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Optimization of Vitamin D Status After Roux-en-Y Gastric Bypass Surgery in Obese Patients Living in Northern Climate

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Abstract

Background

Patients who undergo bariatric surgery are at risk for micronutrient deficiencies. The aims of this study were to determine the prevalence and predictors of vitamin D deficiency in obese patients residing in the northern climate, and to evaluate the effectiveness of a daily maintenance dose of vitamin D 2000 IU in preventing hypovitaminosis D within 1 year after bariatric surgery.

Methods

A cohort study involving adult patients undergoing RYGB was conducted. Longitudinal changes in serum vitamin D concentrations and clinical parameters were measured and collected.

Results

Data from 134 recipients of RYGB were analyzed. Hypovitaminosis D was identified in 86 patients (64 %), and was significantly affected by seasonal change and the number of comorbidities. Follow-up data were available in 60 patients. Vitamin D sufficiency was achieved in 62.5 % of those patients with baseline vitamin D insufficiency. A dose-response relationship of vitamin D intake was observed, with the most significant increase in 25(OH)D associated with daily vitamin D intakes ≥ 2000 IU.

Conclusions

The prevalence of hypovitaminosis D before RYGB was comparable to patients living in the non-northern climate. Daily vitamin D intake meeting at least 2000 IU is associated with greater improvement in serum vitamin D concentration.

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References

  1. Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res. 2011;31(1):48–54.

    Article  CAS  PubMed  Google Scholar 

  2. Aasheim ET, Hofso D, Hjelmesaeth J, et al. Vitamin status in morbidly obese patients: a cross-sectional study. Am J Clin Nutr. 2008;87(2):362–9.

    CAS  PubMed  Google Scholar 

  3. Wortsman J, Matsuoka LY, Chen TC, et al. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000;72:690–3.

    CAS  PubMed  Google Scholar 

  4. Compston JE, Vedi S, Ledger JE, et al. Vitamin D status and bone histomorphometry in gross obesity. Am J Clin Nutr. 1981;34(11):2359–63.

    CAS  PubMed  Google Scholar 

  5. Muscogiuri G, Sorice GP, Prioletta A, et al. 25-Hydroxyvitamin D concentration correlates with insulin-sensitivity and BMI in obesity. Obesity (Silver Spring). 2010;18(10):1906–10.

    Article  CAS  Google Scholar 

  6. Parikh SJ, Edelman M, Uwaifo GI, et al. The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab. 2004;89(3):1196–9.

    Article  CAS  PubMed  Google Scholar 

  7. Lagunova Z, Porojnicu AC, Vieth R, et al. Serum 25-hydroxyvitamin D is a predictor of serum 1,25-dihydroxyvitamin D in overweight and obese patients. J Nutr. 2011;141(1):112–7.

    Article  CAS  PubMed  Google Scholar 

  8. Au LE, Rogers GT, Harris SS, et al. Associations of vitamin D intake with 25-hydroxyvitamin D in overweight and racially/ethnically diverse US children. J Acad Nutr Diet. 2013;113(11):1511–6.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Drincic A, Armas LAG, Van Diest E, et al. Volumetric dilution, rather than sequestration best explains the low vitamin d status of obesity. Obesity. 2012;20:1444–8.

    Article  CAS  PubMed  Google Scholar 

  10. Beckman LM, Earthman CP, Thomas W, et al. Serum 25(OH) vitamin D concentration changes after Roux-en-Y gastric bypass surgery. Obesity (Silver Spring). 2013;21(12):E599–606.

    Article  CAS  Google Scholar 

  11. Ducloux R, Nobécourt E, Chevallier JM, et al. Vitamin D deficiency before bariatric surgery: should supplement intake be routinely prescribed? Obes Surg. 2011;21(5):556–60.

    Article  PubMed  Google Scholar 

  12. Goldner WS, Stoner JA, Thompson J, et al. Prevalence of vitamin D insufficiency and deficiency in morbidly obese patients: a comparison with non-obese controls. Obes Surg. 2008;18(2):145–501.

    Article  PubMed  Google Scholar 

  13. Carlin AM, Rao DS, Meslemani AM, et al. Prevalence of vitamin D depletion among morbidly obese patients seeking gastric bypass surgery. Surg Obes Relat Dis. 2006;2(2):98–103.

    Article  PubMed  Google Scholar 

  14. Gemmel K, Santry HP, Prachand VN, et al. Vitamin D deficiency in preoperative bariatric surgery patients. Surg Obes Relat Dis. 2009;5(1):54–9.

    Article  PubMed  Google Scholar 

  15. Courcoulas AP, Christian NJ, Belle SH, et al. Longitudinal Assessment of Bariatric Surgery(LABS) Consortium. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310(22):2416–25.

    PubMed Central  CAS  PubMed  Google Scholar 

  16. Still CD, Wood GC, Chu X, et al. Clinical factors associated with weight loss outcomes after Roux-en-Y gastric bypass surgery. Obesity (Silver Spring). 2014;22(3):888–94.

    Article  Google Scholar 

  17. Carlsson LM, Peltonen M, Ahlin S, et al. Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects. N Engl J Med. 2012;367(8):695–704.

    Article  CAS  PubMed  Google Scholar 

  18. Hallersund P, Sjöström L, Olbers T, Lönroth H, Jacobson P, Wallenius V, et al. Gastric bypass surgery is followed by lowered blood pressure and increased diuresis - long term results from the Swedish Obese Subjects (SOS) study. PLoS One. 2012;7(11):e49696. [Erratum in: PLoS One. 2013;8(5). doi:10.1371/annotation/88dbb5b7-3f7e-4b26-a5b6-f020d33f0182].

