High vitamin D deficiency rate in metabolic inpatients: is bariatric surgery planning found guilty?
BACKGROUND
High rates of vitamin D insufficiency are usually found in obese patients, even before any malabsorptive bariatric surgery. It is not clear whether they lack vitamin D because of different food intake, different solar exposure, or different storage pathways or bioavailability in adipose tissue. To better understand vitamin D deficiency, we studied different categories of inpatients.


METHODS
We collected clinical and biological data from 457 consecutive inpatients during a year: 217 nonobese diabetic patients, 159 obese nonsurgical diabetic patients, 46 obese surgical nondiabetic patients, and 35 obese surgical diabetic patients. Statistically significant differences between two mean 25-hydroxyvitamin D (25(OH)D) levels were defined at the 5 % level using a Z-test.


RESULTS
Vitamin D deficiency was found in 69 % of the patients, while 24 % had a normal level and 7 % an optimal level. A significant difference was found between obese (25(OH)D = 40.3 nmol/l) and nonobese patients (25(OH)D = 46.8 nmol/l). Patients undergoing bariatric surgery were not different from the other obese patients.


CONCLUSIONS
No significant difference in 25(OH) vitamin D level could be demonstrated between obese patients before bariatric surgery and obese patients with no obesity surgery project. No difference was found between our Parisian obese population and a Spanish obese population, which benefits from a better solar exposure. Both findings suggest that obesity itself is the link with vitamin D deficiency, independently from behavioral differences.
Department of Diabetes-Endocrinology-Nutrition, Georges Pompidou European Hospital, 20 rue Leblanc, 75015, Paris, France, roxane.ducloux@egp.aphp.fr.
Roxane
R
Ducloux
Cécile
C
Janin
Hervé
H
Ducloux
Jean-Jacques
JJ
Altman
D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010297:Paris / Q000453:epidemiology; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000453:epidemiology* / Q000209:etiology
D014807:Vitamin D; C104450:25-hydroxyvitamin D