Skip to main content

Advertisement

SpringerLink
Log in

Vitamin D Status Before Roux-en-Y and Efficacy of Prophylactic and Therapeutic Doses of Vitamin D in Patients After Roux-en-Y Gastric Bypass Surgery

  • Research Article
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Literature regarding the effect of Roux-en-Y gastric bypass (RYGBP) on vitamin D level shows contradictory findings. Our goal was to determine preoperatively vitamin D levels, to evaluate the efficacy of therapeutic and prophylactic doses of vitamin D and to assess the relationship of 25-OH vitamin D level and body mass index (BMI).

Methods

We conducted a retrospective cross-sectional study of 72 patients who underwent RYGBP from April 2007 to October 2007 in Bariatric Surgery Department at Saint Vincent Charity Hospital.

Results

Our study demonstrated that 80% of the obese patients undergoing RYGBP had serum 25-OH vitamin D levels of less than 32 ng/ml. Postoperative data show that 45% of these patients continue being vitamin D insufficient despite the treatment. We demonstrated that a statistically significant inverse correlation between BMI and 25-OH vitamin D levels (r = 0.464, p = 0.01) exists.

Conclusion

Our finding strongly supports the need for aggressive monitoring of vitamin D levels for long-term prevention of complications of vitamin D deficiency in gastric bypass patients. Identifying the factors that predict patient’s responses to vitamin D supplementation requires larger-scale studies and further analysis of these tendencies suggested by our findings.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9

Similar content being viewed by others

References

  1. Mokdad AH, Serdula MK, Dieta WH, et al. The spread of the obesity epidemic in the United States, 1991–1998. JAMA 1999;282:1519–22.

    Article  CAS  Google Scholar 

  2. Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA 2004;294:1909–17.

    Article  Google Scholar 

  3. Prisco C, Levine SN. Metabolic bone disease after gastric bypass surgery for obesity. AM J Med Sci. 2005;329:57–61.

    Article  Google Scholar 

  4. Goldner WS, O’Dorisio TM, Dillon JS, et al. Severe metabolic bone disease as a long-term complication of obesity surgery. Obes Surg. 2002;12:685–92.

    Article  Google Scholar 

  5. Tovey FL, Hall ML, Ell PJ, et al. A review of post-gastrectomy bone disease. J Gastroenterol Hepatol 1992;7:639–45.

    Article  CAS  Google Scholar 

  6. Looker AC, Dawson-Huges B, Calso MS, et al. Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone 2002;30:771–7.

    Article  CAS  Google Scholar 

  7. 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  Google Scholar 

  8. Compston JE, Verdi S, Ledger JE, et al. Vitamin D status and bone histomorphometry in gross obesity. Am J Clin Nutr 1981;34:2359–63.

    Article  CAS  Google Scholar 

  9. Hey H, Stokholm KH, Lund B, et al. Vitamin D deficiency in obese patients and changes in circulating vitamin D metabolites following jejunoileal bypass. Int J Obes 1982;6:473–9.

    CAS  PubMed  Google Scholar 

  10. Bell NH, Epstein S, Greene A, et al. evidence for alteration of the vitamin D-endocrine system in obese subjects. J Clin Invest 1985;76:370–3.

    Article  CAS  Google Scholar 

  11. Liel Y, Ulmer E, Shary J, et al. Low circulating vitamin D in obesity. Calcif Tissue Int 1988;43:199–201.

    Article  CAS  Google Scholar 

  12. Hyldstrup L, Andersen T, McNair P, et al. Bine metabolism in obesity: changes related to severe overweight and dietary weight reduction. Acta Endocrinol (Coppenh) 1993;129:393–8.

    Article  CAS  Google Scholar 

  13. Wortsman J, Matsoka LY, Chen TC, et al. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000;72:690–3.

    Article  CAS  Google Scholar 

  14. Parikh SJ, Edelman M, Uwaifo GI, et al. The relationship between obesity and serum 1,2-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab 2004;89:1196–9.

    Article  CAS  Google Scholar 

  15. Buffington C, Walker B, Cowa GS Jr, et al. Vitamin D deficiency in the morbidly obese. Obes Surg 1993;3:421–4.

    Article  CAS  Google Scholar 

  16. DiGiorgi MF, Daud A, Bessler M. Effectiveness of vitamin D supplementation after gastric bypass. Obes Surg 2003;13:210–1.

    Google Scholar 

  17. Flancbaum L, Belsley S, Drake V, et al. Preoperative nutritional status of patients undergoing Roux-en-Y gastric bypass for morbid obesity. J Gastrointest Surg 2006;10:1033–7.

    Article  Google Scholar 

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

    Article  Google Scholar 

  19. Wilson T, Drake VVI, Colarusso T, et al. Preoperative nutritional status of patients undergoing Roux-en-Y gastric bypass for morbid obesity [abstract]. Gastroenterology 2004;126(suppl 2):A–813.

    Google Scholar 

  20. Hollick MF. Vitamin D: photobiology, metabolism, mechanism of action, and clinical applications. In: Favis MJ, editor. Primer on the metabolic bone diseases and disorders of mineral metabolism, 4th ed. Philadelphia: Lippincott Williams and Wilkins; 1999. p. 92–8.

    Google Scholar 

  21. Holick MF. Vitamin D deficiency in obesity and health consequences. Curr Opin Endocrinol Diabetes. 2006;13:412–8.

    Article  CAS  Google Scholar 

  22. Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 2006;81:353–73.

    Article  CAS  Google Scholar 

  23. Malabanan A, Veronikis IE, Holick MF. Redefining vitamin D insufficiency. Lancet 1998;351:805–6.

    Article  CAS  Google Scholar 

  24. Michael F. Holick, M.D., Ph.D. Vitamin D deficiency. NEJM 2007;357:266–81.

    Article  Google Scholar 

  25. Coates PS, et al. Gastric bypass surgery for morbid obesity leads to an increase in bone turnover and a decrease in bone mass. J Clin Endocrinol Metab 2004;89:1061–5.

    Article  CAS  Google Scholar 

Download references

Acknowledgments

Special thanks to Aleece Caron for her contribution in developing and analyzing statistical data.

Author information

Authors and Affiliations

  1. Saint Vincent Charity Hospital, 2351 East 22nd St., Cleveland, OH, 44115, USA

    Natalia Fendrikova Mahlay, Lisena G. Verka, Kimberly Thomsen, Srinivas Merugu & Mark Salomone

Authors
  1. Natalia Fendrikova Mahlay
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lisena G. Verka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kimberly Thomsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Srinivas Merugu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mark Salomone
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lisena G. Verka.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mahlay, N.F., Verka, L.G., Thomsen, K. et al. Vitamin D Status Before Roux-en-Y and Efficacy of Prophylactic and Therapeutic Doses of Vitamin D in Patients After Roux-en-Y Gastric Bypass Surgery. OBES SURG 19, 590–594 (2009). https://doi.org/10.1007/s11695-008-9698-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-008-9698-1

Keywords

Search

Navigation