Abstract
BackgroundBariatric surgery for severe obesity can lead to micronutrient/vitamin deficiencies.AimsTo study baseline and post-surgical prevalence of vitamin D deficiency in patients undergoing bariatric surgery.Participants and SettingPatients undergoing bariatric surgery in a university teaching hospital in North West England.MethodsWe 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.ResultsWe 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.ConclusionVitamin D deficiency and insufficiency were prevalent pre-surgery and reduced significantly with routine supplementation post-surgery.
Highlights
Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UKDepartment of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation and University Teaching Trust, Salford, UKDepartment of Surgery, Salford Royal NHS Foundation and University Teaching Trust, Salford, UKManchester Metropolitan University, All Saints Building, Manchester, UKUniversity Department of Medicine, Manchester University NHSFoundation Trust, Manchester, UKObesity is a major public health concern of our times
We studied 460 patients who had completed at least 12 months post-operatively; mean 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
Patients who were undergoing another surgical procedure at the same time as gastric bypass or sleeve gastrectomy were not excluded
Summary
Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK. Manchester Metropolitan University, All Saints Building, Manchester, UK. Obesity is a major public health concern of our times. Dietary and behavioural changes and weight loss pharmacotherapy remain key interventions, bariatric surgery is the most effective treatment for severe obesity. It has been demonstrated that it leads to clinically significant weight loss and is cost-effective [1,2,3,4]. Post-bariatric surgery, patients typically achieve substantial weight loss and significant improvement or resolution of weight-related comorbidities including type 2 diabetes mellitus (T2DM), hypertension and hyperlipidaemia. Bariatric surgery is widely recommended as a treatment for severe obesity [6]. Bariatric surgery for severe obesity can lead to micronutrient/vitamin deficiencies
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