Vitamin D deficiency in obese patients and changes in circulating vitamin D metabolites following jejunoileal bypass.
The serum levels of the three major vitamin D metabolites [25-hydroxyvitamin D (25-OHD), 1,25-dihydroxyitamin D (1,25-(OH)2D), 24,25-dihydroxyvitamin D (24,25-(OH)2 D)] and immunoreactive parathyroid hormone (iPTH) were measured in 14 morbid obese patients, who later on were subjected to jejunoileal bypass surgery. The preoperative median values of 25-OHD and 24,25-(OH)2D were reduced compared with controls (P less than 0.001), whereas elevated concentrations were found of 1,25-(OH)2D (P less than 0.005). Median levels of iPTH in the obese group were significantly higher than those found in normal subjects (P less than 0.001). A decrease was observed in serum concentrations of all three vitamin D metabolites following jejunoileal bypass (P less than 0.005). An increase in the serum levels of iPTH and alkaline phosphatase was seen postoperatively (P less than 0.002), probably indicating a secondary hyperparathyroidism. The results show that the vitamin D metabolism is slightly abnormal in severely obese patients. Jejunoileal bypass is followed by severe disturbances of vitamin D metabolism.
D015650:24,25-Dihydroxyvitamin D 3; D000328:Adult; D000469:Alkaline Phosphatase / Q000097:blood; D002112:Calcifediol / Q000097:blood; D002117:Calcitriol / Q000097:blood; D004100:Dihydroxycholecalciferols / Q000097:blood; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007583:Jejunum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000628:therapy*; D010281:Parathyroid Hormone / Q000097:blood; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000209:etiology*
D004100:Dihydroxycholecalciferols; D010281:Parathyroid Hormone; D014807:Vitamin D; D015650:24,25-Dihydroxyvitamin D 3; D000469:Alkaline Phosphatase; D002117:Calcitriol; D002112:Calcifediol