Prevalence of Vitamin D Insufficiency and Deficiency in Morbidly Obese Patients: A Comparison with Non-Obese Controls |
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Authors: | Whitney S Goldner Julie A Stoner Jon Thompson Karen Taylor Luann Larson Judi Erickson Corrigan McBride |
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Institution: | (1) Department of Internal Medicine, Section of Diabetes, Endocrinology, and Metabolism, University of Nebraska Medical Center, Omaha, NE 68198-3020, USA;(2) Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA;(3) Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA;(4) Department of Internal Medicine, Clinical Research Center, University of Nebraska Medical Center, Omaha, NE, USA |
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Abstract: | Background Vitamin D deficiency is common in patients after bariatric surgery. However, obesity itself has also been associated with
decreased vitamin D. The prevalence of vitamin D deficiency in obese persons has not previously been compared to non-obese
controls when controlling for factors that could affect vitamin D status.
Methods We evaluated 25 hydroxy vitamin D, iPTH, calcium, albumin, and creatinine in 41 patients undergoing Roux-en-Y gastric bypass.
We then compared them to healthy non-obese controls matched for age, sex, race/ethnicity, and season of vitamin D measurement.
Results Ninety percent of the pre-bariatric surgery patients had 25-OH-D levels <75 nmol/l, and 61% had 25-OH-D levels <50 nmol/l
versus 32 and 12% in controls, respectively. Additionally, 49% of the pre-bariatric surgery patients had secondary hyperparathyroidism
versus 2% of controls. These differences persisted after controlling for sunlight exposure and dietary intake of calcium and
vitamin D. Mean calcium, corrected for albumin, and creatinine were not significantly different between the groups, but mean
albumin levels were significantly lower among surgery patients.
Conclusion Vitamin D deficiency is common in obese patients at the time of bariatric surgery and is also accompanied by secondary hyperparathyroidism
approximately half the time. These findings suggest that vitamin D deficiency after bariatric surgery is multifactorial and
in part caused by preoperative vitamin D deficiency rather than postoperative malabsorption alone. In this study, increased
vitamin D deficiency in obese persons cannot be explained by a difference in calcium/vitamin D intake or sunlight exposure. |
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Keywords: | Vitamin D deficiency Vitamin D insufficiency Obesity Bariatric surgery Secondary hyperparathyroidism |
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