Serum Vitamin D Increases with Weight Loss in Obese Subjects 6?Months After Roux-en-Y Gastric Bypass
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- 作者：Muriel Coupaye (1)
Marie Christine Breuil (2)
Pauline Rivière (2)
Benjamin Castel (3)
Catherine Bogard (4)
Thierry Dupré (5)
Simon Msika (3)
Séverine Ledoux (1) - 关键词：Morbid obesity ; Bariatric surgery ; Gastric bypass ; Sleeve gastrectomy ; Vitamin D ; Hyperparathyroidism
- 刊名：Obesity Surgery
- 出版年：2013
- 出版时间：April 2013
- 年：2013
- 卷：23
- 期：4
- 页码：486-493
- 全文大小：295KB
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Marie Christine Breuil (2)
Pauline Rivière (2)
Benjamin Castel (3)
Catherine Bogard (4)
Thierry Dupré (5)
Simon Msika (3)
Séverine Ledoux (1)
1. Service des Explorations Fonctionnelles, H?pital Louis Mourier (AP-HP), Centre de référence de prise en charge de l’obésité, Université Paris 7 Denis Diderot, 178 rue des Renouillers, 92701, Colombes Cedex, France
2. Unité de diététique, H?pital Louis Mourier (AP-HP), Centre de référence de prise en charge de l’obésité, 178 rue des Renouillers, 92701, Colombes Cedex, France
3. Service de Chirurgie, H?pital Louis Mourier (AP-HP), Centre de référence de prise en charge de l’obésité, Université Paris 7 Denis Diderot, 178 rue des Renouillers, 92701, Colombes Cedex, France
4. Service de Biochimie, H?pital Louis Mourier (AP-HP), Université Paris 7 Denis Diderot, 178 rue des Renouillers, 92701, Colombes Cedex, France
5. Service de Biochimie, H?pital Bichat (AP-HP), Université Paris 7 Denis Diderot, 46 rue Henri-Huchard, 75008, Paris, France
文摘
Background Malabsorptive surgical procedures lead to deficiencies in fat-soluble vitamins. However, results concerning serum vitamin D (25OHD) after gastric bypass (GBP) are controversial. The aim of the study was to assess the influence of GBP on 25OHD and calcium metabolism. Methods Parameters of calcium metabolism were evaluated in 202 obese subjects before and 6?months after GBP. Thirty of them were matched for age, gender, weight, skin color, and season with 30 subjects who underwent sleeve gastrectomy (SG). A multivitamin preparation that provides 200 to 500?IU vitamin D3 per day was systematically prescribed after surgery. Results In the 202 patients after GBP, serum 25OHD significantly increased from 13.4?±-.1 to 22.8?±-1.3?ng/ml (p-lt;-.0001), whereas parathyroid hormone (PTH) did not change. Despite a decrease in calcium intake (p-lt;-.0001) and urinary calcium/creatinine ratio (p--.015), serum calcium increased after GBP (p-lt;-.0001). Preoperatively, 91?% of patients had 25OHD insufficiency (<30?ng/ml), 80?% deficiency (<20?ng/ml), and 19?% secondary hyperparathyroidism (>65?pg/ml) vs. 76, 44, and 17?%, respectively, following GBP. Serum 25OHD was negatively correlated with BMI at 6?months after GBP (R-??0.299, p-lt;-.0001). In the two groups of 30 subjects, serum 25OHD and PTH did not differ at 6?months after GBP or SG. Conclusions At 6?months after GBP, serum 25OHD significantly increased in subjects supplemented with multivitamins containing low doses of vitamin D. These data suggest that weight loss at 6?months after surgery has a greater influence on vitamin D status than malabsorption induced by GBP.