ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
ORIGINAL ARTICLE

Serum 25(OH) Vitamin D Levels in Severely Obese Patients Evaluated Before Bariatric Surgery
Bariatrik Cerrahi Öncesi Değerlendirilen Ciddi Obezitesi Olan Hastalarda Serum 25(OH) Vitamin D Seviyeleri
Received Date : 08 Oct 2019
Accepted Date : 13 Apr 2020
Available Online : 29 Apr 2020
Doi: 10.25179/tjem.2019-71778 - Makale Dili: EN
Turk J Endocrinol Metab. 2020;24:115-121
Bu makale, CC BY-NC-SA altında lisanslanmış açık erişim bir makaledir.
ABSTRACT
Objective: Obesity is a risk factor for vitamin D deficiency, which is reported to be detected differently in each population. This study aimed to evaluate the 25(OH) vitamin D (25(OH)D) levels, intact parathormone (iPTH) levels, and their relationship with body mass index (BMI) in obese patients, screened prior to bariatric surgery. Material and Methods: This retrospective study comprised of 1.082 obese patients (41±10 years, female/male: 823/259) who were candidates for bariatric surgery. BMI, waist circumference (WC), serum 25(OH)D, iPTH, calcium, phosphorus values of these patients were recorded from patient files. Results: BMI, WC, iPTH, and 25(OH)D levels were 48±8.9 kg/m², 128±11.9 cm, 64±36 pg/mL, and 15±18 ng/mL, respectively. Mean 25(OH)D level of 79.1% of the patients belonged to the deficiency range. Very low 25(OH) vitamin D levels (<10 ng/mL) were witnessed among 40.9% (443/1.082) of the study group. Female obese subjects possessed significantly lower serum 25(OH)D levels as compared to male obese patients. Significant negative correlations were perceived between 25(OH)D levels and iPTH (r=-0.34, p<0.0001), BMI (r=-0.20, p<0.0001), and waist circumferences (r=-0.14, p=0.002) in the whole group. Multivariate analysis indicated that BMI to be an independent risk factor for vitamin D deficiency. Conclusion: A high rate of vitamin D deficiency was documented in our morbidly obese patients who were candidates for bariatric surgery. BMI is a determinant of 25(OH)D levels. It is essential to screen for vitamin D deficiency and possible osteomalacia among the candidates for bariatric surgery of obese patients and should be treated appropriately before bariatric surgery.
ÖZET
Amaç: Obezite, her popülasyonda farklı sıklıkta saptandığı bildirilen vitamin D eksikliği için bir risk faktörüdür. Bu çalışmada, bariatrik cerrahi öncesi değerlendirilen obez hastalarda 25(OH) vitamin D (25(OH)D) düzeyleri, intakt parathormon (iPTH) düzeyleri ve bunların beden kitle indeksi (BKİ) ile ilişkilerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bariatrik cerrahi öncesinde değerlendirilen 1.082 morbid obez hasta (41±10 yaş, kadın/erkek: 823/259) verileri retrospektif olarak değerlendirildi. BKİ, bel çevresi (BÇ), serum 25(OH)D, iPTH, kalsiyum, fosfor değerleri hastaların dosyalarından kaydedildi. Bulgular: BKİ, BÇ, iPTH, 25(OH)D düzeyleri sırasıyla 48±8,9 kg/m², 128±11,9 cm, 64±36 pg/mL, 15±18 ng/mL idi. Ortalama 25(OH)D düzeylerinin, hastaların %79,1’inde yetersiz olduğu tespit edilmiştir. Çalışma grubundaki tüm hastaların %40,9’unda (443/1.082) çok düşük 25(OH)D vitamini seviyesi (<10 ng/mL) vardı. Obez kadınlarda 25(OH)D vitamin düzeyleri, obez erkeklere kıyasla anlamlı olarak düşük bulunmuştur. 25(OH)D vitamin düzeyleri iPTH ile ters orantılı izlenmiştir (r=-0,34, p<0,0001), tüm grupta 25(OH)D vitamin düzeyleri BKİ ve BÇ ile negatif korelasyon göstermiştir (r=-0,20, p<0,0001) (r=- 0,14, p=0,002). Multivaryant analiz, BKİ’nin D vitamini eksikliği için bağımsız bir risk faktörü olduğunu göstermektedir. Sonuç: Bariatrik cerrahi için aday olan morbid obez hastalarımızda yüksek oranda D vitamini eksikliği gözlemledik. BKİ, 25(OH)D seviyelerinin belirleyicisidir. BKİ ile 25(OH)D vitamin düzeyleri negatif korelasyon göstermektedir. Bariatrik cerrahiye aday olan obez hastalar, D vitamini eksikliği ve olası osteomalazi açısından değerlendirilmeli ve bariatrik cerrahi öncesi uygun şekilde tedavi edilmelidir.
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