Læknablaðið - 01.03.2021, Blaðsíða 31

L ÆK N A BL AÐIÐ 2021/107 143
R A N N S Ó K N
INTRODUCTION: Long-term results from bariatric surgery amongst indivi-
duals with obesity is considered good in general, with regard to weight loss,
complications of obesity or quality of life. However, risk of nutrient deficiency
might be increased. The aim of the study was to assess vitamin D status of pati-
ents before and after metabolic and bariatric surgery at Landspitali.
METHODS: Data on 25(OH)D concentration and parathyroid hormone (PTH) was
retrieved from medical records for patients undergoing metabolic and bariatric
surgery at Landspitali from 2001-2018 (n=539). Insufficient vitamin D status was
defined as 25(OH)D concentration <45 nmol/L in 2001-2012 but <50 nnmol/L
from 2013-2018, due to changes in analytical method during the study period.
Vitamin D deficiency was defined as 25(OH)D <30 nmol/L for both time periods.
Guidelines on supplement use are provided before discharge from the hospital
and up to 18 months after surgery,
RESULTS: Mean concentration of 25(OH)D before surgery was 51 nmol/L (SD
30 nmol/L) and 278 (52%) had insufficient vitamin D status, of which quarter
of subjects were defined as being vitamin D deficient. Concentration of 25(OH)
D increased after surgery in majority of subjects (85%). However, about third of
those defined as having insufficient vitamin D status before surgery still had
insufficient status 18 months after surgery. When comparing time periods, 2001-
2012 and 2013-2018 it can be seen that insufficient vitamin D status was less
common in the second period, although still persistent in about 25% of cases
before surgery and 8,5% 18 months after surgery.
CONCLUSION: Insufficient vitamin D status is relatively common before meta-
bolic and bariatric surgery at Landspitali. In large majority of subjects, 25(OH)D
concentration increased after surgery, following recomendations on supplement
intake. The results highlight the need for greater emphasis on correcting possi-
ble nutrient deficiencies before surgery.
E N G L I S H S U M M A R Y
Berglind Lilja Guðlaugsdóttir1,2
Svava Engilbertsdóttir2
Leifur Franzson3,4
Hjörtur Gíslason5
Ingibjörg Gunnarsdóttir2,6
Vitamin D status before and after metabolic and bariatric
surgery at Landspitali
1Unit for Nutrition Research, University of Iceland, 2Department of Clinical
Nutrition, Landspitali – The National University Hospital of Iceland, 3Department
of Genetics and Molecular Medicine, Landspítali – The National University
Hospital of Iceland, 4Faculty of Pharmaceutical Sciences, University of Iceland,
5Surgical Services – The National University Hospital of Iceland, 6Faculty of food
science and nutrition, University of Iceland
Correspondence: Ingibjörg Gunnarsdóttir, ingigun@landspitali.is
Key words: bariatricsurgery, vitamin D, parathyroidhormone, gastric
bypass, vitamin D deficiency.
doi 10.17992/lbl.2021.03.627