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Frequency of Vitamin D Deficiency and Associated Factors in Long-term Bariatric Surgery Patients: a Cross-sectional Study

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Abstract 

Background

Vitamin D deficiency is a common consequence of bariatric surgery (BS). However, few studies have evaluated influential factors and to date there are no studies investigating individual ultraviolet B (UVB) radiation levels in BS patients. This study aimed to evaluate vitamin D deficiency and its associated factors, including UVB radiation, in Roux-Y gastric bypass (RYGB) patients.

Methods

This study included 104 adults (90.4% female) at least 5 years after RYGB. Patients underwent surgery in private hospitals (Private; n = 47) or in two public hospitals, one with ongoing outpatient care (Active; n = 17), and the other with discontinued service for BS (Discontinued; n = 40). 25-hydroxyvitamin D (25(OH)D) concentrations were analyzed by chemiluminescence, individual UVB radiation levels by dosimeter badges. Vitamin D intake, anthropometric, skin phototype, sociodemographic and lifestyle patterns were also assessed.

Results

Mean age was 49.6 ± 9.1 years and post-operative period 8.7 ± 2.2 years. The prevalence of 25(OH)D deficiency and insufficiency was 25.0% and 51.9% respectively. 25(OH)D concentration differed among the hospitals (private = 26.2 ± 8.5; active = 28.7 ± 11.4; discontinued = 23.5 ± 6.5 ng/mL; p = 0.038). A total of 26.2% of the variance observed in 25(OH)D concentrations was explained by daily UVB radiation levels (β = 0.224; p = 0.032) and vitamin D intake (β = 0.431; p < 0.001), controlling for age and BMI.

Conclusion

A quarter of the evaluated patients presented vitamin D deficiency, which was associated with the discontinuation of the health care, higher BMI, lower vitamin D intake, and lower individual UVB radiation levels.

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Funding

The research project was financed by the National Council for Scientific and Technological Development—CNPQ (process number 408340/2017–7).

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Authors and Affiliations

  1. Department of Nutrition, Faculty of Health Science, Federal District, University of Brasília, Brasília, 70910-900, Brazil

    Maísa Miranda Araújo, Marcela Moraes Mendes, Lara Pereira Saraiva Leão Borges, Teresa Helena Macedo da Costa, Kênia Mara Baiocchi de Carvalho & Patrícia Borges Botelho

  2. Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7XH, UK

    Susan A. Lanham-New

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  1. Maísa Miranda Araújo
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  2. Marcela Moraes Mendes
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Conflict of Interest

S.A.L.-N. is the Research Director of D3Tex Ltd., which holds the UK and Gulf Corporation Council (GCC) Patent for the use of UVB transparent material for vitamin D deficiency prevention. The company had no role in the design of the study, in the collection, analyses, or interpretation of data, in the writing of the manuscript or in the decision to publish the results. The remaining authors declare no conflict of interest.

Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

The research project was approved by the appropriate ethics committee.

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Informed consent was obtained from all individual participants included in the study.

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Key Points

• Vitamin D deficiency is often observed after bariatric surgery (BS).

• Serum 25(OH)D was influenced by continuation of the health service and higher BMI

• Supplementation and sun-exposure are essential to achieve adequate vitamin D levels

• Total vitamin D intake had a greater impact on serum 25(OH)D than sun-exposure

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Araújo, M.M., Mendes, M.M., Lanham-New, S.A. et al. Frequency of Vitamin D Deficiency and Associated Factors in Long-term Bariatric Surgery Patients: a Cross-sectional Study. OBES SURG 32, 2386–2396 (2022). https://doi.org/10.1007/s11695-022-06090-0

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