Archives of Osteoporosis

, 13:14 | Cite as

25-Hydroxyvitamin D levels and bone mineral density evaluation in patients with cholecystectomy: a case-control study

  • Timur EkizEmail author
  • Serkan Fatih Yeğen
  • Mehmet Kağan Katar
  • Ömer Genç
  • Selin Genç
Original Article



This study compared the 25-hyrdoxyvitamin (OH) D and bone mineral density (BMD) values of patients with and without cholecystectomy. Although 25(OH) D levels were significantly lower in the cholecystectomy group (12.1 ± 6.2 vs. 15.6 ± 6.6 ng/mL), no significant difference was observed between the groups in terms of BMD measurements.


Although 25 (OH) D levels were studied and found to be lower in patients with cholecystectomy, the data is scarce as regards the BMD. Therefore, the aim of this study was to compare the 25(OH) D and BMD values of patients with cholecystectomy and without cholecystectomy.


This study was a single-center and case-control trial. The cholecystectomy group comprised the patients with a history of cholecystectomy. In addition, a healthy control group without history of cholecystectomy was defined. All patients were selected consecutively from the patients who admitted to the outpatient clinics of physical and rehabilitation medicine or internal medicine between the June 2016 and August 2016. The patients were ambulatory and did not receive any osteoporosis treatment before. Chemiluminescence microparticle immunoassay method was used for 25(OH) D measurements. Dual-energy X-ray absorptiometry was used for the BMD evaluations.


There were 46 patients in the cholecystectomy group with a mean age of 58.6 ± 14.1 years and 64 patients in the control group with a mean age of 59.2 ± 13.3 years. Although 25(OH) D levels were significantly lower in the cholecystectomy group (12.1 ± 6.2 vs. 15.6 ± 6.6 ng/mL) (p =  0.010), no significant difference was observed between the groups in terms of BMD measurements (p > 0.05). While there was a weak positive correlation between the BMI and BMD measurements (all p < 0.05), linear regression analyses showed that the models were not valid (femoral neck R = 0.092; femur total R = 0.170; and lumbar total R = 0.199). No significant difference was observed between the BMD measurements and time after cholecystectomy in the cholecystectomy group (p > 0.05).


In the light of our results, cholecystectomy patients seem to have lower level of 25(OH) D levels in comparison with healthy subjects, but both groups have similar BMD values. Further studies in cohort designs taking into account the bone formation and resorption markers are awaited.


Osteoporosis Cholecystectomy Dual-energy X-ray absorptiometry Alkaline phosphatase 


25(OH) D

25-Hydroxyvitamin D


Bone mineral density


Body mass index


Alkaline phosphatase


Compliance with ethical standards

Local ethics committee approved this study protocol. Informed consent was obtained from the participants.

