title: Impact of Roux-en-Y gastric bypass versus sleeve gastrectomy on vitamin D metabolism: short-term results from a prospective randomized clinical trial.
abstract: OBJECTIVE
  To assess postoperative outcomes of sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB). Short-term results on vitamin D and parathormone (PTH) metabolism are reported.
  
  
  METHODS
  One hundred patients were randomly assigned to RYGB (n = 45) or SG (n = 55). Vitamin D, PTH, and calcium were assessed at inclusion and after 1, 3, 6, and 12 months (M1, M3, M6, and M12). Eighty-eight patients completed 1-year follow-up.
  
  
  RESULTS
  Mean postoperative excess weight loss (%EWL) at M1, M3, M6, and M12 was 25.39, 43.47, 63.75, and 80.38 % versus 25.25, 51.32, 64.67, and 82.97 % in RYGB and SG, respectively. Vitamin D values were statistically significantly higher after SG compared to RYGB at M3 (61.57 pmol/L, standard deviation [SD] 14.29 vs. 54.81 SD 7.65; p = 0.01) and M12 (59.83 pmol/L, SD 6.41 vs. 56.15 SD 8.18; p = 0.02). Vitamin D deficiency rate decreased from 84.62 to 35 % at M6 (p = 0.04) and 48 % at M12 (p = 0.01) in the SG group, while there was no significant improvement in the RYGB group. Serum parathyroid hormone (sPTH) level was decreased significantly in the SG group by M3 (44.8 ng/L vs. 28.6; p = 0.03), M6 (44.9 ng/L vs. 25.8; p = 0.017), and M12 (41.4 ng/L vs. 20.5; p = 0.017). Secondary hyperparathyroidism rate was 20.83 and 24 % at M1 (p = 1), 16.67 and 8 % at M3 (p = 0.41), 14.29 and 0 % at M6 (p = 0.08), and 15 and 0 % at M12 (p = 0.23) in the RYGB and SG groups, respectively.
  
  
  CONCLUSIONS
  Patients after RYGB had a significantly higher postoperative vitamin D deficiency and higher sPTH levels than after SG.
authors.affiliation: Department of General, Digestive, and Endocrine Surgery, IRCAD-IHU, University of Strasbourg, 1, Place de l'Hôpital, 67091, Strasbourg Cedex, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Vix
authors.forename: Keng-Hao
authors.initials: KH
authors.lastname: Liu
authors.forename: Michele
authors.initials: M
authors.lastname: Diana
authors.forename: Antonio
authors.initials: A
authors.lastname: D'Urso
authors.forename: Didier
authors.initials: D
authors.lastname: Mutter
authors.forename: Jacques
authors.initials: J
authors.lastname: Marescaux
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000379:methods; D015415:Biomarkers / Q000097:blood; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D010281:Parathyroid Hormone / Q000097:blood; D011184:Postoperative Period; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors; D014807:Vitamin D / Q000008:administration & dosage / Q000493:pharmacokinetics*; D014815:Vitamins / Q000008:administration & dosage / Q000493:pharmacokinetics; D015431:Weight Loss / Q000502:physiology*
chemical_list: D015415:Biomarkers; D010281:Parathyroid Hormone; D014815:Vitamins; D014807:Vitamin D