Impairment of vitamin D and bone metabolism in patients with bypass operation for obesity.
Thirty-four patients were studied 2--6 years after jejunoileal bypass for morbid obesity. The serum concentration of 25-hydroxyvitamin D (25-OHD) were reduced and related to the frequency fo stools and to the weight reduction. Fifteen patients were not able to normalize serum 25-OHD following a long-term regular vitamin D intake. The serum immunoreactive parathyroid hormone concentration (iPTH) and the alkaline phosphatase levels were elevated in this group, indicating a secondary hyperparathyroidism. The mean bone mineral content of the forearm was reduced 3--6 years after the operation, most severely in those with elevated serum iPTH. The desired weight reduction by jejunoileal shunt was obtained at the expense of a severely disturbed vitamin D metabolism. We suggest, that all patients with an intestinal bypass for obesity should receive regular vitamin D supplement, and serum 25-OHD should be measured in order to monitor the effect of therapy.
D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D001835:Body Weight; D001842:Bone and Bones / Q000378:metabolism*; D002118:Calcium / Q000378:metabolism; D006801:Humans; D006887:Hydroxycholecalciferols / Q000097:blood; D006962:Hyperparathyroidism, Secondary / Q000209:etiology; D007421:Intestine, Small / Q000601:surgery*; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism / Q000628:therapy*; D010281:Parathyroid Hormone / Q000097:blood; D010710:Phosphates / Q000097:blood; D011183:Postoperative Complications; D014807:Vitamin D / Q000008:administration & dosage; D014808:Vitamin D Deficiency / Q000097:blood / Q000209:etiology*
D006887:Hydroxycholecalciferols; D010281:Parathyroid Hormone; D010710:Phosphates; D014807:Vitamin D; D000469:Alkaline Phosphatase; D002118:Calcium