Department of Nutrition, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands.
Obesity Center, Catharina Hospital, 5623 EJ Eindhoven, The Netherlands.
Medicina (Kaunas). 2019 Jun 6;55(6):252. doi: 10.3390/medicina55060252.
Vitamin D is an essential vitamin that plays a key role in maintaining physiological calcium balance, and is also a pivotal element in the formation of bone structure. Vitamin D deficiency is associated with a wide array of clinical symptoms. Vitamin and mineral deficiencies are quite common prior to and after bariatric surgery, and therefore we have evaluated the effects of two different cholecalciferol supplementation regimes on serum calcium, 25(OH) cholecalciferol, and parathyroid hormone (PTH). In this retrospective matched cohort study, two different cholecalciferol supplementation regimes were compared. Group A consisted of 50 patients who had 1000 mg calcium and 800 IU cholecalciferol. In Group B, 50 patients had 1000 mg calcium and 800 IU cholecalciferol with an additional 1 ml liquid cholecalciferol (50,000 IU) monthly. The primary outcome was the effects on blood serum levels of calcium, 25(OH) cholecalciferol, and PTH. In group A and group B, there were significant increases in 25(OH) cholecalciferol, with a higher delta in favor of group B (for all three < 0.001). A decrease was seen in PTH ( < 0.001), and no differences were measured in calcium levels in both groups. Our study suggests that an additional 1 ml cholecalciferol (50,000 IU) monthly can result in less biochemically 25(OH) cholecalciferol deficient patients after bariatric surgery. No effects were seen on the calcium balance. However, larger randomized clinical trials need to be done to assess the effects on clinical outcomes like bone health and fracture risk.
维生素 D 是一种必需维生素，在维持生理钙平衡方面发挥着关键作用，也是骨骼结构形成的关键元素。维生素 D 缺乏与广泛的临床症状有关。在减重手术前后，维生素和矿物质缺乏很常见，因此我们评估了两种不同的胆钙化醇补充方案对血清钙、25（OH）胆钙化醇和甲状旁腺激素（PTH）的影响。
在这项回顾性匹配队列研究中，比较了两种不同的胆钙化醇补充方案。A 组由 50 名患者组成，他们服用 1000 毫克钙和 800 国际单位胆钙化醇。B 组中，50 名患者服用 1000 毫克钙和 800 国际单位胆钙化醇，外加每月 1 毫升液体胆钙化醇（50000 国际单位）。主要结局是对血清钙、25（OH）胆钙化醇和 PTH 水平的影响。在 A 组和 B 组中，25（OH）胆钙化醇水平均显著升高，B 组的增量更高（所有三个均 <0.001）。PTH 水平下降（<0.001），两组的钙水平无差异。
我们的研究表明，每月额外服用 1 毫升胆钙化醇（50000 国际单位）可使减重手术后生化 25（OH）胆钙化醇缺乏患者减少。对钙平衡没有影响。然而，需要进行更大规模的随机临床试验来评估对骨健康和骨折风险等临床结果的影响。
