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Effects of Omega-Loop Gastric Bypass on Vitamin D and Bone Metabolism in Morbidly Obese Bariatric Patients

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Abstract

Background

Bariatric patients often suffer from nutrient deficiencies. Little is known about vitamin D levels and bone metabolism in patients undergoing omega-loop gastric bypass (OLGB). We, therefore, evaluated parameters of vitamin D metabolism preoperatively and during the first postoperative year.

Methods

Within our cohort study, we retrospectively evaluated the respective parameters pre-, 3, 6, and 12 months postoperatively in patients with OLGB, between February 2011 and February 2013.

Results

In patients [n = 50; age 46 (15) years, mean (SD); 12 male, 38 female] BMI was 45.4 (6.6) kg/m2 preoperatively and decreased to 29.1 (3.8) kg/m2 after 12 months, corresponding to a total body weight loss of 36 %. Preoperatively, the prevalence of vitamin D deficiency was 96 and 30 % demonstrated elevated parathyroid hormone yielding a prevalence of secondary hyperparathyroidism of 17 %. Postoperatively, subjects received individually adjusted vitamin D3 supplementation (95 % CI 200–3000 IU/day), according to the available guidelines at that time. Nevertheless, every third patient was vitamin D deficient at 12 months (80 %). In patients with preoperative BMI >45 vs. <45 kg/m2, we observed a 3-fold higher risk for vitamin D deficiency over 12 months [OR = 3.10, 95 % CI (1.01–9.51), p = 0.048].

Conclusions

To avoid vitamin D deficiency, morbidly obese patients, particularly those with higher preoperative BMI, should be regularly screened pre- and postoperatively. Standard postsurgical supplementation has not been adequate to restore 25-OHD status and current guidelines are not very specific in terms of timing and dosing of vitamin D3 supplementation. Consequently, further trials to enhance the evidence on vitamin D supplementation are warranted.

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Acknowledgments

The authors’ responsibilities were as follows: KS, BL, FL, and GP designed the research. ML, RK and RM analysed the data and performed statistical analyses. KS and BL supervised the statistical analysis. ML, RK, and RM drafted the manuscript with appreciable input from FL, GP, MW, and FH. KS and BL had prime responsibility for the final manuscript content. All authors read and approved the final manuscript.

Conflict of Interest

Maria Luger, Renate Kruschitz, Gerhard Prager, Melanie Walker, Rodrig Marculescu, Friedrich Hoppichler, Karin Schindler, and Bernhard Ludvik declare that they have no conflict of interests in the preparation of this manuscript. Felix Langer reports personal fees from Ethicon, non-financial support from Ethicon, outside the submitted work.

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Maria Luger, Renate Kruschitz, Karin Schindler & Bernhard Ludvik

  2. Special Institute for Preventive Cardiology and Nutrition–SIPCAN save your life, Guggenbichlerstraße 8/15, Salzburg, 5026, Austria

    Maria Luger & Friedrich Hoppichler

  3. Division of General Surgery, Department of Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Felix Langer & Gerhard Prager

  4. Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Melanie Walker

  5. Clinical Institute for Medical and Chemical Laboratory Diagnostics, Department of Laboratory Medicine, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria

    Rodrig Marculescu

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  1. Maria Luger
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Correspondence to Karin Schindler.

Additional information

Maria Luger and Renate Kruschitz contributed equally.

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Luger, M., Kruschitz, R., Langer, F. et al. Effects of Omega-Loop Gastric Bypass on Vitamin D and Bone Metabolism in Morbidly Obese Bariatric Patients. OBES SURG 25, 1056–1062 (2015). https://doi.org/10.1007/s11695-014-1492-7

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  • DOI: https://doi.org/10.1007/s11695-014-1492-7

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