Teitelbaum S L, Halverson J D, Bates M, Wise L, Haddad J G
Ann Intern Med. 1977 Mar;86(3):289-93. doi: 10.7326/0003-4819-86-3-289.
Circulating levels of 25-OH vitamin D were measured in 44 patients who had undergone small intestinal bypass for obesity. Sixty-one percent had low circulating levels of the metabolite, which tended to normalize with time. This adaptive response also occurred for circulating total calcium, magnesium, albumin, and alkaline phosphatase. Serum concentrations of 25-OH vitamin D were directly related to total serum calcium and albumin. Impaired intestinal absorption of 25-OH vitamin D was seen in two patients. Following correction of total serum calcium for attendant hypoalbuminemia, 27% of patients remained hypocalcemic. The bone densities of two of 32 patients were low. In addition, skeletal biopsies of three of six patients were abnormal. It is concluded that small intestinal bypass results in at least transient deficits of circulating 25-OH vitamin D. As this operation may be associated with abnormal bone morphology, clinically significant skeletal disease may become apparent with long-term follow-up.
对44例因肥胖接受小肠旁路手术的患者测量了循环中25-羟基维生素D的水平。61%的患者该代谢物的循环水平较低，且其水平有随时间趋于正常化的趋势。循环中的总钙、镁、白蛋白和碱性磷酸酶也出现了这种适应性反应。血清25-羟基维生素D浓度与血清总钙和白蛋白直接相关。在两名患者中观察到25-羟基维生素D的肠道吸收受损。在对伴随的低白蛋白血症校正血清总钙后，27%的患者仍存在低钙血症。32例患者中有2例骨密度较低。此外，6例患者中有3例的骨骼活检结果异常。结论是小肠旁路手术导致循环中25-羟基维生素D至少出现短暂缺乏。由于该手术可能与骨骼形态异常有关，长期随访可能会出现具有临床意义的骨骼疾病。
