Skip to main content
Log in

Utilization of Preoperative Patient Factors to Predict Postoperative Vitamin D Deficiency for Patients Undergoing Gastric Bypass

  • SSAT Poster Presentation
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Vitamin D deficiency occurring after gastric bypass procedures can predispose patients to calcium and parathyroid hormone (PTH) level abnormalities. The aim of the study is to identify preoperative patient risk factors for postoperative vitamin D deficiency.

Methods

We retrospectively reviewed patients who underwent Roux-en-Y gastric bypass procedures between 2005 and 2006. Patient demographics, laboratory values of calcium, vitamin D, and PTH were followed at quarterly intervals for 1 year.

Results

One hundred forty-five patients were included in the study. The mean age for the group was 44 years with an average body mass index of 49.5 kg/m2. Eighty-six percent of patients were female and 23% was African–American. Forty-two percent of the patients had vitamin D deficiency (<20 ng/mL) either preoperatively or at year 1. The mean calcium levels decreased from 9.39 to 9.16 mg/dL (p < 0.001) while the mean PTH levels increased from 25.7 to 43.9 ng/mL (p < 0.001). A logistic regression model recognized preoperative vitamin D levels, race, and bypass limb length to be the only significant factors (p < 0.05) for postoperative vitamin D deficiency.

Conclusion

It is important to recognize patients who are at risk for vitamin D deficiency before surgery so that early intervention could be in place to minimize further postoperative deficiency.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Trus TL, Pope GD, Finlayson SR. National trends in utilization and outcomes of bariatric surgery. Surg Endosc 2005;19(5):616–620. doi:10.1007/s00464-004-8827-8.

    Article  PubMed  CAS  Google Scholar 

  2. 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. discussion 104 doi:10.1016/j.soard.2005.12.001.

    Article  PubMed  Google Scholar 

  3. Carlin AM, Rao DS, Yager KM, et al. Effect of gastric bypass surgery on vitamin D nutritional status. Surg Obes Relat Dis 2006;2(6):638–642. doi:10.1016/j.soard.2006.09.003.

    Article  PubMed  Google Scholar 

  4. Johnson JM, Maher JW, DeMaria EJ, et al. The long-term effects of gastric bypass on vitamin D metabolism. Ann Surg 2006;243(5):701–704. discussion 704–705 doi:10.1097/01.sla.0000216773.47825.c1.

    Article  PubMed  Google Scholar 

  5. Ybarra J, Sanchez-Hernandez J, Gich I, et al. Unchanged hypovitaminosis D and secondary hyperparathyroidism in morbid obesity after bariatric surgery. Obes Surg 2005;15(3):330–335. doi:10.1381/0960892053576758.

    Article  PubMed  Google Scholar 

  6. Team RDCR. A language and environment for statistical computing. Vienna: R Foundation for Statistical Computing, 2007.

    Google Scholar 

  7. Digiorgi M, Daud A, Inabnet WB, et al. Markers of bone and calcium metabolism following gastric bypass and laparoscopic adjustable gastric banding. Obes Surg 2008;18(9):1144–1148.

    Article  PubMed  Google Scholar 

  8. Nelson ML, Bolduc LM, Toder ME, et al. Correction of preoperative vitamin D deficiency after Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis 2007;3(4):434–437. doi:10.1016/j.soard.2007.02.007.

    Article  PubMed  Google Scholar 

  9. Lo CW, Paris PW, Clemens TL, et al. Vitamin D absorption in healthy subjects and in patients with intestinal malabsorption syndromes. Am J Clin Nutr 1985;42(4):644–649.

    PubMed  CAS  Google Scholar 

  10. Youssef Y, Richards WO, Sekhar N, et al. Risk of secondary hyperparathyroidism after laparoscopic gastric bypass surgery in obese women. Surg Endosc 2007;21(8):1393–1396. doi:10.1007/s00464-007-9228-6.

    Article  PubMed  CAS  Google Scholar 

  11. Weng FL, Shults J, Leonard MB, et al. Risk factors for low serum 25-hydroxyvitamin D concentrations in otherwise healthy children and adolescents. Am J Clin Nutr 2007;86(1):150–158.

    PubMed  CAS  Google Scholar 

  12. Webb AR, Holick MF. The role of sunlight in the cutaneous production of vitamin D3. Annu Rev Nutr 1988;8:375–399. doi:10.1146/annurev.nu.08.070188.002111.

    Article  PubMed  CAS  Google Scholar 

  13. Talwar SA, Aloia JF, Pollack S, Yeh JK. Dose response to vitamin D supplementation among postmenopausal African–American women. Am J Clin Nutr 2007;86(6):1657–1662.

    PubMed  CAS  Google Scholar 

  14. Perry HM 3rd, Horowitz M, Morley JE, et al. Aging and bone metabolism in African–American and Caucasian women. J Clin Endocrinol Metab 1996;81(3):1108–1117. doi:10.1210/jc.81.3. 1108.

    Article  PubMed  CAS  Google Scholar 

  15. Jin J, Robinson AV, Hallowell PT, et al. Increases in parathyroid hormone (PTH) after gastric bypass surgery appear to be of a secondary nature. Surgery 2007;142(6):914–920. discussion 914–920 doi:10.1016/j.surg.2007.09.023.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Scott Wilhelm.

Additional information

This paper had been presented as a poster at the DDW meeting May 2008, San Diego, CA, USA.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jin, J., Stellato, T.A., Hallowell, P.T. et al. Utilization of Preoperative Patient Factors to Predict Postoperative Vitamin D Deficiency for Patients Undergoing Gastric Bypass. J Gastrointest Surg 13, 1052–1057 (2009). https://doi.org/10.1007/s11605-009-0847-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-009-0847-1

Keywords

Navigation