Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Vitamin D in Obesity (VIDeO): Assessing Vitamin D Deficiency in the Bariatric Population.
Lau1, Arthur N., Tiboni1, Maria, Khalid1, Zara, Jaeschke1, Roman, Anvari1, Mehran, Adachi2, Jonathan D.
Gastric bypass surgery (GBS) is becoming an increasingly common intervention for the morbidly obese. Little is known about the effects of GBS on bone metabolism. Adiposity has been inversely associated with vitamin D levels across a range of BMI and cultural groups. Our goal was to assess the prevalence of vitamin D deficiency pre-operatively, and post-operatively. As a quality assurance initiative, we also wanted to assess if our center was doing a satisfactory role in promoting vitamin D and calcium supplementation in this population, and if aggressive screening and treatment of deficiency had any effect on 25-hydroxyvitamin D levels.
In a retrospective chart review of 173 bariatric patients, baseline 25-hydroxyvitamin D, PTH and calcium levels were obtained pre-operatively and post-operatively at 3 and 6 months. We also assessed the percentage of patients on oral vitamin D and calcium supplementation at baseline and at each follow-up visit, and the number of patients receiving aggressive treatment with 50,000 IU of Vitamin D2 weekly. All patients with vitamin D deficiency during the follow-up period (below 50 mmol/L) were treated with 50,000 IU of vitamin D2 weekly for eight week duration.
Of the 173 patients, 170 had undergone laparoscopic roux-en-y bypass, 3 received a gastric sleeve. Their mean baseline BMI was 46.0 and weight of 126.8 kg. Baseline 25-hydroxyvitamin D levels were 55.4, PTH levels of 5.68, and Calcium of 2.46. From the 164 patients with baseline blood work, 76 had baseline vitamin D deficiency (<50mmol/l) and 130 had vitamin D insufficiency (77.8%). A total of 32/93 (34.4%) patients were vitamin D insufficient at 3 months, and 19/67 (28.4%) were at 6 months follow-up. Regarding vitamin D deficiency, 5/93 (5.4%) patients were found to have a 25-hydroxyvitamin D level in the deficient range at 3 months, and 2/67 (3.0%) at the 6 month follow-up. All 100% of patients at the 3 month follow-up assessment were on oral supplementation with calcium and vitamin D, and 75% were on supplementation at the 6 month follow-up.
Our study shows a majority of bariatric patients have vitamin D deficiency at baseline. After GBS, much lower rates of vitamin D deficiency/insufficiency were seen compared to the current literature. We also found a high percentage of our patients were supplemented with calcium and vitamin D post-operatively. The aggressive screening for vitamin D deficiency, aggressive treatment when it was found, and emphasis on preventing vitamin D deficiency post-operatively with routine oral supplementation likely accounted for the low rates of vitamin D deficiency seen in our cohort.
To cite this abstract, please use the following information:
Lau, Arthur N., Tiboni, Maria, Khalid, Zara, Jaeschke, Roman, Anvari, Mehran, Adachi, Jonathan D.; Vitamin D in Obesity (VIDeO): Assessing Vitamin D Deficiency in the Bariatric Population. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1123