  19. Sjöström L, Narbro K, Sjöström CD, et al. Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.

    Article  PubMed  Google Scholar 

  20. Sjöström L, Lindroos AK, Peltonen M, et al. Swedish Obese Subjects Study Scientific Group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.

    Article  PubMed  Google Scholar 

  21. Lin E, Armstrong-Moore D, Liang Z, et al. Contribution of adipose tissue to plasma 25-hydroxyvitamin D concentrations during weight loss following gastric bypass surgery. Obesity (Silver Spring). 2011;19(3):588–94.

    Article  CAS  Google Scholar 

  22. Aasheim ET, Bjorkman S, Sovik TT, et al. Vitamin status after bariatric surgery: a randomized study of gastric bypass and duodenal switch. Am J Clin Nutr. 2009;90(1):15–22.

    Article  PubMed  Google Scholar 

  23. Vilarrasa N, San Jose P, Garcia I, et al. Evaluation of bone mineral density loss in morbidly obese women after gastric bypass: 3-year follow-up. Obes Surg. 2011;21(4):465–72.

    Article  PubMed  Google Scholar 

  24. Scibora LM, Ikramuddin S, Buchwald H, et al. Examining the link between bariatric surgery, bone loss, and osteoporosis: a review of bone density studies. Obes Surg. 2012;22(4):654–67.

    Article  PubMed  Google Scholar 

  25. Casagrande DS, Repetto G, Mottin CC, et al. Changes in bone mineral density in women following 1-year gastric bypass surgery. Obes Surg. 2012;22(8):1287–92.

    Article  PubMed  Google Scholar 

  26. Levinson R, Silverman JB, Catella JG, et al. Pharmacotherapy prevention and management of nutritional deficiencies post Roux-en-Y gastric bypass. Obes Surg. 2013;23(7):992–1000.

    Article  PubMed  Google Scholar 

  27. Samuel L, Borrell LN. The effect of body mass index on optimal vitamin D status in U.S. adults: the National Health and Nutrition Examination Survey 2001-2006. Ann Epidemiol. 2013;23(7):409–14.

    Article  PubMed  Google Scholar 

  28. Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab. 1988;67(2):373–8.

    Article  CAS  PubMed  Google Scholar 

  29. Fish E, Beverstein G, Olson D, et al. Vitamin D status of morbidly obese bariatric surgery patients. J Surg Res. 2010;164(2):198–202.

    Article  CAS  PubMed  Google Scholar 

  30. Aarts E, van Groningen L, Horst R, et al. Vitamin D absorption: consequences of gastric bypass surgery. Eur J Endocrinol. 2011;164(5):827–32.

    Article  CAS  PubMed  Google Scholar 

  31. Flores L, Osaba MJ, Andreu A, et al. Calcium and vitamin D supplementation after gastric bypass should be individualized to improve or avoid hyperparathyroidism. Obes Surg. 2010;20(6):738–43.

    Article  PubMed  Google Scholar 

  32. Mahlay NF, Verka LG, Thomsen K, et al. Vitamin D status before Roux-en-Y and efficacy of prophylactic and therapeutic doses of vitamin D in patients after Roux-en-Y gastric bypass surgery. Obes Surg. 2009;19(5):590–4.

    Article  PubMed  Google Scholar 

  33. Gasteyger C, Suter M, Gaillard RC, et al. Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation. Am J Clin Nutr. 2008;87(5):1128–33.

    CAS  PubMed  Google Scholar 

  34. Khan S, Mai XM, Chen Y. Plasma 25-hydroxyvitamin D associated with pulmonary function in Canadian adults with excess adiposity. Am J Clin Nutr. 2013;98:174–9.

    Article  CAS  PubMed  Google Scholar 

  35. Thuesen B, Husemoen L, Fenger M, et al. Determinants of vitamin D status in a general population of Danish adults. Bone. 2012;50(3):605–10.

    Article  CAS  PubMed  Google Scholar 

  36. Mechanick JI, Youdim A, Jones DB, et al. American Association of Clinical Endocrinologists; Obesity Society; American Society for Metabolic & Bariatric Surgery. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring). 2013;21 Suppl 1:S1–27.

    Article  CAS  Google Scholar 

  37. Goldner WS, Stoner JA, Lyden E, et al. Finding the optimal dose of vitamin D following Roux-en-Y gastric bypass: a prospective, randomized pilot clinical trial. Obes Surg. 2009;19(2):173–9.

    Article  PubMed  Google Scholar 

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Conflict of Interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Pharmacy, School of Pharmacy, University of Washington, 1959 NE Pacific Street, Box 357630, Seattle, WA, 98195, USA

    Lingtak-Neander Chan, Tiana F. Colovos & Diane R. Javelli

  2. Graduate Program in Nutritional Sciences, School of Public Health, Seattle, WA, USA

    Lingtak-Neander Chan, Charlotte H. Neilson, Elizabeth A. Kirk, Tiana F. Colovos & Diane R. Javelli

  3. Department of Nutritional Services, University of Washington Medical Center, Seattle, WA, USA

    Tiana F. Colovos & Diane R. Javelli

  4. Department of Surgery, School of Medicine, University of Washington, Seattle, WA, USA

    Saurabh Khandelwal

Authors
  1. Lingtak-Neander Chan
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  2. Charlotte H. Neilson
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Correspondence to Lingtak-Neander Chan.

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Chan, LN., Neilson, C.H., Kirk, E.A. et al. Optimization of Vitamin D Status After Roux-en-Y Gastric Bypass Surgery in Obese Patients Living in Northern Climate. OBES SURG 25, 2321–2327 (2015). https://doi.org/10.1007/s11695-015-1685-8

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  • DOI: https://doi.org/10.1007/s11695-015-1685-8

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