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Cited by 489Bariatric Surgery and OutcomesClinical Nutrition and GastroenterologyBody Contouring and Surgery

Serum fat-soluble vitamin deficiency andabnormal calcium metabolism after malabsorptivebariatric surgery

Slater, Guy H, Ren, Christine J, Siegel, Niccole, Williams, Trudy, Barr, Di, Wolfe, Barrie, Dolan, Kevin, Fielding, George A·2004·Journal of Gastrointestinal Surgery
DOI 10.1016/j.gassur.2003.09.020
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Abstract

Weight loss after biliopancreatic diversion or duodenal switch is due to decreased calorie absorption secondary to fat malabsorption. Fat malabsorption may also cause essential fat-soluble vitamin deficiencies, which may have severe clinical consequences and alter calcium metabolism. Serum vitamins A, D, E, and K, zinc, parathyroid hormone, corrected calcium, and alkaline phosphatase levels were measured in a cohort of patients who had previously undergone biliopancreatic diversion. Two bariatric surgery units were involved in the study: New York University School of Medicine (New York, NY), and the Wesley Medical Center (Brisbane, Australia). A total of 170 patients completed the study. The incidence of vitamin A deficiency was 69%, vitamin K deficiency 68%, and vitamin D deficiency 63% by the fourth year after surgery. The incidence of vitamin E and zinc deficiency did not increase with time after surgery. The incidence of hypocalcemia increased from 15% to 48% over the study period with a corresponding increase in serum parathyroid hormone values in 69% of patients in the fourth postoperative year. There is a progressive increase in the incidence and severity of hypovitaminemia A, D, and K with time after biliopancreatic diversion and duodenal switch. Calcium metabolism is affected with an increasing incidence of secondary hyperparathyrodisim and evidence of increased bone resorption in 3% of patients. Long-term nutritional monitoring is necessary after malabsorptive operations for morbid obesity.

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  • After BPD/DS, more than 50% of patients have vitamin D deficiency and estimates of secondary hyperparathyroidism range from 60% to 100% even with aggressive supplementation.

    “After BPD/DS more than 50% of patients have vitamin D deficiency and estimates of secondary hyperparathyroidism range from 60-100% even with aggressive supplementation75, 77-79.”

    From Bone loss after bariatric surgery: causes, consequences, and management (2014) · cites this paper as [78]

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Authors
Slater, G. H., Ren, C. J., Siegel, N., Williams, T., Barr, D., Wolfe, B., Dolan, K., & Fielding, G. A.
Affiliations
Wesley Hospital (AU)
Corresponding author
Slater, Guy H
Venue
Journal of Gastrointestinal Surgery
Publisher
Elsevier BV
Published
2004-01
Volume
8
Issue
1
Pages
48-55
ISSN
1091-255X (ISSN-L)
DOI
10.1016/j.gassur.2003.09.020
OpenAlex
W2158926591
Cited by
489
References
16
Citations by year
2026: 2 · 2025: 10 · 2024: 8 · 2023: 19 · 2022: 17 · 2021: 16 · 2020: 16 · 2019: 15 · 2018: 17 · 2017: 22 · 2016: 30 · 2015: 35 · 2014: 41 · 2013: 17 · 2012: 29
FWCI
23.69
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Journal of Gastrointestinal Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
  • Health Sciences › Medicine › Surgery › Body Contouring and Surgery
Keywords
fat-soluble vitamin deficiency, biliopancreatic diversion, duodenal switch, malabsorptive bariatric surgery, fat malabsorption, vitamin A deficiency, vitamin D deficiency, vitamin K deficiency, vitamin E deficiency, zinc deficiency, hypocalcemia, secondary hyperparathyroidism, parathyroid hormone, bone resorption, morbid obesity
MeSH terms
Adolescent, Adult, Aged, Avitaminosis, Calcium, Female, Humans, Hyperparathyroidism, Hypocalcemia, Malabsorption Syndromes, Male, Middle Aged, Time Factors, Vitamin A Deficiency, Vitamin D Deficiency, Vitamin K Deficiency, Biliopancreatic Diversion

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