Clare Grace1, Royce Vincent2, Simon J Aylwin3. 1. Department of Nutrition and Dietetics, Kings College Hospital NHS Foundation Trust, London, United Kingdom. Electronic address: clare.grace@nhs.net. 2. Department of Clinical Biochemistry, Kings College Hospital NHS Foundation Trust, London, United Kingdom. 3. Department of Endocrinology, Kings College Hospital NHS Foundation Trust, London, United Kingdom.
Abstract
BACKGROUND: Current recommendations suggest universal screening of vitamin D status before bariatric surgery to identify individuals at risk for postoperative deficiency. However little is known about the magnitude or severity of vitamin D insufficiency in the morbidly obese population awaiting bariatric surgery in the United Kingdom. The purpose of this prospective observational study was to assess the prevalence and determinants of vitamin D insufficiency in an urban multiethnic U.K. population awaiting bariatric surgery. METHODS: Consecutive patients attending a morbid obesity service were comprehensively assessed using a recognized obesity staging tool. Data collected included 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), corrected calcium (Ca(2+)), body mass index (BMI), and the presence and severity of obesity associated co-morbidities, including type 2 diabetes (T2 DM), cardiovascular disease (CVD), depression, obstructive sleep apnea (OSA), and functional limitation. RESULTS: Of the 118 patients assessed, 79% were female, and 21% were male, with BMI of 52.6 ± 9.4 kg/m(2) (mean ± standard deviation) and mean age of 44 ± 11 years. Twenty-four percent had T2 DM, 28% CVD, 31% OSA, and 21% depression. Vitamin D insufficiency was found in 90% of the population, with a median serum 25(OH)D of 8.8 ng/mL. Secondary hyperparathyroidism was present in 43% of those with vitamin D insufficiency. Risk was not influenced by ethnicity, age, or gender. However severe functional limitation was associated with lower vitamin D status. CONCLUSION: Regardless of ethnicity, vitamin D insufficiency appears to be typical among this clinic population; therefore, routine vitamin D supplementation is suggested for all individuals awaiting bariatric surgery rather than testing vitamin D status in an attempt to identify high-risk individuals.
BACKGROUND: Current recommendations suggest universal screening of vitamin D status before bariatric surgery to identify individuals at risk for postoperative deficiency. However little is known about the magnitude or severity of vitamin Dinsufficiency in the morbidly obese population awaiting bariatric surgery in the United Kingdom. The purpose of this prospective observational study was to assess the prevalence and determinants of vitamin Dinsufficiency in an urban multiethnic U.K. population awaiting bariatric surgery. METHODS: Consecutive patients attending a morbid obesity service were comprehensively assessed using a recognized obesity staging tool. Data collected included 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), corrected calcium (Ca(2+)), body mass index (BMI), and the presence and severity of obesity associated co-morbidities, including type 2 diabetes (T2 DM), cardiovascular disease (CVD), depression, obstructive sleep apnea (OSA), and functional limitation. RESULTS: Of the 118 patients assessed, 79% were female, and 21% were male, with BMI of 52.6 ± 9.4 kg/m(2) (mean ± standard deviation) and mean age of 44 ± 11 years. Twenty-four percent had T2 DM, 28% CVD, 31% OSA, and 21% depression. Vitamin Dinsufficiency was found in 90% of the population, with a median serum 25(OH)D of 8.8 ng/mL. Secondary hyperparathyroidism was present in 43% of those with vitamin Dinsufficiency. Risk was not influenced by ethnicity, age, or gender. However severe functional limitation was associated with lower vitamin D status. CONCLUSION: Regardless of ethnicity, vitamin Dinsufficiency appears to be typical among this clinic population; therefore, routine vitamin D supplementation is suggested for all individuals awaiting bariatric surgery rather than testing vitamin D status in an attempt to identify high-risk individuals.
Authors: Clare F Dix; Judith D Bauer; Ian Martin; Sharon Rochester; Briony Duarte Romero; Johannes B Prins; Olivia R L Wright Journal: Nutrients Date: 2017-10-04 Impact factor: 5.717