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01-12-2015 | Original Contributions

Optimization of Vitamin D Status After Roux-en-Y Gastric Bypass Surgery in Obese Patients Living in Northern Climate

Authors: Lingtak-Neander Chan, Charlotte H. Neilson, Elizabeth A. Kirk, Tiana F. Colovos, Diane R. Javelli, Saurabh Khandelwal

Published in: Obesity Surgery | Issue 12/2015

Abstract

Background

Patients who undergo bariatric surgery are at risk for micronutrient deficiencies. The aims of this study were to determine the prevalence and predictors of vitamin D deficiency in obese patients residing in the northern climate, and to evaluate the effectiveness of a daily maintenance dose of vitamin D 2000 IU in preventing hypovitaminosis D within 1 year after bariatric surgery.

Methods

A cohort study involving adult patients undergoing RYGB was conducted. Longitudinal changes in serum vitamin D concentrations and clinical parameters were measured and collected.

Results

Data from 134 recipients of RYGB were analyzed. Hypovitaminosis D was identified in 86 patients (64 %), and was significantly affected by seasonal change and the number of comorbidities. Follow-up data were available in 60 patients. Vitamin D sufficiency was achieved in 62.5 % of those patients with baseline vitamin D insufficiency. A dose-response relationship of vitamin D intake was observed, with the most significant increase in 25(OH)D associated with daily vitamin D intakes ≥ 2000 IU.

Conclusions

The prevalence of hypovitaminosis D before RYGB was comparable to patients living in the non-northern climate. Daily vitamin D intake meeting at least 2000 IU is associated with greater improvement in serum vitamin D concentration.

Forrest KY, Stuhldreher WL. Prevalence and correlates of vitamin D deficiency in US adults. Nutr Res. 2011;31(1):48–54.CrossRefPubMed

Aasheim ET, Hofso D, Hjelmesaeth J, et al. Vitamin status in morbidly obese patients: a cross-sectional study. Am J Clin Nutr. 2008;87(2):362–9.PubMed

Wortsman J, Matsuoka LY, Chen TC, et al. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr. 2000;72:690–3.PubMed

Compston JE, Vedi S, Ledger JE, et al. Vitamin D status and bone histomorphometry in gross obesity. Am J Clin Nutr. 1981;34(11):2359–63.PubMed

Muscogiuri G, Sorice GP, Prioletta A, et al. 25-Hydroxyvitamin D concentration correlates with insulin-sensitivity and BMI in obesity. Obesity (Silver Spring). 2010;18(10):1906–10.CrossRef

Parikh SJ, Edelman M, Uwaifo GI, et al. The relationship between obesity and serum 1,25-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab. 2004;89(3):1196–9.CrossRefPubMed

Lagunova Z, Porojnicu AC, Vieth R, et al. Serum 25-hydroxyvitamin D is a predictor of serum 1,25-dihydroxyvitamin D in overweight and obese patients. J Nutr. 2011;141(1):112–7.CrossRefPubMed

Au LE, Rogers GT, Harris SS, et al. Associations of vitamin D intake with 25-hydroxyvitamin D in overweight and racially/ethnically diverse US children. J Acad Nutr Diet. 2013;113(11):1511–6.PubMedCentralCrossRefPubMed

Drincic A, Armas LAG, Van Diest E, et al. Volumetric dilution, rather than sequestration best explains the low vitamin d status of obesity. Obesity. 2012;20:1444–8.CrossRefPubMed

10.

Beckman LM, Earthman CP, Thomas W, et al. Serum 25(OH) vitamin D concentration changes after Roux-en-Y gastric bypass surgery. Obesity (Silver Spring). 2013;21(12):E599–606.CrossRef

11.

Ducloux R, Nobécourt E, Chevallier JM, et al. Vitamin D deficiency before bariatric surgery: should supplement intake be routinely prescribed? Obes Surg. 2011;21(5):556–60.CrossRefPubMed

12.

Goldner WS, Stoner JA, Thompson J, et al. Prevalence of vitamin D insufficiency and deficiency in morbidly obese patients: a comparison with non-obese controls. Obes Surg. 2008;18(2):145–501.CrossRefPubMed

13.

Carlin AM, Rao DS, Meslemani AM, et al. Prevalence of vitamin D depletion among morbidly obese patients seeking gastric bypass surgery. Surg Obes Relat Dis. 2006;2(2):98–103.CrossRefPubMed

14.

Gemmel K, Santry HP, Prachand VN, et al. Vitamin D deficiency in preoperative bariatric surgery patients. Surg Obes Relat Dis. 2009;5(1):54–9.CrossRefPubMed

15.

Courcoulas AP, Christian NJ, Belle SH, et al. Longitudinal Assessment of Bariatric Surgery(LABS) Consortium. Weight change and health outcomes at 3 years after bariatric surgery among individuals with severe obesity. JAMA. 2013;310(22):2416–25.PubMedCentralPubMed

16.

Still CD, Wood GC, Chu X, et al. Clinical factors associated with weight loss outcomes after Roux-en-Y gastric bypass surgery. Obesity (Silver Spring). 2014;22(3):888–94.CrossRef

17.

Carlsson LM, Peltonen M, Ahlin S, et al. Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects. N Engl J Med. 2012;367(8):695–704.CrossRefPubMed

18.

