Vol. 21 No. 2 (2022)
Original Articles

Hypovitaminosis D in patients after bariatric surgery by Y-Roux and sleeve

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  • Ana Carla de O. Lopes,
  • Alessandra da R. P. Mulder,
  • Camila F. Lima,
  • Glauciane L. Miranda
DOI: https://doi.org/10.12957/bjhbs.2022.71626

Published 2023-01-03

Keywords

  • Obesity,
  • Bariatric surgery,
  • Gastric bypass,
  • Vertical gastrectomy

How to Cite

1.
de O. Lopes AC, da R. P. Mulder A, F. Lima C, L. Miranda G. Hypovitaminosis D in patients after bariatric surgery by Y-Roux and sleeve. BJHBS [Internet]. 2023 Jan. 3 [cited 2024 Oct. 11];21(2):121-9. Available from: https://bjhbs.hupe.uerj.br/bjhbs/article/view/15

Copyright (c) 2022 Brazilian Journal of Health and Biomedical Sciences

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Abstract

Introduction: Obesity is a multifactorial chronic disease, resulting from complex interactions between genetic, psychological, environments, lifestyles and emotional facts. Bariatric surgery is the most effective tool in the control and treatment of severe obesity. However, individuals submitted to this surgery may present malabsorption, some degrees of protein-energy malnutrition and hypovitaminoses. Objectives: To evaluate the prevalence of hypovitaminosis D in bariatric patients submitted to BPGYR and to the Sleeve using conventional multivitamins (group with supplementation) or without supplementation. Metodology: A cross-sectional, retrospective analysis of the medical records of female and male patients submitted to BPGYR and Sleeve in the late postoperative period. Data regarding the time after surgery, pre- and post-surgery weight, percentage loss of excess weight and serumlevels of vitamin D, PTH and calcium were analyzed. A total of 93 patients were analyzed, with a mean age of 41.4±7.1 in the SS group and 43.7±10.4 in the CS group. The mean time after bariatric surgery was 52.4±46.4 months in the SS and 46.2±37.1 in the CS, with no difference between groups. Results: Sugery was effective in the weight loss of the patients studied (SS-70.3%±22.6; CS-79.3%±26.8; p=0.19); however, hypovitaminosis D was found (SS-26.4±10.0, CS-24.9±10, p=0.91) even in the group receiving conventional multivitamin supplementation. Conclusion: BPGYR and Sleeve are effective procedures in weight loss; these patients, however, are deficient in vitamin D. Supplementation with multivitamins is not sufficient to avoid hypovitaminosis, so vitamin D supplementation is required.

