Bariatric surgery and vitamin D: key messages for surgeons and clinicians before and after bariatric surgery.
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
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.