Nelson Monica L, Bolduc Lynn M, Toder Michelle E, Clough Donald M, Sullivan Susan S
Department of Food Science and Human Nutrition, University of Maine, Orono, Maine 04469, USA.
Surg Obes Relat Dis. 2007 Jul-Aug;3(4):434-7. doi: 10.1016/j.soard.2007.02.007. Epub 2007 Apr 2.
To evaluate the adequacy of supplementation to correct preoperative vitamin D deficiency in adult patients during the year after Roux-en-Y gastric bypass (RYGB) surgery.
The medical records were reviewed and the preoperative and 12-month postoperative serum 25-hydroxyvitamin D [25(OH)D] levels were compared in patients who underwent RYGB from 2002 to 2004. The serum 25(OH)D levels were defined as being optimal (> or = 80 nmol/L), suboptimal (50-79 nmol/L), or deficient (<50 nmol/L). Patients with deficient 25(OH)D levels were prescribed 50,000 IU ergocalciferol weekly. The remaining patients averaged 710 IU supplemental vitamin D intake daily.
The mean patient age was 43.8 +/- 10.7 years, and the mean preoperative body mass index was 51.8 +/- 9.8 kg/m2. Of the 95 patients with baseline and 12-month 25(OH)D levels, 89% were women. The mean preoperative 25(OH)D level was 49.7 +/- 26.5 nmol/L; 34% had suboptimal 25(OH)D levels and 54% had deficient levels before surgery. Twelve months after surgery, those receiving 50,000 IU weekly (n = 40) had a mean 25(OH)D level of 69.2 +/- 22.2 nmol/L; 63% had suboptimal and 8% deficient levels. Those taking 710 IU daily (n = 55) had a mean 25(OH)D level of 85.5 +/- 33.0 nmol/L; 44% had suboptimal and 6% deficient levels.
Vitamin D deficiency is prevalent in RYGB patients before surgery. The vitamin D status improved markedly after RYGB surgery with either 710 IU vitamin D daily or 50,000 IU weekly. Current supplementation practices do not appear to optimize the serum 25(OH)D levels and need to be more closely examined.
评估成人患者在接受 Roux-en-Y 胃旁路术（RYGB）后的一年内，补充剂纠正术前维生素 D 缺乏的充足性。
回顾病历，比较 2002 年至 2004 年接受 RYGB 手术患者术前和术后 12 个月的血清 25-羟维生素 D [25(OH)D] 水平。血清 25(OH)D 水平被定义为最佳（≥80 nmol/L）、次优（50 - 79 nmol/L）或缺乏（<50 nmol/L）。25(OH)D 水平缺乏的患者每周服用 50,000 IU 麦角钙化醇。其余患者平均每日补充维生素 D 摄入量为 710 IU。
患者平均年龄为 43.8 ± 10.7 岁，术前平均体重指数为 51.8 ± 9.8 kg/m²。在 95 例有基线和 12 个月 25(OH)D 水平的患者中，89% 为女性。术前平均 25(OH)D 水平为 49.7 ± 26.5 nmol/L；34% 的患者 25(OH)D 水平次优，54% 的患者术前水平缺乏。术后 12 个月，每周接受 50,000 IU（n = 40）的患者平均 25(OH)D 水平为 69.2 ± 22.2 nmol/L；63% 的患者次优，8% 的患者缺乏。每日服用 710 IU（n = 55）的患者平均 25(OH)D 水平为 85.5 ± 33.0 nmol/L；44% 的患者次优，6% 的患者缺乏。
RYGB 患者术前普遍存在维生素 D 缺乏。RYGB 术后，每日补充 710 IU 维生素 D 或每周补充 50,000 IU，维生素 D 状态均有显著改善。目前的补充做法似乎未使血清 25(OH)D 水平达到最佳，需要更仔细地研究。
