Vitamin D supplementation helps after obesity treatment

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Observational Study PLoS One

. 2023 Dec 22;18(12):e0292780. doi: 10.1371/journal.pone.0292780. FREE PDF

Effects of medical and surgical treatment on vitamin D levels in obesity

Ala Mejaddam 1 2, Gudrún Höskuldsdóttir 2 3, Frida Lenér 2 4, Ville Wallenius 5, Penelope Trimpou 2 3, Lars Fändriks 5, Karin Mossberg 2 4, Björn Eliasson 3, Kerstin Landin-Wilhelmsen 2 3

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PMID: 38134006 PMCID: PMC10745143 DOI: 10.1371/journal.pone.0292780

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Abstract

Introduction: Persons living with obesity treated with bariatric surgery are at a high risk of developing nutritional deficiencies. The primary aim of this observational cohort study was to compare vitamin D levels in patients two years after bariatric surgery (Roux-en-Y gastric bypass/RYGB and sleeve gastrectomy/SG) with a very low-energy diet (VLED). The same subjects were also compared with a population sample from the same region at baseline. The primary hypothesis was that surgery, especially RYGB, would lead to an increased prevalence of vitamin D deficiency compared to subjects treated with VLED. 971 individuals eligible for surgical, RYGB (n = 388), SG (n = 201), and medical treatment (n = 382), in routine care, were included consecutively between 2015 and 2017. A random population sample from the WHO-MONICA project was used as a reference, (n = 414). S-calcium, S-25(OH)D (vitamin D), and S-PTH (parathyroid hormone) were measured in all persons with obesity at baseline and two years after treatment (n = 713). Self-reported use of vitamin D and calcium supplementation was registered.

Results: Vitamin D deficiency (S-25(OH)D <25mmol/l) was found in 5.2% of the persons with obesity at baseline versus 1.7% of the general population (SMD>0.1). S-25(OH)D increased for all treatment groups but was higher in RYGB and SG (SMD>0.1, standardized mean difference). Thirteen subjects (1.8%) had vitamin D deficiency after obesity treatment.

Conclusion: Surgical intervention for obesity followed by vitamin D supplementation was not associated with a higher risk for vitamin D deficiency, irrespective of surgery type, compared to individuals on medical treatment. However, persons living with obesity seeking weight loss treatment are more likely to have deficient vitamin D levels compared to the general population.

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