减肥手术对严重肥胖患者维生素D代谢和微量营养素缺乏的影响

Q2 Medicine

Medicine in Drug Discovery Pub Date : 2025-04-04 DOI:10.1016/j.medidd.2025.100207

Letícia de Oliveira Souza Bratti , Bruno Fonseca Nunes , Daphany Marah Gorges , Emerita Quintina de Andrade Moura , Ana Carolina Rabello de Moraes , Fabíola Branco Filippin-Monteiro

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引用次数: 0

摘要

目的：本研究旨在探讨减肥手术对肥胖患者维生素D代谢和相关微量营养素缺乏的影响，强调严重肥胖患者维生素D缺乏的患病率，这是体重显著减轻后持续关注的问题。方法对肥胖患者减肥手术前后血清25(OH)D、甲状旁腺激素（PTH）、钙水平进行综合分析，随访6个月。检查药物使用情况，并比较不同手术方式的结果。结果观察到显著的代谢改善，与术后BMI降低和药物依赖性降低有关。袖式胃切除术（SG）在预防微量营养素缺乏方面显示出潜在的优势。许多患者术前维生素D缺乏，甲状旁腺激素水平升高。相关分析显示，术前PTH水平超过70 pg/mL的患者，PTH水平越高，6个月后体重减轻越少。结论本研究强调了对减肥手术患者进行骨骼健康评估的重要性，强调了术前和术后监测的必要性，特别是在继发性甲状旁腺功能亢进的情况下。这些考虑对于优化减肥手术患者的长期健康至关重要。

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Impact of bariatric surgery on vitamin D metabolism and micronutrient deficiencies in severe obesity

Objective

This study aimed to investigate the impact of bariatric surgery on vitamin D metabolism and associated micronutrient deficiencies in individuals with obesity, emphasizing the prevalence of vitamin D deficiency in patients with severe obesity—a persistent concern after significant weight loss.

Methods

A comprehensive analysis of serum levels of 25(OH)D, parathyroid hormone (PTH), and calcium was conducted in patients with obesity before and after bariatric surgery, with a six-month follow-up. Medication usage was examined, and outcomes between different surgical techniques were compared.

Results

Notable metabolic improvements, linked to reduced BMI and diminished medication reliance post-surgery, were observed. Sleeve gastrectomy (SG) demonstrated potential advantages in preventing micronutrient deficiencies. Many patients had preoperative vitamin D deficiency and elevated PTH levels. Correlation analysis revealed that among those with preoperative PTH levels exceeding 70 pg/mL, higher PTH levels were associated with lower weight loss after six months. No significant correlation was found for vitamin D.

Conclusion

This study underscores the importance of critically assessing bone health in bariatric surgery candidates, emphasizing the need for meticulous preoperative evaluation and postoperative monitoring, particularly in cases of secondary hyperparathyroidism. These considerations are pivotal for optimizing the long-term well-being of bariatric surgery patients.

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