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

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.