Department of Internal Medicine, Recep Tayyip Erdogan University Hospital, Sehitler Avenue, No:74, Rize, Turkey.
Department of Physical Medicine and Rehabilitation Training, Recep Tayyip Erdogan University Hospital, Rize, Turkey.
Arch Osteoporos. 2018 May 22;13(1):61. doi: 10.1007/s11657-018-0458-0.
Vitamin D deficiency has been reported in patients with gastrointestinal disorders. Little is known on the potentially deleterious effect of cholecystectomy on vitamin D levels and osteoporosis. We found that 25-hydroxyvitamin D levels and bone mineral density were lower in patients with prior cholecystectomy.
The influence of bile salts on vitamin D absorption is well-known, and increased incidence of vitamin D deficiency has been reported in patients with gastrointestinal disorders. Little is known on the potentially deleterious effect of cholecystectomy on vitamin D levels and osteoporosis. Herein, we aimed to investigate the effects of cholecystectomy on vitamin D levels and osteoporosis in postmenopausal women.
The study group comprised 50 postmenopausal women who had previously undergone cholecystectomy; the control group comprised 50 age-matched postmenopausal women. Serum vitamin D, calcium, and phosphorus levels were determined. Bone mineral density (BMD) was determined using dual-energy X-ray absorptiometry.
The study group had significantly higher parathyroid hormone levels (94.4 ± 45.1 vs. 69.2 ± 37.5, p < 0.001) but significantly lower 25-hydroxyvitamin D levels (16.3 ± 7.6 vs. 19.8 ± 8.7, p = 0.03). Compared with the control group, the BMDs of both the lumbar spine (- 1.5 ± 1.0 vs. - 0.9 ± 1.0, p = 0.004) and femur (- 0.5 ± 0.8 vs. 0.19 ± 1.1, p = 0.001) were significantly lower in the study group. Body mass index [B = 0.81 (CI 0.67-0.98), p = 0.03] and prior cholecystectomy [B = 7.9 (CI 1.0-71.7), p = 0.04] were independent predictors of osteoporosis.
In postmenopausal women, prior cholecystectomy is associated with lower serum 25-hydroxyvitamin D levels and BMD.
众所周知,胆盐会影响维生素 D 的吸收,患有胃肠道疾病的患者维生素 D 缺乏的发生率增加。关于胆囊切除术对维生素 D 水平和骨质疏松症的潜在有害影响知之甚少。在此,我们旨在研究胆囊切除术对绝经后妇女维生素 D 水平和骨质疏松症的影响。
研究组包括 50 名既往行胆囊切除术的绝经后妇女;对照组包括 50 名年龄匹配的绝经后妇女。测定血清维生素 D、钙和磷水平。采用双能 X 线吸收法测定骨密度(BMD)。
研究组甲状旁腺激素水平明显升高(94.4±45.1 vs. 69.2±37.5,p<0.001),25-羟维生素 D 水平明显降低(16.3±7.6 vs. 19.8±8.7,p=0.03)。与对照组相比,研究组腰椎(-1.5±1.0 vs. -0.9±1.0,p=0.004)和股骨(-0.5±0.8 vs. 0.19±1.1,p=0.001)的 BMD 均显著降低。体重指数(B=0.81(CI 0.67-0.98),p=0.03)和既往胆囊切除术(B=7.9(CI 1.0-71.7),p=0.04)是骨质疏松症的独立预测因素。
在绝经后妇女中,既往胆囊切除术与血清 25-羟维生素 D 水平和 BMD 降低有关。