Censani Marisa, Stein Emily M, Shane Elizabeth, Oberfield Sharon E, McMahon Donald J, Lerner Shulamit, Fennoy Ilene
Department of Pediatrics, Columbia University Medical Center, 622 West 168th Street, PH 5E-522, New York, NY 10032, USA.
ISRN Obes. 2013;2013. doi: 10.1155/2013/284516.
Obese adults are frequently vitamin D deficient before bariatric surgery; whether similar abnormalities exist in morbidly obese adolescents is unknown.
To determine the prevalence of vitamin D deficiency in morbidly obese adolescents.
Cross-sectional study of preoperative laboratory measures from 236 adolescents evaluated for bariatric surgery.
The group ( = 219 with 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) levels; 76 boys, 143 girls; 15.9 ± 1.2 years; 43% Caucasian, 35% Hispanic, and 15% African American) had mean BMI of 47.6 ± 8.1 kg/m. 25OHD levels were deficient (<20 ng/mL) in 53%; 8% had severe deficiency (<10 ng/mL); only 18% of patients were replete (>30 ng/mL). 25OHD levels were inversely associated with BMI ( = -0.28, < 0.0001) and PTH levels ( = -0.24, = 0.0003). Race was the strongest predictor of 25OHD ( < 0.002); 82% of African Americans, 59% of Hispanics, and 37% of Caucasians were deficient. African American race, BMI, and PTH explained 21% of the variance in 25OHD ( < 0.0001).
Most adolescents presenting for bariatric surgery have suboptimal vitamin D levels, with African Americans and those with higher BMIs at greatest risk for vitamin D deficiency. All morbidly obese adolescents should be screened for vitamin D deficiency before bariatric procedures.
肥胖成年人在接受减肥手术前常存在维生素D缺乏；病态肥胖青少年是否存在类似异常尚不清楚。
确定病态肥胖青少年维生素D缺乏的患病率。
对236名接受减肥手术评估的青少年术前实验室检查进行横断面研究。
该组（219人有25-羟维生素D（25OHD）和甲状旁腺激素（PTH）水平；76名男孩，143名女孩；15.9±1.2岁；43%为白种人，35%为西班牙裔，15%为非裔美国人）平均BMI为47.6±8.1kg/m。53%的人25OHD水平不足（<20ng/mL）；8%的人严重缺乏（<10ng/mL）；只有18%的患者维生素D充足（>30ng/mL）。25OHD水平与BMI呈负相关（r=-0.28，P<0.0001），与PTH水平呈负相关（r=-0.24，P=0.0003）。种族是25OHD最强的预测因素（P<0.002）；82%的非裔美国人、59%的西班牙裔和37%的白种人维生素D不足。非裔美国人种族、BMI和PTH解释了25OHD变异的21%（P<0.0001）。
大多数接受减肥手术的青少年维生素D水平不理想，非裔美国人以及BMI较高者维生素D缺乏风险最大。所有病态肥胖青少年在进行减肥手术前都应筛查维生素D缺乏情况。
