ◽

25 Hydroxy Vitamin D ◽

One Year

Aim. The interaction between vitamin D deficiency and primary hyperparathyroidism (PHPT) is not fully understood. The aim of this study was to investigate whether patients with PHPT from Spain and Sweden differed in vitamin D status and PHPT disease activity before and after surgery.Methods. We compared two cohorts of postmenopausal women from Spain(n=126)and Sweden(n=128)that had first-time surgery for sporadic, uniglandular PHPT. Biochemical variables reflecting bone metabolism and disease activity, including levels of 25-hydroxy vitamin D3(25(OH)D) and bone mineral density, BMD, were measured pre- and one year postoperatively.Results. Median preoperative 25(OH)D levels were lower, and adenoma weight, PTH, and urinary calcium levels were higher in the Spanish cohort. The Spanish patients had higher preoperative levels of PTH (13.5 versus 11.0 pmol/L,P<0.001), urinary calcium (7.3 versus 4.1 mmol/L,P<0.001), and heavier adenomas (620 versus 500 g,P<0.001). The mean increase in BMD was higher in patients from Spain and in patients with vitamin D deficiency one year after surgery.Conclusion. Postmenopasual women with PHPT from Spain had a more advanced disease and lower vitamin 25(OH)D levels. Improvement in bone density one year after surgery was higher in patients with preoperative vitamin D deficiency.

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