title: Vitamin D3Loading Is Superior to Conventional Supplementation After Weight Loss Surgery in Vitamin D-Deficient Morbidly Obese Patients: a Double-Blind Randomized Placebo-Controlled Trial.
abstract: Bariatric patients often suffer from vitamin D deficiency (VDD), and both, morbid obesity and VDD, are related to non-alcoholic fatty liver disease. However, limited data are available regarding best strategies for treating VDD, particularly, in bariatric patients undergoing omega-loop gastric bypass (OLGB). Therefore, we examined the efficacy and safety of a forced vitamin D dosing regimen and intervention effects in liver fibrotic patients.
  
  
  
  In this double-blind, randomized, placebo-controlled trial, 50 vitamin D-deficient patients undergoing OLGB were randomly assigned to receive, in the first month postoperatively, oral vitamin D3(≤3 doses of 100,000 IU; intervention group) or placebo as loading dose (control group) with subsequent maintenance dose (3420 IU/day) in both groups until 6-month visit.
  
  
  
  Compared with control group, higher increase of 25(OH)D (67.9 (21.1) vs. 55.7 nmol/L (21.1); p = 0.049) with lower prevalence of secondary hyperparathyroidism (10 vs. 24 %; p = 0.045) was observed in intervention group. No (serious) adverse events related to study medication were found. The loading dose regimen was more effective in increasing 25(OH)D in patients with significant liver fibrosis while this was not the case for conventional supplementation (placebo with maintenance dose) (71.5 (20.5) vs. 22.5 nmol/L (13.8); p = 0.022; n = 14).
  
  
  
  Our findings indicate that a high vitamin D3loading dose, in the first month postoperatively, with subsequent maintenance dose is effective and safe in achieving higher vitamin D concentrations in OLGB patients. Unexpectedly, it is more effective in patients with significant liver fibrosis which is of potentially high clinical relevance and requires further investigation.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.|Special Institute for Preventive Cardiology and Nutrition-SIPCAN Save Your Life, Salzburg, Austria.|Institute of Social Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria.
authors.forename: Maria
authors.initials: M
authors.lastname: Luger
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria. renate.kruschitz@meduniwien.ac.at.|Department of Medicine 1 and Karl Landsteiner Institute for Obesity and Metabolic Diseases, Rudolfstiftung Hospital, Juchgasse 25, 1030, Vienna, Austria. renate.kruschitz@meduniwien.ac.at.
authors.forename: Renate
authors.identifier: 0000-0001-6722-9780
authors.initials: R
authors.lastname: Kruschitz
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Kienbacher
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Traussnigg
authors.affiliation: Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Felix B
authors.initials: FB
authors.lastname: Langer
authors.affiliation: Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Prager
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
authors.forename: Karin
authors.initials: K
authors.lastname: Schindler
authors.affiliation: Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.
authors.forename: Enikö
authors.initials: E
authors.lastname: Kallay
authors.affiliation: Special Institute for Preventive Cardiology and Nutrition-SIPCAN Save Your Life, Salzburg, Austria.|Division of Internal Medicine, Krankenhaus der Barmherzigen Brüder Salzburg, Salzburg, Austria.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Hoppichler
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Trauner
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Krebs
authors.affiliation: Clinical Institute for Medical and Chemical Laboratory Diagnostics, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
authors.forename: Rodrig
authors.initials: R
authors.lastname: Marculescu
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.|Department of Medicine 1 and Karl Landsteiner Institute for Obesity and Metabolic Diseases, Rudolfstiftung Hospital, Juchgasse 25, 1030, Vienna, Austria.
authors.forename: Bernhard
authors.initials: B
authors.lastname: Ludvik
mesh_terms: D000328:Adult; D002762:Cholecalciferol / Q000008:administration & dosage*; D019587:Dietary Supplements; D004311:Double-Blind Method; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery; D011184:Postoperative Period; D015995:Prevalence; D014807:Vitamin D / Q000627:therapeutic use; D014808:Vitamin D Deficiency / Q000150:complications* / Q000188:drug therapy; D014815:Vitamins / Q000008:administration & dosage*; D015431:Weight Loss
chemical_list: D014815:Vitamins; D014807:Vitamin D; D002762:Cholecalciferol
keywords: Gastric bypass; Liver fibrosis; Obesity; Omega-loop gastric bypass; Secondary hyperparathyroidism; Vitamin D; Vitamin D supplementation; Weight loss