Effects of Bariatric Surgery on Vitamin D Status and Secondary Hyperparathyroidism: A Prospective Study |
| |
Authors: | Joan Sánchez-Hernández Juan Ybarra Ignasi Gich Alberto De Leiva Xavier Rius Jose Rodríguez-Espinosa Antonio Pérez |
| |
Institution: | (1) Department of Medicine, Universitat Autònoma de Barcelona, Spain;(2) Department of Endocrinology, Hospital de Sant Pau, Barcelona, Spain;(3) Department of Epidemiology, Hospital de Sant Pau, Barcelona, Spain;(4) Department of Endocrinology, Hospital de Sant Pau, Barcelona, Spain;(5) Department of Surgery, Hospital de Sant Pau, Barcelona, Spain;(6) Deparment of Biochemistry, Hospital de Sant Pau, Barcelona, Spain;(7) Department of Endocrinology, Hospital de Sant Pau, Barcelona, Spain |
| |
Abstract: | Background: Morbidly obese patients have been reported to present with vitamin D insufficiency and secondary hyperparathyroidism.
Scattered data are available regarding the effects of bariatric surgery on vitamin D status. We studied calcium metabolism
and vitamin D status before and after bariatric surgery. Methods: In this prospective study, 64 patients (M5/F59) fulfilled
the inclusion criteria (i.e. 2 calcidiol serum determinations in the winter season) among 457 morbidly obese individuals who
underwent Roux-en-Y gastric bypass (RYGBP) a mean of 36 months previously. Laboratory data (serum calcium, phosphorus, creatinine,
alkaline phosphatase, albumin, calcidiol, albumin and iPTH) were determined before and after RYGBP. Pre- and postoperative
calcidiol levels were categorized as being normal (>50 nmol/L), insufficient (25-50 nmol/L), and deficient (<25 nmol/L). Pre-
and postoperative mild secondary hyperparathyroidism was defined as iPTH >7.3 pmol/L with simultaneous normal values for creatinine,
calcium and phosphorus. Results: RYGBP produced a significant weight loss coupled with a simultaneous increase in calcidiol
(+28%, P<0.0005) and decrements in total alkaline phosphatase (-53%, P<0.0005) and iPTH (-74%, P=0.001). Corrected serum calcium, phosphorus, and creatinine levels were indistinguishable before and after RYGBP. Additionally,
37.5% of the patients maintained their calcidiol category, while 42.2 % improved it and 20.3% lost one category. Conclusions:
RYGBP does not completely correct pre-existing vitamin D deficient states with secondary hyperparathyroidism. Low calcidiol
bioavailability and or insufficient sunlight exposure do probably persist after bariatric surgery. While randomized controlled
studies are warranted, it seems advisable to support vitamin D supplementation as well as increasing sunlight exposure in
the morbidly obese population. |
| |
Keywords: | MORBID OBESITY BARIATRIC SURGERY GASTRIC BYPASS HYPOVITAMINOSIS D SECONDARY HYPERPARATHYROIDISM |
本文献已被 PubMed SpringerLink 等数据库收录! |
|