Conflicts of interest



  1. 1.
    Comitalo JB (2012) Laparoscopic cholecystectomy and newer techniques of gallbladder removal. JSLS 16(3):406–412CrossRefGoogle Scholar
  2. 2.
    Shabanzadeh DM, Jørgensen T, Linneberg A, Sørensen LT, Skaaby T (2016) Vitamin D and gallstone disease—a population-based study. Endocrine 54(3):818–825CrossRefGoogle Scholar
  3. 3.
    Marcinowska-Suchowierska EB, Tałałaj MJ, Włodarcyzk AW, Bielecki K, Zawadzki JJ, Brzozowski R (1995) Calcium/phosphate/vitamin D homeostasis and bone mass in patients after gastrectomy, vagotomy, and cholecystectomy. World J Surg 19(4):597–601 discussion 601–602CrossRefGoogle Scholar
  4. 4.
    Handzlik-Orlik G, Holecki M, Wilczyński K, Duława J (2016) Osteoporosis in liver disease: pathogenesis and management. Ther Adv Endocrinol Metab 7(3):128–135CrossRefGoogle Scholar
  5. 5.
    Braun F (1986) [Effect of bile on intestinal calcium and vitamin D absorption. Animal experiment studies in swine].Wien Klin Wochenschr Suppl 166:1–23Google Scholar
  6. 6.
    Koricheva ES, Il’chenko AA, Selezneva EIa, Drozdov VN (2010) [Disorders of bone mineral density in patients with cholelithiasis and postcholecystectomic syndrome]. Eksp Klin Gastroenterol (4):14–20Google Scholar
  7. 7.
    Lee SH, Park SJ, Kim KM, Lee DJ, Kim WJ, Park RW, Joo NS (2012) Effect of sunlight exposure on serum 25-hydroxyvitamin d concentration in women with vitamin d deficiency: using ambulatory lux meter and sunlight exposure questionnaire. Korean J Fam Med 33(6):381–389CrossRefGoogle Scholar
  8. 8.
    Lips P (2006) Vitamin D physiology. Prog Biophys Mol Biol 92(1):4–8CrossRefGoogle Scholar
  9. 9.
    Wintermeyer E, Ihle C, Ehnert S, Stöckle U, Ochs G, de Zwart P, Flesch I, Bahrs C, Nussler AK (2016) Crucial role of vitamin D in the musculoskeletal system. Nutrients 8(6)Google Scholar
  10. 10.
    Holick MF (2009) Vitamin D status: measurement, interpretation, and clinical application. Ann Epidemiol 19(2):73–78CrossRefGoogle Scholar
  11. 11.
    Matsuo K, Mukai T, Furuya A, Suzuki S, Tanahashi Y, Azuma H (2013) A case of vitamin D deficiency without elevation of serum alkaline phosphatase in a carrier of Hypophosphatasia. Clin Pediatr Endocrinol 22(4):73–76CrossRefGoogle Scholar
  12. 12.
    Ekiz T, Helvacı S (2016) Bone mineral density and 25-hydroxyvitamin D levels in patients with ocular pseudoexfoliation syndrome: a case-control study. J Clin Densitom 19(4):419–422CrossRefGoogle Scholar
  13. 13.
    Yıldızgören MT, Öziş TN, Baki AE, Tutkun E, Yılmaz H, Tiftik T, Ekiz T, Özgirgin N (2016) Evaluation of bone mineral density and 25-hydroxyvitamin D levels in subjects with silica exposure. Environ Health Prev Med 21(3):149–153CrossRefGoogle Scholar
  14. 14.
    Ekiz T, Vural S, Biçer S, Hatipoğlu C, Özgirgin N (2014) Sacral insufficiency fracture in a hemiplegic patient. Rehabil Nurs 41(3):158–161CrossRefGoogle Scholar
  15. 15.
    Yildizgören MT, Ekiz T, Nadir Öziş T, Baki AE, Tutkun E, Özgirgin N (2014) Osteoporosis: can it be related to silicosis? Tuberk Toraks 62(1):98–99CrossRefGoogle Scholar
  16. 16.
    Kara M, Ozçakar L, Sümer HG, Ekiz T, Ozbudak Demir S, Akıncı A (2014) Recurrent stroke and myocardial infarction in a young woman with severe osteoporosis and hyperparathyroidism. Int J Cardiol 172(1):e192–e193CrossRefGoogle Scholar
  17. 17.
    Silva HG, Mendonça LM, Conceição FL, Zahar SE, Farias ML (2007) Influence of obesity on bone density in postmenopausal women. Arq Bras Endocrinol Metabol 51(6):943–999CrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Timur Ekiz
    • 1
    Email author
  • Serkan Fatih Yeğen
    • 2
  • Mehmet Kağan Katar
    • 2
  • Ömer Genç
    • 3
  • Selin Genç
    • 3
  1. 1.Department of Physical and Rehabilitation MedicineElbistan State HospitalKahramanmaraşTurkey
  2. 2.Department of General SurgeryElbistan State HospitalKahramanmaraşTurkey
  3. 3.Department of Internal MedicineElbistan State HospitalKahramanmaraşTurkey

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