病态肥胖患者减重手术后 25(OH)D 和 f25(OH)D3 的差异行为。

Differential Behavior of 25(OH)D and f25(OH)D3 in Patients with Morbid Obesity After Bariatric Surgery.

机构信息

Endocrinology and Nutrition Service, Department of Medicine, Universitat Autònoma de Barcelona, Germans Trias I Pujol University Hospital and Research Institute, Carretera del Canyet sn, 08916, Badalona, Spain.

Clinical Biochemistry Service, Universitat Autònoma de Barcelona, Germans Trias I Pujol University Hospital and Research Institute, Badalona, Spain.

出版信息

Obes Surg. 2021 Sep;31(9):3990-3995. doi: 10.1007/s11695-021-05442-6. Epub 2021 May 17.

DOI:10.1007/s11695-021-05442-6

PMID:33999327

Abstract

BACKGROUND

Total 25-OH-vitamin D (25(OH)D) levels are decreased in patients with obesity, but few data exist regarding free-vitamin D3 (f25(OH)D3) concentrations. We aimed to evaluate the effect of bariatric surgery on 25(OH)D and f25(OH)D3 in a cohort of patients with morbid obesity.

METHODS

Twenty-four patients submitted to sleeve gastrectomy (SG) (mean age 48 years, body mass index (BMI) 48.16±10.73k/m) were evaluated before and 1 year after surgery. Anthropometric data, parathormone (PTH), calcium, alkaline phosphatase, 25(OH)D, and f25(OH)D3 were recorded.

RESULTS

25(OH)D and f25(OH)D3 correlated well before and after SG. Baseline determinations did not correlate with BMI, but they inversely correlated with BMI 1 year after surgery (r=-0.46, p=0.02 and r=-0.60, p=0.002, respectively). Post-surgery % total body weight loss (%TBWL) was 27.4±13.8 %; f25(OH)D3 concentrations increased significantly (5.28±2.29 pg/mL vs 6.64±2.25 pg/mL; p=0.03), whereas 25(OH)D did not change. Patients who achieved a BMI <35 kg/m 1 year after surgery had significantly higher concentrations of f25(OH)D3 (7.9±1 pg/mL vs 4.8±1.1, p<0.001) and 25(OH)D (30.9±9.4 ng/mL vs 22.3±13.4; p=0.03) compared to those who remained with BMI >35 kg/m.

CONCLUSION

There is a significant inverse relationship between BMI and both f25(OH)D3 and 25(OH)D 1 year after surgery. Only f25(OH)D3 concentrations increased 1 year after surgery, which could be explained by a greater f25(OH)D3 sequestration before SG in the adipose tissue, potentially due to the more liposoluble nature of f25(OH)D3 than the protein-bound form 25(OH)D.

摘要

背景

肥胖患者体内的总 25-羟维生素 D（25(OH)D）水平降低，但关于游离维生素 D3（f25(OH)D3）浓度的数据很少。我们旨在评估肥胖症患者中袖状胃切除术（SG）对 25(OH)D 和 f25(OH)D3 的影响。

方法

对 24 例接受袖状胃切除术（SG）的患者（平均年龄 48 岁，体重指数（BMI）48.16±10.73kg/m）进行术前和术后 1 年的评估。记录人体测量数据、甲状旁腺激素（PTH）、钙、碱性磷酸酶、25(OH)D 和 f25(OH)D3。

结果

SG 前后 25(OH)D 和 f25(OH)D3 相关性良好。基线测定值与 BMI 不相关，但与术后 1 年 BMI 呈负相关（r=-0.46，p=0.02 和 r=-0.60，p=0.002）。术后体重总减轻百分比（%TBWL）为 27.4±13.8%；f25(OH)D3 浓度显著增加（5.28±2.29pg/mL 与 6.64±2.25pg/mL；p=0.03），而 25(OH)D 没有变化。术后 1 年 BMI<35kg/m2 的患者 f25(OH)D3 浓度显著升高（7.9±1pg/mL 与 4.8±1.1，p<0.001）和 25(OH)D（30.9±9.4ng/mL 与 22.3±13.4；p=0.03）与 BMI>35kg/m2 的患者相比。