Abstract
Evaluating the influence of vitamin D concentrations together with preoperative metabolic phenotypes on remission of chronic noncommunicable diseases (CNCDs) after 6 months of Roux-en-Y gastric bypass (RYGB). Cross-sectional analytical study comprising 30 adult individuals who were assessed preoperatively (T0) and 6 months (T1) after undergoing RYGB. Participants were distributed preoperatively into metabolically healthy obese (MHO) and metabolically unhealthy obese (MUHO) individuals according to HOMA-IR classification and to the adequacy and inadequacy of vitamin D concentrations in the form of 25(OH)D. All participants were assessed for anthropometric characteristics, biochemical variables, and presence of CNCDs. The statistical program used was the SPSS version 21. In face of vitamin D adequacy and regardless of the metabolic phenotype classification in the preoperative period, the means found for HOMA-IR allowed us to define them as metabolically healthy 6 months after RYGB. Only those with vitamin D inadequacy with the MUHO phenotype showed better results regarding the reduction of glucose that accompanied the shift in serum 25(OH)D concentrations from deficient to insufficient. It is possible that preoperative vitamin D adequacy, even in the presence of an unhealthy phenotype, may contribute to the reduction of dyslipidemia and improvement in cholesterol. It is suggested that preoperative vitamin D adequacy in both phenotypes may have a protective effect on metabolic health.
Highlights
Bariatric surgery aims to reduce the total body mass with consequent remission of chronic noncommunicable diseases (CNCDs), which can happen more intensely in the minimum period of 6 months after the procedure [1]
The scientific literature, when comparing metabolically healthy obese (MHO) or unhealthy obese (MUHO) individuals, shows that metabolically unhealthy obese (MUHO) presents characteristics that can facilitate the onset of obesity-associated diseases, such as inadequate functionality of adipose tissue that, in turn, favors the appearance of lipotoxic products, presence of insulin resistance (IR), greater ectopic and visceral fat storage that contribute to the development of cardiometabolic diseases [2,3,4,5]
The patients were divided into groups, considering the metabolic phenotypes together with the adequacy/inadequacy of serum vitamin D concentrations, and were matched for body mass index (BMI), age and sex
Summary
Bariatric surgery aims to reduce the total body mass with consequent remission of chronic noncommunicable diseases (CNCDs), which can happen more intensely in the minimum period of 6 months after the procedure [1]. The weight loss process promoted by bariatric surgery may be related to lipolytic gene expression that correlates inversely with biomarkers of lipid and glucose metabolism [6]. Some studies evaluating the preoperative interference of the MHO and MUHO phenotypes on remission of CNCDs after a period of 6 to 24 months after bariatric surgery found contradictory results [7,8,9]. Weight loss resulting from bariatric surgery may promote metabolic benefits, there may be disorders originating from the procedure
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