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References

  1. Jesus AD. Vitamin d levels after gastric bypass : implications and recommendations. Acta portuguesa de nutrição. 2016;6:42-45.Doi.org/10.21011/apn.20
  2. Associação brasileira para estudo da obesidade e de sindrome metabolica.Diretrizes Brasileiras de Obesidade [Online], 2009/2010. Accessed on March 5, 2019. Available from: https://www.saude.df.gov.br/documents/37101/621198/2009_DIRETRIZES_BRASILEIRAS_DE_OBESIDADE.pdf/e325df5a-3410-2113-ccc3-aae9994357ce?t=1649078305619
  3. Zeve JL, Novais POJ. Técnicas em cirurgia bariátrica: uma revisão da literatura. Ciência & saúde. 2016;5(2):132. Doi.org/10.15448/1983-652X.2012.2.10966
  4. Ramos CP. Manejo nutrológico no pós-operatório de cirurgia bariátrica nutrologic management in postoperative bariatric surgery. International jornal of nutrology. 2015;8(2):39-49. Doi.org/10.1055/s-0040-170507
  5. Almeida SS, Zanatta DP, Rezende FF. Imagem corporal, ansiedade e depressão em pacientes obesos submetidos à cirurgia bariátrica. Estudos de psicologia. 2012;17(1): 153-160. Doi.org/10.1590/S1413-294X2012000100019
  6. Cabral JA, Souza GP, Nascimento J, et al. Impacto da deficiência da vitamina d e cálcio em ossos de pacientes submetidos à cirurgia bariátrica: uma revisão sistemática. 2016;29:120-123. Doi.org/10.1590/0102-6720201600S10029
  7. Pinheiro ACQ, Da Silva DAM, Santana EMT. Deficiências de micronutrientes após cirurgia bariátrica. REVISTAS UNIFACS. 2020;19(1): 102-118.
  8. Skare TL, Burkievcz C JL, Malafaia O,et al. Prevalência de deficiência de vitamina D em pacientes com úlceras de perna de etiologia venosa. Revista do Colégio Brasileiro de Cirurgiões. 2012;39(1):60-63. Doi.org/10.1590/S0100-69912012000100012
  9. Coutinho J, Nora C, Morais T,. et al. Gastrectomia vertical e bypass gástrico no tratamento da síndrome metabólica. Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo. 2015;11(1):23-29. Doi.org/10.1016/j.rpedm.2015.09.002
  10. Bordalo LA, Mourão DM, Bressan J. Deficiências Nutricionais pós cirurgia bariátrica: por que ocorrem ? Acta médica portuguesa. 2011;24(4): 1021-1028.
  11. Santos MT, Suano-Souza FI, Fonseca FL, et al. Is there association between vitamin d concentrations and body mass index variation in women submitted to y-roux surgery? Journal of obesity. 2018. Doi/10.1155%2F2018%2F3251675
  12. Camargo MB, Borba VZ, Maeda SS, et al. Recomendações da sociedade brasileira de endocrinologia e metabologia (sbem) para o diagnóstico e tratamento da hipovitaminose d. Arquivos brasileiros de endocrinologia & metabologia. 2014;58(5): 411-433. Doi.org/10.1590/0004-2730000003388
  13. Gonçalves CL. O sistema endocrinológico vitamina d. Arquivos brasileiros de endocrinologia & metabologia. 2011;55(8): 566-575. Doi.org/10.1590/S0004-27302011000800010
  14. Silva PZ, Schneider HH. The role of vitamin d in muscle strength among the elderly. Acta fisiátrica. 2016;23:96-101. Doi.org/10.5935/0104-7795.20160019
  15. Andronini L, Penna G. Control of autoimmune diseases by the vitamin D endocrine system. Nature clinical practice rheumatology. 2008;4(8): 404-412. Doi.org/10.1038/ncprheum0855
  16. Beltrame Gbz, Cardoso Sdo, Pietro L. Vitamin D supplementation in patients after bariatric surgery. Brazilian Journal of Health Review. 2022 SEP/OCT;5(5):18402-18417. Doi.org/10.34119/bjhrv5n5-049
  17. Sempos CT, , Heijboer AC, Bike DD, et al. Vitamin D assays and the definition of hypovitaminosis D: results from the First International Conference on Controversies in Vitamin D. British Journal of Clinical Pharmacology. 2018;84: 2194-2207. Doi.org/10.1111/bcp.13652
  18. Goldner WS, Stoner JA, Lyden E, et al. inding the optimal dose of vitamin D following roux- en-y gastric bypass: a prospective, randomized pilot clinical trial. Obesity surgery. 2009;19(2): 173-179. Doi.org/10.1007/s11695-008-9680-y
  19. Ferraz AA, Carvalho RM, Siqueira LT, et al. Deficiências de micronutrientes após cirurgia bariátrica: análise comparativa entre gastrectomia vertical e derivação gástrica em y de roux. Revista do colégio Brasileiro de cirurgiões. 2018;45(6): 1-9. Doi.org/10.1590/0100-6991e-20182016
  20. Yao Y, Zhu L, He L, et al. A meta-analysis of the relationship between vitamin d deficiency and obesity. Internacional journal of clinical an experimental medicine. 2015 Setembro 30:14977-14984. Accessed on January 27, 2019.Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4658869/
  21. Leiro LS, Melendez-Araujo MS. Adequação de micronutrientes da dieta de mulheres após um ano de bypass gástrico. Arq Bras Cir Dig. 2014;27(1):21-25. Doi.org/10.1590/S0102-6720201400S100006
  22. Diniz FH, Araujo FC, Diniz TC. Risk of secondary hyperparathyroidism after laparoscopic gastric bypass surgery in obese women. Surgical endoscopy and other interventional techniques. 2007;21(8):1393-1396. Doi.org/10.1007/s00464-007-9228-6
  23. Pramyothin P, Biancuzzo RM, Lu Z, et al. Vitamin d in adipose tissue and serum 25- hydroxyvitamin d after roux-en- y gástric bypass Obesity. 2011;19(11):2228-2234. Doi.org/10.1038/oby.2011.170
  24. Mônaco-Ferreira DV, Leandro-Merhi VA, Aranha NC, et al. Artigo original deficiência de vitamina d e elevação do paratohôrmonio no pós operatório tardio de bypass gástrico em y-de roux. 2018;13(4):1-5. Doi.org/10.1590/0102-672020180001e1407
  25. Padovani RM, Farfán AJ, Colugnati FA, et al. Ietary reference intakes: aplicabilidade das tabelas em estudos nutricionais dietary reference intakes: application of tables in nutritional studies. Revista de Nutrição. 2006;19(6):741-760. Doi.org/10.1590/S1415-52732006000600010
  26. Pramyothin P, Holick MF. Vitamin d supplementation: guidelines and evidence for subclinical deficiency. Current opinion in gastroenterology. 2012;28(2): 139-150. Doi.org/10.1097/mog.0b013e32835004dc
  27. Sarmento R, Casagrande D, Schaan B. Cirurgia bariátrica no tratamento da obesidade: impacto sobre o metabolismo ósseo. Revista Hospital Pedro Ernesto. 2014;13(1): 87-93. Doi/org./10.12957/rhupe.2014.9811
  28. Moreira RO, Mônica PC, Farias ML. Eixo cálcio-vit D nas hepatopatias crônicas. Arq bras endocrinol metab. 2004;28:443-450. Doi.org/10.1590/S0004-27302004000400004
  29. Costa TM, Paganoto M, Radominski RB, et al. Impacto da deficiência nutricional na massa óssea após cirurgia bariátrica. Arquivos brasileiros de cirurgia digestiva. 2018;19(1):38-42. Accessed on January 3, 2019. Available In: https://www.scielo.br/j/abcd/a/fJWrR9SfqDvXgRTLTLXtj9D/?lang=pt#
  30. Paixão MP, Bressan J. Calcium and bone health treatment and prevention. Revista saúde e pesquisa. 2010. 3(9). ISSN:1983-1870.
  31. Peters BS, Martini LA. Funções plenamente reconhecidas de nutrientes vitamina d. Série de publicações isli brasil. 2014;2: 1-24. Accessed on March 29, 2019. Avaiable in: https://ilsibrasil.org/publication/funcoes-plenamente-reconhecidas/