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Differential Behavior of 25(OH)D and f25(OH)D3 in Patients with Morbid Obesity After Bariatric Surgery

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Abstract

Background

Total 25-OH-vitamin D (25(OH)D) levels are decreased in patients with obesity, but few data exist regarding free-vitamin D3 (f25(OH)D3) concentrations. We aimed to evaluate the effect of bariatric surgery on 25(OH)D and f25(OH)D3 in a cohort of patients with morbid obesity.

Methods

Twenty-four patients submitted to sleeve gastrectomy (SG) (mean age 48 years, body mass index (BMI) 48.16±10.73k/m2) were evaluated before and 1 year after surgery. Anthropometric data, parathormone (PTH), calcium, alkaline phosphatase, 25(OH)D, and f25(OH)D3 were recorded.

Results

25(OH)D and f25(OH)D3 correlated well before and after SG. Baseline determinations did not correlate with BMI, but they inversely correlated with BMI 1 year after surgery (rs=−0.46, p=0.02 and rs=−0.60, p=0.002, respectively). Post-surgery % total body weight loss (%TBWL) was 27.4±13.8 %; f25(OH)D3 concentrations increased significantly (5.28±2.29 pg/mL vs 6.64±2.25 pg/mL; p=0.03), whereas 25(OH)D did not change. Patients who achieved a BMI <35 kg/m2 1 year after surgery had significantly higher concentrations of f25(OH)D3 (7.9±1 pg/mL vs 4.8±1.1, p<0.001) and 25(OH)D (30.9±9.4 ng/mL vs 22.3±13.4; p=0.03) compared to those who remained with BMI >35 kg/m2.

Conclusion

There is a significant inverse relationship between BMI and both f25(OH)D3 and 25(OH)D 1 year after surgery. Only f25(OH)D3 concentrations increased 1 year after surgery, which could be explained by a greater f25(OH)D3 sequestration before SG in the adipose tissue, potentially due to the more liposoluble nature of f25(OH)D3 than the protein-bound form 25(OH)D.

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Acknowledgements

We want to particularly acknowledge the patients and the IGTP-HUGTIP Biobank integrated in the Spanish National Biobanks Network of Instituto de Salud Carlos III (PT13/0010/0009) and Tumour Bank Network of Catalonia for its collaboration.

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Authors and Affiliations

  1. Endocrinology and Nutrition Service, Department of Medicine, Universitat Autònoma de Barcelona, Germans Trias I Pujol University Hospital and Research Institute, Carretera del Canyet sn, 08916, Badalona, Spain

    Montserrat Marques-Pamies, Silvia Pellitero, Cecilia S Santillan & Manel Puig-Domingo

  2. Clinical Biochemistry Service, Universitat Autònoma de Barcelona, Germans Trias I Pujol University Hospital and Research Institute, Badalona, Spain

    María López-Molina, Eva Martínez & María L Granada

  3. General Surgery Service, Department of Surgery, Universitat Autònoma de Barcelona, Germans Trias I Pujol University Hospital and Research Institute, Badalona, Spain

    Pablo Moreno & Jordi Tarascó

Authors
  1. Montserrat Marques-Pamies
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  2. María López-Molina
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  3. Silvia Pellitero
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  4. Cecilia S Santillan
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  5. Eva Martínez
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  6. Pablo Moreno
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  8. María L Granada
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  9. Manel Puig-Domingo
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Corresponding authors

Correspondence to Montserrat Marques-Pamies or Manel Puig-Domingo.

Ethics declarations

Ethical Approval

All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards (Ref: PI-17-070; approved on April 28th, 2017).

Informed Consent

Informed consent was obtained from all individual participants included in the study prior to the analysis of clinical data.

Competing Interests

The authors declare no competing interests.

Limitations

This study has some limitations due to its retrospective design. It includes a relatively small number of cases, and we have no information about the percentage of body fat or data of bone densitometry changes that could be related to vitamin D determinations.

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Key Points

1. Serum 25(OH)D and F25(OH)D3 concentrations significantly correlated before and after bariatric surgery.

2. 25(OH)D and F25(OH)D3 showed an inverse correlation with BMI one year after bariatric surgery, but not before surgery.

3. Only F25(OH)D3 increased 1 year after bariatric surgery, which could be explained by a greater f25(OH)D3 sequestration before SG in the adipose tissue, potentially due to the more liposoluble nature of f25(OH)D3 than the protein-bound form 25(OH)D.

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Marques-Pamies, M., López-Molina, M., Pellitero, S. et al. Differential Behavior of 25(OH)D and f25(OH)D3 in Patients with Morbid Obesity After Bariatric Surgery. OBES SURG 31, 3990–3995 (2021). https://doi.org/10.1007/s11695-021-05442-6

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  • DOI: https://doi.org/10.1007/s11695-021-05442-6

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