Alistair Fox1,2, Chris Slater2, Babur Ahmed3, Basil J Ammori1,3, Siba Senapati3,4, Khurshid Akhtar3, Jodi Ellison3, Lucinda K M Summers1,2, Adam Robinson2, John P New1,2, Handrean Soran1,5, Safwaan Adam1,2,5, Akheel A Syed6,7. 1. Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK. 2. Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation and University Teaching Trust, Salford, UK. 3. Department of Surgery, Salford Royal NHS Foundation and University Teaching Trust, Salford, UK. 4. Manchester Metropolitan University, All Saints Building, Manchester, UK. 5. University Department of Medicine, Manchester University NHS Foundation Trust, Manchester, UK. 6. Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK. akheel.syed@manchester.ac.uk. 7. Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation and University Teaching Trust, Salford, UK. akheel.syed@manchester.ac.uk.
Abstract
BACKGROUND: Bariatric surgery for severe obesity can lead to micronutrient/vitamin deficiencies. AIMS: To study baseline and post-surgical prevalence of vitamin D deficiency in patients undergoing bariatric surgery. PARTICIPANTS AND SETTING: Patients undergoing bariatric surgery in a university teaching hospital in North West England. METHODS: We performed an observational cohort analysis of longitudinal data on vitamin D and related parameters in patients who underwent bariatric surgery. Patients were routinely recommended daily combined calcium and vitamin D supplementation post-surgery. RESULTS: We studied 460 patients who had completed at least 12 months post-operatively; mean (standard deviation) age was 48.0 (10.5) years, weight 144.7 (27.3) kg and body mass index 50.0 (7.6) kg/m2; 292 (63.5%) underwent gastric bypass and 168 (36.5%) sleeve gastrectomy. Vitamin D level was 33.1 (23.9) nmol/L at baseline, rising to 57.1 (23.1) nmol/L at 12 months post-surgery. Whereas 43.2% had vitamin D deficiency and 34.7% insufficiency preoperatively, 8.9% and 26.7% had deficiency and insufficiency, respectively, at 12 months with similar trends up to 4 years of follow-up. There were no significant differences between procedures or sexes in vitamin D levels or sufficiency rates. CONCLUSION: Vitamin D deficiency and insufficiency were prevalent pre-surgery and reduced significantly with routine supplementation post-surgery.
BACKGROUND: Bariatric surgery for severe obesity can lead to micronutrient/vitamin deficiencies. AIMS: To study baseline and post-surgical prevalence of vitamin D deficiency in patients undergoing bariatric surgery. PARTICIPANTS AND SETTING:Patients undergoing bariatric surgery in a university teaching hospital in North West England. METHODS: We performed an observational cohort analysis of longitudinal data on vitamin D and related parameters in patients who underwent bariatric surgery. Patients were routinely recommended daily combined calcium and vitamin D supplementation post-surgery. RESULTS: We studied 460 patients who had completed at least 12 months post-operatively; mean (standard deviation) age was 48.0 (10.5) years, weight 144.7 (27.3) kg and body mass index 50.0 (7.6) kg/m2; 292 (63.5%) underwent gastric bypass and 168 (36.5%) sleeve gastrectomy. Vitamin D level was 33.1 (23.9) nmol/L at baseline, rising to 57.1 (23.1) nmol/L at 12 months post-surgery. Whereas 43.2% had vitamin D deficiency and 34.7% insufficiency preoperatively, 8.9% and 26.7% had deficiency and insufficiency, respectively, at 12 months with similar trends up to 4 years of follow-up. There were no significant differences between procedures or sexes in vitamin D levels or sufficiency rates. CONCLUSION:Vitamin Ddeficiency and insufficiency were prevalent pre-surgery and reduced significantly with routine supplementation post-surgery.
Entities:
Keywords:
Bariatric surgery; Calcium; Hyperparathyroidism; Parathyroid hormone; Vitamin D deficiency
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