İstanbul Medical Journal (Nov 2024)

Risk of Hypocalcemia and Osteoporosis due to Vitamin D Deficiency in Patients Undergoing Sleeve Gastrectomy and Bypass Surgery for Obesity

  • Meliha Özyalvaç,
  • Enes Şahin,
  • Mehmet Eşref Ulutaş,
  • Mehmet Ertuğrul Kafalı,
  • Mustafa Şahin,
  • Zuhal Aydan Sağlam

DOI
https://doi.org/10.4274/imj.galenos.2024.65789
Journal volume & issue
Vol. 25, no. 4
pp. 298 – 303

Abstract

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Introduction: Obesity is a chronic disease that is increasing worldwide. It is known that mineral and vitamin deficiencies develop in obese individuals. Surgical treatment options are becoming increasingly common for the permanent and effective treatment of obesity. It was observed that mineral and vitamin deficiencies increased after surgical interventions. The aim of this study was to investigate the efficacy of laparoscopic sleeve gastrectomy (LSG) and combined Roux-en-Y Gastric Bypass (RYGB) methods for weight loss in obese patients and their effects on vitamin D, calcium+2 (Ca+2), parathyroid hormone (PTH), and P levels and the risk of osteoporosis in patients after surgery. Methods: The study included 50 patients who underwent LSG and 47 patients who underwent RYGB. Routine preparations and standard surgical procedures were performed. Body mass index, blood vitamin D, Ca+2, PTH, and P levels were measured preoperatively and postoperatively at 3-month intervals for 12 months. Data were analyzed using independent and dependent t-tests. Results: Preoperative hypocalcemia was observed in both groups (LSG: 14%, RYGB: 19.1%). It was observed that both surgical methods were effective for weight loss. Postoperative hypocalcemia rates increased in both groups (LSG: 26%, RYGB: 33.3%). After vitamin and mineral supplementation, hypocalcemia rates improved but could not be brought to normal levels. In addition, decreased vitamin D and PTH levels were observed after the surgical intervention. Conclusion: Low vitamin D and Ca+2 levels were increased in patients after bariatric surgery. Mineral and vitamin supplementation decreased these decreases but did not increase their normal levels. This treatment is thought to increase the risk of osteoporosis. It would be useful to investigate the effects of higher-dose supplements.

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