Department of Gastrointestinal Surgery.
Department of medical imaging, Dongguan Songshan Lake Central Hospital, Affiliated Dongguan Shilong People's Hospital of Southern Medical University, Dongguan.
Int J Surg. 2023 Dec 1;109(12):4273-4285. doi: 10.1097/JS9.0000000000000732.
To estimate the prevalence and associated factors of vitamin D deficiency (VDD) after Roux-en-Y gastric bypass (RYGB).
PubMed, EMBASE, and CENTRAL were searched for relevant records from inception to 17 March 2023, using search terms: vitamin D, vitamin D3, vitamin D deficiency, hypovitaminosis D, gastric bypass, and RYGB. Studies were eligible for inclusion if they provided related data on VDD prevalence after RYGB.
Of the 1119 screened studies, 72 studies involving 7688 individuals were enrolled in the final analysis. The prevalence estimates of VDD after RYGB were 42%. Subgroup analyses suggested the pooled prevalence of postoperative VDD was 35% for follow-up duration less than or equal to 1 year, 43% for greater than 1 and less than or equal to 5 years, and 54% for greater than 5 years. Meta-regression showed that VDD prevalence was positively correlated with follow-up time. Also, the prevalence was higher in studies with inadequate vitamin D supplementation than in those with adequate supplementation and in Asia population than in those from South America, Europe, and North America. Other factors associated with high VDD prevalence after RYGB included high presurgical VDD prevalence, noncompliant patients, and black populations. No significant association existed between VDD and alimentary length.
VDD presented a high prevalence in patients following RYGB. It occurred more frequently with longer postoperative follow-up time. Population-specific vitamin D supplementation measures, targeted treatment for presurgical VDD, improved patient compliance, and periodical follow-ups were necessary to reduce VDD and other adverse outcomes.
评估胃旁路术后维生素 D 缺乏（VDD）的患病率及其相关因素。
检索 PubMed、EMBASE 和 CENTRAL 自成立至 2023 年 3 月 17 日的相关记录，使用的检索词包括：维生素 D、维生素 D3、维生素 D 缺乏、维生素 D 不足、胃旁路术和 RYGB。如果研究提供了与 RYGB 后 VDD 患病率相关的数据，则将其纳入研究。
在筛选出的 1119 篇研究中，最终有 72 项研究涉及 7688 人纳入最终分析。胃旁路术后 VDD 的患病率估计值为 42%。亚组分析表明，术后 VDD 的汇总患病率在随访时间小于或等于 1 年时为 35%，大于 1 年且小于或等于 5 年时为 43%，大于 5 年时为 54%。Meta 回归显示，VDD 患病率与随访时间呈正相关。此外，在维生素 D 补充不足的研究中，VDD 的患病率高于补充充足的研究，在亚洲人群中的患病率高于南美洲、欧洲和北美人群。与 RYGB 后 VDD 患病率较高相关的其他因素包括术前 VDD 患病率高、不依从的患者和黑人人群。VDD 与肠袢长度之间无显著相关性。
胃旁路术后患者 VDD 患病率较高，且随着术后随访时间的延长而增加。有必要针对特定人群采取维生素 D 补充措施、针对术前 VDD 进行针对性治疗、提高患者依从性以及定期随访，以降低 VDD 及其他不良结局的发生风险。
