Vitamin D levels in relation to bariatric surgery: a single center experience

Authors

  • Husain Alaradi Department of Surgery, Salmaniya Medical Complex, Manama, Bahrain

DOI:

https://doi.org/10.18203/2349-2902.isj20231377

Keywords:

Laparoscopic sleeve gastrectomy, Laparoscopic mini bypass, Laparoscopic Roux en Y bypass, Vitamin D deficiency

Abstract

Background: Bariatric surgery has become a major component of the treatment of obesity and obesity related illnesses such as diabetes mellitus, hypertension and dyslipidemia. However, bariatric surgeries have been linked to some disturbances in the overall micronutrient profile in the post-operative period. In obese patients, visceral fat, is most closely related to the development of metabolic syndrome (MS). In this respect, vitamin D is of major importance, since numerous studies have shown that it can impact the prevention of MS, immune diseases and some cancers. Furthermore, given its inverse association with adiposity, high rates of vitamin D deficiency (VDD) have been found in obese patients, including those with morbid obesity who are candidates for bariatric surgery.

Methods: A cross sectional study design was carried out after obtaining the required ethical approval. The surgery register was scanned for all bariatric procedures done from January 2018 till December 2018. Data were retrieved about each case through ISEHA labs, progress notes, medications summary, radiological images. Files were retrieved from the filing department for cases who were admitted to the surgical HDU or ICU (as they still use paper documentation). All data were compiled into a detailed excel sheet.

Results: The total number of included patients was 232, with a mean age of 41.3. The majority of patients underwent laparoscopic Roux-En-Y bypass (67.2%), while laparoscopic sleeve gastrectomy was done in 32.8% of patients. As expected, mean body mass index (BMI) dropped down from (46.3 to 35.1). The striking result noted was the percentage of patients who had vitamin D deficiency pre bariatric surgery (44 patients, 19%). This percentage has increased up to (73 patients, 31.4%) post bariatric surgery at 12 months follow up.

Conclusions: Bariatric surgery is linked to increased incidence of vitamin D deficiency post operatively. Vitamin D level close monitoring in peri-operative management of bariatric patients is recommended to avoid potential complications.

 

References

Du X, Fu XH, Peng BQ, Luo R, Hu JK, Cheng Z. Resolution of metabolic syndrome and related metabolic disorders after bariatric surgery: comparison of sleeve gastrectomy and gastric bypass. Surg Obes Relat Dis. 2018;14(9):1348-56.

Padwal R, Klarenbach S, Wiebe N, Birch D, Karmali S, Manns B, et al. Bariatric surgery: a systematic review and network meta-analysis of randomized trials. Obes Rev. 2011;12(8):602-21.

Obispo Entrenas A, Legupin Tubio D, Lucena Navarro F, Martin Carvajal F, Gandara Adan N, Redondo Bautista M, et al. Relationship Between Vitamin D Deficiency and the Components of Metabolic Syndrome in Patients with Morbid Obesity, Before and 1 Year After Laparoscopic Roux-en-Y Gastric Bypass or Sleeve Gastrectomy. Obes Surg. 2017;27(5):1222-8.

Chakhtoura MT, Nakhoul NN, Shawwa K, Mantzoros C, El Hajj Fuleihan GA. Hypovitaminosis D in bariatric surgery: A systematic review of observational studies. Metabolism. 2016;65(4):574-85.

Gasmi A, Bjørklund G, Mujawdiya PK, Semenova Y, Peana M, Dosa A, et al. Micronutrients deficiences in patients after bariatric surgery. Eur J Nutr. 2022;61(1):55-67.

Araújo MM, Mendes MM, Lanham-New SA, Borges LPSL, da Costa THM, de Carvalho KMB, et al. Frequency of Vitamin D Deficiency and Associated Factors in Long-term Bariatric Surgery Patients: a Cross-sectional Study. Obes Surg. 2022;32(7):2386-96.

Galyean S, Syn D, Subih HS, Boylan M. Improving vitamin D status in bariatric surgery subjects with monthly high-dose ergocalciferol. Int J Vitam Nutr Res. 2022;92(2):109-17.

Lespessailles E, Toumi H. Vitamin D alteration associated with obesity and bariatric surgery. Exp Biol Med (Maywood). 2017;242(10):1086-94.

Mangan A, Le Roux CW, Miller NG, Docherty NG. Iron and Vitamin D/Calcium Deficiency after Gastric Bypass: Mechanisms Involved and Strategies to Improve Oral Supplement Disposition. Curr Drug Metab. 2019;20(3):244-52.

Global nutrition report. Bahrain. Available at: https://globalnutritionreport.org/resources/nutrition-profiles/asia/western-asia/bahrain/#:~:text=39.5% 25%20of%20adult%20(aged%2018,and%2012.8%25%20of%20adult%20men. Accessed on 12 January 2023.

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Published

2023-04-29

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Section

Original Research Articles