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Bariatric surgery and vitamin D: key messages for surgeons and clinicians before and after bariatric surgery.

Minerva chirurgica
October 1, 2016
Leigh A Peterson
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the prevalence of vitamin D deficiency in bariatric surgery candidates and its potential impact on surgical outcomes, as well as the long-term metabolic complications of bariatric surgery.

Results Summary

The study found that over 50% of bariatric surgery candidates have vitamin D deficiency, which persists post-operatively and may contribute to adverse surgical outcomes like poor wound healing and infection. Obesity-related chronic inflammation combined with vitamin D deficiency likely exacerbates these risks, and correcting deficiency preoperatively could improve outcomes.

Population

Obese individuals undergoing or considering bariatric surgery.

Effective Dosage

Not Assessed

Duration

Not Assessed

Interactions

None mentioned

Extracted Claims (15)
InterventionDirectionEndpointPopulationDosageImpactClaim #
bariatric surgery
decrease
obesity
obese individuals
-
is the preeminent long-term treatment
#1
bariatric procedures
increase
malabsorption and/or restrict the size of the stomach
-
-
manipulate the intestines to produce
#2
Roux-en-Y gastric bypass
increase
restriction (small stomach pouch) and malabsorption (duodenum bypass)
-
-
utilizes
#3
vertical sleeve gastrectomy
decrease
the greater curvature of the stomach
-
-
is resection of
#4
malabsorptive procedures
decrease
nutrient absorption, primarily fat and fat-soluble nutrients (vitamins A, D, E, and K)
-
-
function by decreasing
#5
bariatric surgery
increase
vitamin D deficiency (<50 nmol/L)
bariatric surgery candidates
over 50%
reported a prevalence of over 50%
#6
bariatric surgery
increase
vitamin D deficiency
post-bariatric surgery patients
65%
enduring post-operatively with one study reporting 65% deficient at 10 years
#7
obesity
increase
chronic inflammation
-
-
is associated with
#8
chronic inflammation
increase
adverse surgical outcomes, e.g. poor healing and infection
-
-
may contribute to
#9
vitamin D deficiency
increase
chronic inflammation
-
-
is also associated with
#10
vitamin D deficiency
increase
adverse surgical outcomes, particularly delayed wound healing and infection
obese individuals
-
have extraordinary risk of
#11
vitamin D
increase
re-epithelialization and innate immunity
-
-
plays a role in
#12
risk of adverse surgical outcomes in obesity combined with vitamin D deficiency
increase
adverse surgical outcomes
-
-
there is likely an additive or potentially a synergistic effect
#13
bariatric surgery
increase
fat-soluble vitamin deficiency
-
-
deficiency in fat-soluble vitamins, such as vitamin D, is considered a metabolic complication of
#14
determining the vitamin D status of bariatric surgery candidates and amending it preoperatively
improve
surgical outcomes
bariatric surgery candidates
-
may prove greatly beneficial
#15
Abstract

Obesity is the most widespread nutritional problem globally. Bariatric surgery is the preeminent long-term obesity treatment. Bariatric procedures manipulate the intestines to produces malabsorption and/or restrict the size of the stomach. The most enduring bariatric procedure is the Roux-en-Y gastric bypass, which utilizes both restriction (small stomach pouch) and malabsorption (duodenum bypass). The in-vogue procedure is the vertical sleeve gastrectomy - resection of the greater curvature of the stomach (predominantly restrictive). Malabsorptive procedures function by decreasing nutrient absorption, primarily fat and fat-soluble nutrients (vitamins A, D, E, and K). Most studies of vitamin D status in bariatric surgery candidates reported a prevalence of over 50% vitamin D deficiency (<50 nmol/L), enduring post-operatively with one study reporting 65% deficient at 10 years post-bariatric surgery. Obesity is associated with chronic inflammation, which may contribute to adverse surgical outcomes, e.g. poor healing and infection. Since vitamin D deficiency is also associated with chronic inflammation, obese individuals with vitamin D deficiency have extraordinary risk of adverse surgical outcomes, particularly delayed wound healing and infection due to the role of vitamin D in re-epithelialization and innate immunity. When the risk of adverse surgical outcomes in obesity is combined with that of vitamin D deficiency, there is likely an additive or potentially a synergistic effect. Furthermore, deficiency in fat-soluble vitamins, such as vitamin D, is considered a metabolic complication of bariatric surgery. Thus, determining the vitamin D status of bariatric surgery candidates and amending it preoperatively may prove greatly beneficial acutely and lifelong.

Medical Subject Headings (MeSH)
Bariatric SurgeryBody Mass IndexDietary SupplementsGastric BypassHumansMalabsorption SyndromesObesity, MorbidPostoperative CarePractice Guidelines as TopicPreoperative CarePrevalenceTreatment OutcomeUnited StatesVitamin DVitamin D DeficiencyVitamins
Study Links
PubMed ID27280871
Quality Scores
Safety60
Efficacy80/10
Quality70/10
Citation Metrics
Total Citations8
Citations/Year0.9
Relative Citation Ratio0.40
NIH Percentile21.8%
Research Impact Scores
APT Score0.50
Weight Score1.61
Normalized Score0.70
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