Impairment of vitamin D and bone metabolism in patients with bypass operation for obesity

Acta Med Scand Suppl. 1979:624:73-8. doi: 10.1111/j.0954-6820.1979.tb00723.x.

Abstract

Thirty-four patients were studied 2--6 years after jejunoileal bypass for morbid obesity. The serum concentration of 25-hydroxyvitamin D (25-OHD) were reduced and related to the frequency fo stools and to the weight reduction. Fifteen patients were not able to normalize serum 25-OHD following a long-term regular vitamin D intake. The serum immunoreactive parathyroid hormone concentration (iPTH) and the alkaline phosphatase levels were elevated in this group, indicating a secondary hyperparathyroidism. The mean bone mineral content of the forearm was reduced 3--6 years after the operation, most severely in those with elevated serum iPTH. The desired weight reduction by jejunoileal shunt was obtained at the expense of a severely disturbed vitamin D metabolism. We suggest, that all patients with an intestinal bypass for obesity should receive regular vitamin D supplement, and serum 25-OHD should be measured in order to monitor the effect of therapy.

MeSH terms

  • Adult
  • Alkaline Phosphatase / blood
  • Body Weight
  • Bone and Bones / metabolism*
  • Calcium / metabolism
  • Humans
  • Hydroxycholecalciferols / blood
  • Hyperparathyroidism, Secondary / etiology
  • Intestine, Small / surgery*
  • Middle Aged
  • Obesity / metabolism
  • Obesity / therapy*
  • Parathyroid Hormone / blood
  • Phosphates / blood
  • Postoperative Complications
  • Vitamin D / administration & dosage
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / etiology*

Substances

  • Hydroxycholecalciferols
  • Parathyroid Hormone
  • Phosphates
  • Vitamin D
  • Alkaline Phosphatase
  • Calcium