Center for Research On Micronutrients, Federal University of Rio de Janeiro (NPqM/UFRJ), Rio de Janeiro, 21941-902, Brazil.
Multidisciplinary Center for Bariatric and Metabolic Surgery, Federal University of Rio de Janeiro (NPqM/UFRJ), Rio de Janeiro, 21941-902, Brazil.
Obes Surg. 2024 May;34(5):1561-1568. doi: 10.1007/s11695-024-07148-x. Epub 2024 Mar 8.
To evaluate the influence of vitamin D (VD) concentrations coupled with metabolic phenotypes preoperatively and 6 months after Roux-en-Y gastric bypass (RYGB) on body variables and weight loss.
A longitudinal, retrospective, analytical study comprising 30 adult individuals assessed preoperatively (T0) and 6 months (T1) after undergoing Roux-en-Y gastric bypass. The participants were distributed preoperatively into metabolically healthy obese (MHO) and metabolically unhealthy obese individuals (MUHO) according to the HOMA-IR classification, as well as the adequacy and inadequacy of vitamin D concentrations in the form of 25(OH)D. All participants were assessed for weight, height, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), visceral adiposity index (VAI), body circularity index (BCI), body adiposity index (BAI), weight loss, and assessment of 25(OH)D and 1,25(OH)2D concentrations using high-performance liquid chromatography with an ultraviolet detector (HPLC-UV). The statistical program used was SPSS version 21.
VD adequacy and a healthy phenotype in the preoperative period may play an important role concerning body fat distribution, as the body averages for WHtR (0.020*) and BCI (0.020*) were lower in MHO participants. In comparison, those with VD inadequacy and MUHOs had higher BAI averages (0.000*) in the postoperative period. Furthermore, it is possible that VD inadequacy before and after RYGB, even in the presence of an unhealthy phenotype, may contribute to the increase in VAI values (0.029*) after this surgery. Only those with inadequate VD and MUHOs had higher 25(OH)D concentrations. Besides, this unhealthy phenotype had a greater reduction in BMI in the early postoperative period (p < 0.001).
This study suggests that VD adequacy and the presence of a healthy phenotype appear to have a positive impact on the reduction of visceral fat in the context of pre- and postoperative obesity. In addition, there was a greater weight reduction in those with VD inadequacy and in MUHO, which suggests that the volumetric dilution effect of VD and catabolism after bariatric surgery is more pronounced in this specific metabolic phenotype.
评估术前和 Roux-en-Y 胃旁路术（RYGB）后 6 个月维生素 D（VD）浓度与代谢表型对身体变量和体重减轻的影响。
这是一项纵向、回顾性、分析性研究，纳入了 30 名成年患者，在接受 Roux-en-Y 胃旁路术前（T0）和术后 6 个月（T1）进行评估。根据 HOMA-IR 分类，将患者术前分为代谢健康肥胖（MHO）和代谢不健康肥胖（MUHO）人群，并根据 25（OH）D 的形式评估维生素 D 浓度是否充足。所有患者均接受体重、身高、体重指数（BMI）、腰围（WC）、腰高比（WHtR）、内脏脂肪指数（VAI）、体圆度指数（BCI）、体脂肪指数（BAI）、体重减轻以及使用高效液相色谱-紫外检测（HPLC-UV）评估 25（OH）D 和 1,25（OH）2D 浓度的评估。使用 SPSS 版本 21 进行统计分析。
术前维生素 D 充足和健康表型可能对体脂分布具有重要作用，因为 MHO 患者的 WHtR（0.020*）和 BCI（0.020*）平均值较低。相比之下，术后维生素 D 不足和 MUHO 患者的 BAI 平均值（0.000*）较高。此外，即使存在不健康表型，RYGB 前后的维生素 D 不足也可能导致手术后 VAI 值（0.029*）升高。只有那些维生素 D 不足和 MUHO 患者的 25（OH）D 浓度较高。此外，这种不健康表型在术后早期 BMI 下降更大（p<0.001）。
本研究表明，维生素 D 充足和健康表型似乎对术前和术后肥胖的内脏脂肪减少有积极影响。此外，维生素 D 不足和 MUHO 患者的体重减轻更大，这表明维生素 D 的体积稀释效应和减重手术后的分解代谢在这种特定代谢表型中更为明显。
