Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11451, Saudi Arabia.
Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham NG1 8NS, UK.
Nutrients. 2022 May 13;14(10):2052. doi: 10.3390/nu14102052.
Weight Loss Surgery (WLS), including sleeve-gastrectomy (SG), results in significant weight loss and improved metabolic health in severe obesity (BMI ≥ 35 kg/m2). Previous studies suggest post-operative health benefits are impacted by nutrient deficiencies, such as Vitamin D (25(OH)D) deficiency, while it is currently unknown whether nutrient levels may actually predict post-surgery outcomes. As such, this study investigated whether 25(OH)D levels could predict metabolic improvements in patients who underwent SG. Patients with severe obesity (n = 309; 75% female) undergoing SG participated in this ethics-approved, non-randomized retrospective cohort study. Anthropometry, clinical data, 25(OH)D levels and serum markers were collected at baseline, 6-, 12- and 18-months post-surgery. SG surgery resulted in significant improvements in metabolic health at 6- and 12-months post-surgery compared with baseline, as expected. Patients with higher baseline 25(OH)D had significantly lower HbA1c levels post-surgery (p < 0.01) and better post-surgical T2DM outcomes, including reduced weight regain (p < 0.05). Further analysis revealed that baseline 25(OH)D could predict HbA1c levels, weight regain and T2DM remission one-year post-surgery, accounting for 7.5% of HbA1c divergence (p < 0.01). These data highlight that higher circulating 25(OH)D levels are associated with significant metabolic health improvements post-surgery, notably, that such baseline levels are able to predict those who attain T2DM remission. This highlights the importance of 25(OH)D as a predictive biomarker of post-surgery benefits.
减重手术（WLS），包括袖状胃切除术（SG），可显著减轻严重肥胖症（BMI≥35kg/m2）患者的体重并改善其代谢健康。先前的研究表明，术后健康益处受到营养缺乏的影响，例如维生素 D（25（OH）D）缺乏症，而目前尚不清楚营养水平是否实际上可以预测术后结果。因此，本研究调查了 25（OH）D 水平是否可以预测接受 SG 的患者的代谢改善情况。接受 SG 的严重肥胖症患者（n=309；75%为女性）参与了这项经伦理批准的非随机回顾性队列研究。在基线、术后 6 个月、12 个月和 18 个月收集人体测量、临床数据、25（OH）D 水平和血清标志物。与基线相比，SG 手术后 6 个月和 12 个月的代谢健康状况显著改善，这是意料之中的。基线 25（OH）D 较高的患者术后 HbA1c 水平显著降低（p<0.01），并且术后 2 型糖尿病（T2DM）结局更好，包括体重减轻（p<0.05）。进一步的分析表明，基线 25（OH）D 可以预测术后一年的 HbA1c 水平、体重减轻和 T2DM 缓解，占 HbA1c 差异的 7.5%（p<0.01）。这些数据表明，较高的循环 25（OH）D 水平与术后显著的代谢健康改善相关，特别是，基线水平能够预测那些达到 T2DM 缓解的患者。这凸显了 25（OH）D 作为术后益处预测生物标志物的重要性。
