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Prospective Study of Individualized or High Fixed Doses of Vitamin D Supplementation After Bariatric Surgery

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Abstract

Background

The degree of bariatric surgery (BS) induced vitamin D (VD) malabsorption is not well established.

Objective

The aim of this study is to evaluate the efficacy and safety of achieving 25-hydroxy VD (25(OH)D) levels ≥75 nmol/L with two regimens of VD supplementation after BS.

Methods

We performed two open-label, prospective studies in patients undergoing BS from 2009 to 2011. Postoperatively, all patients received Ca citrate 1,000 mg and 800 IU of VD3/day. In the first study, additional VD3 was prescribed according to preoperative 25(OH)D levels— < 25 nmol/L:2,800 IU/day; 26–50 nmol/L:2,000–1,200 IU/day, 51–62 nmol/L:1,000 IU; >63 nmol/L:0 IU/day—and we evaluated the patients at baseline and at 4 months. In the second study, an additional fixed high dose of 2,000 IU/day of VD3 was administered, and we evaluated patients at baseline and at 4 and 12 months after BS.

Results

The first study included 176 patients [mean age 44 (11)]; 140 were females. Before BS, 171 subjects (98 %) presented 25(OH)D levels <75 nmol/L. Postoperatively, the mean 25(OH)D levels increased from 40 (17) to 77 nmol/L (29) (p < 0.001) with no differences in parathormone (PTH) or 25(OH)D levels between dose groups. In the second study, we enrolled 52 patients [mean age 45 (10)]; 32 were females. Postoperatively, the mean 25(OH)D levels increased from 32 (12) to 80 (22) and to 75 nmol/L (15) (p < 0.001) at 4 and 12 months, respectively. In both studies, a high percentage of patients achieved 25(OH)D ≥75 nmol/L levels and no subject reported any serious adverse event.

Conclusions

Both schedules of daily VD3 supplementation were effective and safe under conditions of clinical practice.

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Abbreviations

BS:

Bariatric surgery

VD:

Vitamin D

25(OH)D:

25-Hydroxy VD

PTH:

Parathormone

HPT:

Hyperparathyroidism

Ca:

Calcium

P:

Phosphorous

VD3:

Cholecalciferol

VD2:

Ergocalciferol

BMI:

Body mass index

EBW:

Excess body weight

BWL:

Body weight loss

EBWL:

Excess body weight loss

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Conflict of Interest

The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research reported.

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Authors and Affiliations

  1. Endocrinology and Nutrition Department, Obesity Unit, Hospital Clínic i Universitari, Villarroel, 170, Escalera 11, 2° piso, CP 08036, Barcelona, Spain

    Lilliam Flores, Violeta Moizé, Emilio Ortega, Lucía Rodríguez, Alba Andreu & Josep Vidal

  2. CIBERDEM—Spanish Biomedical Research Network in Diabetes and Associated Metabolic Disorders, Barcelona, Spain

    Lilliam Flores, Emilio Ortega & Josep Vidal

  3. IDIBAPS—Institut d’Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain

    Emilio Ortega & Josep Vidal

  4. Department of Biochemistry and Molecular Genetics, Biomedical Diagnostic Center (CDB), Barcelona, Spain

    Xavier Filella

Authors
  1. Lilliam Flores
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  2. Violeta Moizé
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  3. Emilio Ortega
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  4. Lucía Rodríguez
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  5. Alba Andreu
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  6. Xavier Filella
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  7. Josep Vidal
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Corresponding author

Correspondence to Lilliam Flores.

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Flores, L., Moizé, V., Ortega, E. et al. Prospective Study of Individualized or High Fixed Doses of Vitamin D Supplementation After Bariatric Surgery. OBES SURG 25, 470–476 (2015). https://doi.org/10.1007/s11695-014-1393-9

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  • DOI: https://doi.org/10.1007/s11695-014-1393-9

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