Obesity Surgery

, Volume 20, Issue 6, pp 732–737

Effect of a Single ‘Megadose’ Intramuscular Vitamin D (600,000 IU) Injection on Vitamin D Concentrations and Bone Mineral Density Following Biliopancreatic Diversion Surgery

  • Kristjana Einarsdóttir
  • David B. Preen
  • Timothy D. Clay
  • Laura Kiely
  • C. D’Arcy J. Holman
  • Leon D. Cohen
Clinical Research

Abstract

Background

Vitamin D (VitD) deficiency is common following biliopancreatic diversion (BPD). We conducted a prospective open-label study to evaluate the efficacy of a single intramuscular injection with 600,000 IU of cholecalciferol in an arachis oil depot formulation (VitD3, Arachitol Solvay Pharmacia) as an adjunct to regular oral VitD supplementation (Citrical+D) for a period of 12 months following BPD surgery.

Methods

Some 29 patients who had undergone BPD during 2000–2005 were recruited and received a single injection of 600,000 IU of cholecalciferol. Venous blood VitD, parathyroid hormone (PTH), alkaline phosphatase (ALP), ionised calcium and urinary N-telopeptide (NTX) were assessed at baseline and at 1.5, 3, 6, 9 and 12 months post-injection. Bone mineral density (BMD) was determined at baseline and 12 months post-injection.

Results

VitD concentrations (mean ± SD) were significantly increased from baseline values (61.5 ± 18.8 nmol/L) at 1.5 months (92.4 ± 21.5, p < 0.001), 3 months (100.5 ± 24.4, p < 0.001) and 6 months (79.1 ± 20.9, p = 0.014) post-injection, with non-significant elevations at 9 months (73.3 ± 15.1, p = 0.248) and 12 months (73.4 ± 17.3, p = 0.278). The proportion of patients with ‘normalised’ VitD levels was significantly higher at all post-injection time points (range, 93–100%) compared with baseline (71.4%; p < 0.01). Ionised calcium and ALP remained within normal levels at baseline and all follow-up time points, although ionised calcium decreased by 3.4% (p = 0.015) and ALP increased by 14.6% (p = 0.021) at 12 months compared with baseline. No significant change in PTH, NTX or BMD was observed.

Conclusions

Intramuscular cholecalciferol injection, as an adjunct to oral supplementation, appears a safe and effective method to increase and maintain VitD levels after BPD.

Keywords

Vitamin D Bone mineral density Biliopancreatic diversion surgery 

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Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Kristjana Einarsdóttir
    • 1
  • David B. Preen
    • 1
  • Timothy D. Clay
    • 2
  • Laura Kiely
    • 3
  • C. D’Arcy J. Holman
    • 1
  • Leon D. Cohen
    • 3
  1. 1.Centre for Health Services Research, School of Population Health M431The University of Western AustraliaPerthAustralia
  2. 2.Royal Perth HospitalPerthAustralia
  3. 3.Mercy Bariatrics Obesity Surgery Centre, Mercy Medical CentrePerthAustralia

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