Hallersund P, Sjöström L, Olbers T, Lönroth H, Jacobson P, Wallenius V, et al. Gastric bypass surgery is followed by lowered blood pressure and increased diuresis - long term results from the Swedish Obese Subjects (SOS) study. PLoS One. 2012;7(11):e49696. [Erratum in: PLoS One. 2013;8(5). doi:10.1371/annotation/88dbb5b7-3f7e-4b26-a5b6-f020d33f0182].

19.

Sjöström L, Narbro K, Sjöström CD, et al. Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRefPubMed

20.

Sjöström L, Lindroos AK, Peltonen M, et al. Swedish Obese Subjects Study Scientific Group. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.CrossRefPubMed

21.

Lin E, Armstrong-Moore D, Liang Z, et al. Contribution of adipose tissue to plasma 25-hydroxyvitamin D concentrations during weight loss following gastric bypass surgery. Obesity (Silver Spring). 2011;19(3):588–94.CrossRef

22.

Aasheim ET, Bjorkman S, Sovik TT, et al. Vitamin status after bariatric surgery: a randomized study of gastric bypass and duodenal switch. Am J Clin Nutr. 2009;90(1):15–22.CrossRefPubMed

23.

Vilarrasa N, San Jose P, Garcia I, et al. Evaluation of bone mineral density loss in morbidly obese women after gastric bypass: 3-year follow-up. Obes Surg. 2011;21(4):465–72.CrossRefPubMed

24.

Scibora LM, Ikramuddin S, Buchwald H, et al. Examining the link between bariatric surgery, bone loss, and osteoporosis: a review of bone density studies. Obes Surg. 2012;22(4):654–67.CrossRefPubMed

25.

Casagrande DS, Repetto G, Mottin CC, et al. Changes in bone mineral density in women following 1-year gastric bypass surgery. Obes Surg. 2012;22(8):1287–92.CrossRefPubMed

26.

Levinson R, Silverman JB, Catella JG, et al. Pharmacotherapy prevention and management of nutritional deficiencies post Roux-en-Y gastric bypass. Obes Surg. 2013;23(7):992–1000.CrossRefPubMed

27.

Samuel L, Borrell LN. The effect of body mass index on optimal vitamin D status in U.S. adults: the National Health and Nutrition Examination Survey 2001-2006. Ann Epidemiol. 2013;23(7):409–14.CrossRefPubMed

28.

Webb AR, Kline L, Holick MF. Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. J Clin Endocrinol Metab. 1988;67(2):373–8.CrossRefPubMed

29.

Fish E, Beverstein G, Olson D, et al. Vitamin D status of morbidly obese bariatric surgery patients. J Surg Res. 2010;164(2):198–202.CrossRefPubMed

30.

Aarts E, van Groningen L, Horst R, et al. Vitamin D absorption: consequences of gastric bypass surgery. Eur J Endocrinol. 2011;164(5):827–32.CrossRefPubMed

31.

Flores L, Osaba MJ, Andreu A, et al. Calcium and vitamin D supplementation after gastric bypass should be individualized to improve or avoid hyperparathyroidism. Obes Surg. 2010;20(6):738–43.CrossRefPubMed

32.

Mahlay NF, Verka LG, Thomsen K, et al. Vitamin D status before Roux-en-Y and efficacy of prophylactic and therapeutic doses of vitamin D in patients after Roux-en-Y gastric bypass surgery. Obes Surg. 2009;19(5):590–4.CrossRefPubMed

33.

Gasteyger C, Suter M, Gaillard RC, et al. Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation. Am J Clin Nutr. 2008;87(5):1128–33.PubMed

34.

Khan S, Mai XM, Chen Y. Plasma 25-hydroxyvitamin D associated with pulmonary function in Canadian adults with excess adiposity. Am J Clin Nutr. 2013;98:174–9.CrossRefPubMed

35.

Thuesen B, Husemoen L, Fenger M, et al. Determinants of vitamin D status in a general population of Danish adults. Bone. 2012;50(3):605–10.CrossRefPubMed

36.

Mechanick JI, Youdim A, Jones DB, et al. American Association of Clinical Endocrinologists; Obesity Society; American Society for Metabolic & Bariatric Surgery. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring). 2013;21 Suppl 1:S1–27.CrossRef

37.

Goldner WS, Stoner JA, Lyden E, et al. Finding the optimal dose of vitamin D following Roux-en-Y gastric bypass: a prospective, randomized pilot clinical trial. Obes Surg. 2009;19(2):173–9.CrossRefPubMed

Title: Optimization of Vitamin D Status After Roux-en-Y Gastric Bypass Surgery in Obese Patients Living in Northern Climate
Authors: Lingtak-Neander Chan
Charlotte H. Neilson
Elizabeth A. Kirk
Tiana F. Colovos
Diane R. Javelli
Saurabh Khandelwal
Publication date: 01-12-2015
Publisher: Springer US
Published in: Obesity Surgery / Issue 12/2015
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI: https://doi.org/10.1007/s11695-015-1685-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Optimization of Vitamin D Status After Roux-en-Y Gastric Bypass Surgery in Obese Patients Living in Northern Climate

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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