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Mid-term Effects of Sleeve Gastrectomy on Calcium Metabolism Parameters, Vitamin D and Parathormone (PTH) in Morbid Obese Women

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Despite routine supplementation of vitamins and minerals after bariatric surgery, an important number of patients suffer from deficiencies. Little is still known about the novel restrictive procedure, sleeve gastrectomy.


A retrospective study of 30 morbidly obese patients undergoing a laparoscopic sleeve gastrectomy, between May 2008 and September 2010, was performed. Baseline albumin, ferritin, iron, zinc, calcium, vitamin D, parathormone (PTH), vitamin B12, and folic acid were obtained before operation and postoperative determinations 1, 3, 6, 9, 12, 18, and 24 months after surgery.


Before surgery, 96.7% of the patients presented vitamin D deficiency, 20% had elevated PTH, 3.3% hypoalbuminemia, and 3.3% folic acid deficiency. One year after surgery, only one patient (3.3%) presented vitamin D deficiency and had elevated PTH. The rest of parameters were within normal range. The second year after surgery, the results remain similar. A significant difference was obtained when comparing preoperative vitamin D values and postoperative determinations 12 months after surgery (increasement of 51.9 ng/dl, 95% confidence interval (CI) (41.8–61.3); p < 0.001). A significant difference was determined when comparing preoperative PTH values and postoperative determinations 3 months after surgery (decreasement of 16.6 pg/ml, 95% CI (2.6–30.6); p = 0.03). A significant inverse correlation was observed between weight loss and vitamin D increasement at the third month after surgery (Pearson correlation coefficient −0.948; p = 0.033).


Postoperative values of vitamin D show a progressive increasement, while PTH ones present a significant reduction, without any impact on serum calcium levels. We have demonstrated an inverse correlation between weight loss and vitamin D increasement at the third month after surgery.

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  1. Sjostrom L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.

    Article  PubMed  Google Scholar 

  2. Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes Surg. 2004;14:1157–64.

    Article  PubMed  Google Scholar 

  3. Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med. 2005;142:547–59.

    PubMed  Google Scholar 

  4. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.

    Article  PubMed  CAS  Google Scholar 

  5. Davies DJ, Baxter JM, Baxter JN. Nutritional deficiencies after bariatric surgery. Obes Surg. 2007;17:1150–8.

    Article  PubMed  CAS  Google Scholar 

  6. Giusti V, Suter M, Héraïef E, et al. Effects of laparoscopic gastric banding on body composition, metabolic profile and nutritional status of obese women: 12-months follow-up. Obes Surg. 2004;14:239–45.

    Article  PubMed  CAS  Google Scholar 

  7. Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.

    Article  PubMed  CAS  Google Scholar 

  8. Melissas J, Daskalakis M, Koukouraki S, et al. Sleeve gastrectomy—a “food limiting” operation. Obes Surg. 2008;18:1251–6.

    Article  PubMed  Google Scholar 

  9. Gehrer S, Kern B, Peters T, et al. Fewer nutrient deficiencies after laparoscopic sleeve gastrectomy than after laparoscopic Roux-Y-Gastric bypass—a prospective study. Obes Surg. 2010;20:447–53.

    Article  PubMed  Google Scholar 

  10. Malinowski SS. Nutritional and metabolic complications of bariatric surgery. Am J Med Sci. 2006;331:219–25.

    Article  PubMed  Google Scholar 

  11. Toh SY, Zarshenas N, Jorgensen J. Prevalence of nutrient deficiencies in bariatric patients. Nutrition. 2009;25:1150–6.

    Article  PubMed  CAS  Google Scholar 

  12. Vargas-Ruiz AG, Hernandez-Rivera G, Herrera MF. Prevalence of iron, folate and vitamin B12 deficiency anemia after laparoscopic Roux-en-Y gastric bypass. Obes Surg; 18:288-293.

  13. Brolin RE, Leung M. Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity. Obes Surg. 1999;9:150–4.

    Article  PubMed  CAS  Google Scholar 

  14. Johnson JM, Maher JW, Samuel I, et al. Effects of gastric bypass procedures on bone mineral density, calcium, parathyroid hormone and vitamin D. J Gastrointest Surg. 2005;9:1106–10.

    Article  PubMed  Google Scholar 

  15. Ybarra J, Sánchez-Hernández J, Gich I, et al. Unchanged hypovitaminosis D and secondary hyperparathyroidism in morbid obesity after bariatric surgery. Obes Surg. 2005;15:330–5.

    Article  PubMed  Google Scholar 

  16. Carlin AM, Rao DS, Yager KM, et al. Effect of gastric bypass surgery on vitamin D nutritional status. Surg Obes Relat Dis. 2006;2:638–42.

    Article  PubMed  Google Scholar 

  17. 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;2:98–103.

    Article  PubMed  Google Scholar 

  18. Tsiaras WG, Weinstock MA. Factors influencing vitamin D status. Acta Derm Venereol. 2011;91:115–24.

    PubMed  Google Scholar 

  19. Blum M, Dolnikowski G, Seyoum E, et al. Vitamin D(3) in fat tissue. Endocrine. 2008;33:90–4.

    Article  PubMed  CAS  Google Scholar 

  20. Holick MF. Vitamin D deficiency. N Engl J Med. 2007;357:266–81.

    Article  PubMed  CAS  Google Scholar 

  21. Johnson JM, Maher JW, DeMaria EJ, et al. The long-term effects of gastric bypass on vitamin D metabolism. Ann Surg. 2006;243:701–4.

    Article  PubMed  Google Scholar 

  22. Maxwell CS, Wood RJ. Update on vitamin D and type 2 diabetes. Nutr Rev. 2011;69:291–5.

    Article  PubMed  Google Scholar 

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All authors declare that they have no conflict of interests in the preparation of this manuscript.

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Correspondence to Jaime Ruiz-Tovar.

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Ruiz-Tovar, J., Oller, I., Tomas, A. et al. Mid-term Effects of Sleeve Gastrectomy on Calcium Metabolism Parameters, Vitamin D and Parathormone (PTH) in Morbid Obese Women. OBES SURG 22, 797–801 (2012).

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