Correction of preoperative vitamin D deficiency after Roux-en-Y gastric bypass surgery.
BACKGROUND
To evaluate the adequacy of supplementation to correct preoperative vitamin D deficiency in adult patients during the year after Roux-en-Y gastric bypass (RYGB) surgery.


METHODS
The medical records were reviewed and the preoperative and 12-month postoperative serum 25-hydroxyvitamin D [25(OH)D] levels were compared in patients who underwent RYGB from 2002 to 2004. The serum 25(OH)D levels were defined as being optimal (> or = 80 nmol/L), suboptimal (50-79 nmol/L), or deficient (<50 nmol/L). Patients with deficient 25(OH)D levels were prescribed 50,000 IU ergocalciferol weekly. The remaining patients averaged 710 IU supplemental vitamin D intake daily.


RESULTS
The mean patient age was 43.8 +/- 10.7 years, and the mean preoperative body mass index was 51.8 +/- 9.8 kg/m2. Of the 95 patients with baseline and 12-month 25(OH)D levels, 89% were women. The mean preoperative 25(OH)D level was 49.7 +/- 26.5 nmol/L; 34% had suboptimal 25(OH)D levels and 54% had deficient levels before surgery. Twelve months after surgery, those receiving 50,000 IU weekly (n = 40) had a mean 25(OH)D level of 69.2 +/- 22.2 nmol/L; 63% had suboptimal and 8% deficient levels. Those taking 710 IU daily (n = 55) had a mean 25(OH)D level of 85.5 +/- 33.0 nmol/L; 44% had suboptimal and 6% deficient levels.


CONCLUSIONS
Vitamin D deficiency is prevalent in RYGB patients before surgery. The vitamin D status improved markedly after RYGB surgery with either 710 IU vitamin D daily or 50,000 IU weekly. Current supplementation practices do not appear to optimize the serum 25(OH)D levels and need to be more closely examined.
Nelson
Monica L
ML
Department of Food Science and Human Nutrition, University of Maine, Orono, Maine 04469, USA. monica.nelson@umit.maine.edu
Bolduc
Lynn M
LM
Toder
Michelle E
ME
Clough
Donald M
DM
Sullivan
Susan S
SS
D000328:Adult; D000704:Analysis of Variance; D000713:Anastomosis, Roux-en-Y; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D011182:Postoperative Care; D015995:Prevalence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014807:Vitamin D / Q000008:administration & dosage*; D014808:Vitamin D Deficiency / Q000188:drug therapy* / Q000453:epidemiology
D014807:Vitamin D