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Serum Bioavailable Vitamin D Concentrations and Bone Mineral Density in Women After Obesity Surgery

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Abstract

Introduction

Low bone mass after obesity surgery may arise as a consequence of chronic malabsorption of calcium and vitamin D. However, we have not found any role of serum 25-hydroxyvitamin D or of polymorphisms in the vitamin D receptor gene in previous studies.

Purpose

To investigate the circulating bioavailable 25-hydroxyvitamin D in women after bariatric procedures and its association with bone mass.

Patients and Methods

The study consisted of 91 women on follow-up for 7 ± 2 years after bariatric surgery. We measured bone mineral density (BMD), serum parathormone (PTH), 25-hydroxyvitamin D, and vitamin D binding protein (VDBP). All patients were genotyped for two variants in the coding region of VDBP (rs4588 and rs7041). Bioavailable 25-hydroxyvitamin D was calculated in double homozygotes.

Results

We found a negative correlation between bioavailable 25-hydroxyvitamin D and PTH (r = −0.373, P = 0.018), but not with BMD at lumbar spine (r = −0.065, P = 0.682) or hip (r = −0.029, P = 0.857). When adjusting by age, similar results were found for PTH (r = −0.441, P = 0.005), BMD at lumbar spine (r = −0.026, P = 0.874) and hip (r = −0.096, P = 0.561). After multivariate linear regression, forcing bioavailable 25-hydroxyvitamin D into the model resulted in a weak significant association with BMD at the lumbar spine (β = − 0.247, P = 0.025).

Conclusions

Serum bioavailable 25-hydroxyvitamin D concentrations are not associated with bone mass loss after bariatric surgery in women. The negative association with serum PTH levels suggests that vitamin D supplementation partly improves secondary hyperparathyroidism, yet other mechanisms may contribute to low bone mass after bariatric surgery.

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Acknowledgments

We thank the nurse staff of the Department of Endocrinology and Nutrition for their help with the anthropometric and blood sampling of the patients. This work was supported in part by the Fundación para la Investigación Biomédica del Hospital Universitario Ramón y Cajal (FIBio-HRC 119/08), and Fondo de Investigación Sanitaria (FIS PI1100357), Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness. This study is supported in part by Fondo Europeo de Desarrollo Regional FEDER, European Union.

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Author notes

  1. Jose Balsa

    Present address: Department of Endocrinology and Nutrition, Hospital Infanta Sofía, Madrid, Spain

Authors and Affiliations

  1. Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, 28034, Madrid, Spain

    Jose I. Botella-Carretero, Christian Lafuente, Rafael Montes-Nieto, Jose Balsa, Belen Vega-Piñero & Hector Escobar-Morreale

  2. Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (CIBERobn) & Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain

    Jose I. Botella-Carretero & Jose Balsa

  3. Centro de Investigación Biomédica en Red-Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) & Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034, Madrid, Spain

    Rafael Montes-Nieto, Jose L. San-Millan & Hector Escobar-Morreale

  4. Department of General and Digestive Surgery, Hospital Universitario Ramón y Cajal, 28034, Madrid, Spain

    Francisca Garcia-Moreno, Roberto Peromingo & Julio Galindo

  5. Department of Molecular Genetics, Hospital Universitario Ramón y Cajal, 28034, Madrid, Spain

    Jose L. San-Millan

Authors
  1. Jose I. Botella-Carretero
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  2. Christian Lafuente
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  3. Rafael Montes-Nieto
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  4. Jose Balsa
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  6. Francisca Garcia-Moreno
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  7. Roberto Peromingo
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  9. Jose L. San-Millan
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  10. Hector Escobar-Morreale
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Corresponding author

Correspondence to Jose I. Botella-Carretero.

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Conflict of Interest

The Authors declare that they have no conflict of interest.

Ethical and Consent Statements

The study was approved by the Ethics Committee of the Hospital Universitario Ramón y Cajal, and informed consent was obtained from all individual participants included in the study.

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Botella-Carretero, J.I., Lafuente, C., Montes-Nieto, R. et al. Serum Bioavailable Vitamin D Concentrations and Bone Mineral Density in Women After Obesity Surgery. OBES SURG 26, 2732–2737 (2016). https://doi.org/10.1007/s11695-016-2185-1

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  • DOI: https://doi.org/10.1007/s11695-016-2185-1

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