Effect of gastric bypass surgery on vitamin D nutritional status.
BACKGROUND
We previously reported a 60% prevalence of vitamin D (VitD) depletion, defined as a 25-hydroxyvitamin D (25-OHD) level of < or =20 ng/mL, in morbidly obese patients preoperatively. We now report the effect of gastric bypass (GB) on the VitD nutritional status in these patients.


METHODS
We prospectively studied 108 morbidly obese patients who had undergone GB. Routine postoperative supplementation consisted of 800 IU VitD and 1500 mg calcium daily. Serum calcium, parathyroid hormone, and 25-OHD were measured before and 1 year after GB.


RESULTS
The mean patient age was 46 +/- 9 years, 93% were women, and 72% were white. Preoperatively and at 1 year postoperatively, the prevalence of VitD depletion and hyperparathyroidism (HPT) and the mean 25-OHD level was 53% and 44%, 47% and 39%, and 20 and 24 ng/mL, respectively. One year after GB, the percentage of excess weight loss was 67% and demonstrated significant correlations both positively with 25-OHD and inversely with parathyroid hormone. At both intervals, blacks had a greater incidence of VitD depletion than did whites, and, at 1 year after GB, HPT was more common in patients with VitD depletion (55% versus 26%, P = .002).


CONCLUSIONS
With customary supplementation, VitD nutrition is improved after GB, but VitD depletion persists in almost one half of patients, and blacks are at a significantly greater risk than whites. HPT did not improve, and those with VitD depletion had a significantly greater rate of HPT. Additional prospective studies are needed to determine how to optimize VitD nutrition and avoid potential long-term skeletal complications after GB.
Carlin
Arthur M
AM
Department of Surgery, Henry Ford Hospital, Detroit, Michigan 48082, USA. acarlin1@hfhs.org
Rao
D Sudhaker
DS
Yager
Kelli M
KM
Genaw
Jeffrey A
JA
Parikh
Nayana J
NJ
Szymanski
Wanda
W
D000328:Adult; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D006961:Hyperparathyroidism / Q000453:epidemiology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014807:Vitamin D / Q000008:administration & dosage / Q000031:analogs & derivatives; D014808:Vitamin D Deficiency / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D044465:White People / Q000706:statistics & numerical data*
D014807:Vitamin D; C104450:25-hydroxyvitamin D