Archives of Osteoporosis

, 13:61 | Cite as

The effect of cholecystectomy on 25-hydroxyvitamin D levels and bone mineral density in postmenopausal women

  • Hatice Beyazal PolatEmail author
  • Munevver Serdaroglu Beyazal
Original Article



Vitamin D deficiency has been reported in patients with gastrointestinal disorders. Little is known on the potentially deleterious effect of cholecystectomy on vitamin D levels and osteoporosis. We found that 25-hydroxyvitamin D levels and bone mineral density were lower in patients with prior cholecystectomy.


The influence of bile salts on vitamin D absorption is well-known, and increased incidence of vitamin D deficiency has been reported in patients with gastrointestinal disorders. Little is known on the potentially deleterious effect of cholecystectomy on vitamin D levels and osteoporosis. Herein, we aimed to investigate the effects of cholecystectomy on vitamin D levels and osteoporosis in postmenopausal women.


The study group comprised 50 postmenopausal women who had previously undergone cholecystectomy; the control group comprised 50 age-matched postmenopausal women. Serum vitamin D, calcium, and phosphorus levels were determined. Bone mineral density (BMD) was determined using dual-energy X-ray absorptiometry.


The study group had significantly higher parathyroid hormone levels (94.4 ± 45.1 vs. 69.2 ± 37.5, p < 0.001) but significantly lower 25-hydroxyvitamin D levels (16.3 ± 7.6 vs. 19.8 ± 8.7, p = 0.03). Compared with the control group, the BMDs of both the lumbar spine (− 1.5 ± 1.0 vs. − 0.9 ± 1.0, p = 0.004) and femur (− 0.5 ± 0.8 vs. 0.19 ± 1.1, p = 0.001) were significantly lower in the study group. Body mass index [B = 0.81 (CI 0.67–0.98), p = 0.03] and prior cholecystectomy [B = 7.9 (CI 1.0–71.7), p = 0.04] were independent predictors of osteoporosis.


In postmenopausal women, prior cholecystectomy is associated with lower serum 25-hydroxyvitamin D levels and BMD.


Osteoporosis Cholecystectomy Vitamin D Postmenopausal women 


Compliance with ethical standards

This cross-sectional analytical study was approved by the Research Ethics Committee of the Recep Tayyip Erdogan University Hospital. All participants provided written informed consent before participating in the study.

Conflicts of interest



  1. 1.
    Kanis JA (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group Osteoporos Int 4:368–381CrossRefGoogle Scholar
  2. 2.
    Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141CrossRefGoogle Scholar
  3. 3.
    Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136CrossRefGoogle Scholar
  4. 4.
    Guillemin F, Martinez L, Calvert M, Cooper C, Ganiats T, Gitlin M, Horne R, Marciniak A, Pfeilschifter J, Shepherd S, Tosteson A, Wade S, Macarios D, Freemantle N (2013) Fear of falling, fracture history, and comorbidities are associated with health-related quality of life among European and US women with osteoporosis in a large international study. Osteoporos Int 24:3001–3010CrossRefGoogle Scholar
  5. 5.
    Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22:465–475CrossRefGoogle Scholar
  6. 6.
    Phetfong J, Sanvoranart T, Nartprayut K et al (2016) Osteoporosis: the current status of mesenchymal stem cell-based therapy. Cell Mol Biol Lett 12:21Google Scholar
  7. 7.
    Bilkle DD (1992) Bone disease due to nutritional, gastrointestinal, and hepatic disorders. In: Coe FL, Farus MJ (eds) Disorders of bone and mineral metabolism. Raven Press, New York, pp 951–971Google Scholar
  8. 8.
    Glasgow RE, Mulvihill SJ (2010) Treatment of gallstone disease. In: Feldman M, Friedman LS, Brandt LJ (eds) Sleisenger and Fordtran’s gastrointestinal and liver disease, 9th edn. Saunders Elsevier, PhiladelphiaGoogle Scholar
  9. 9.
    Stoker GE, Buchowski JM, Stoker ME (2012) Prior cholecystectomy as a predictor of preoperative vitamin D deficiency in adults undergoing spine surgery. Arch Surg 147:577–578CrossRefGoogle Scholar
  10. 10.
    Schüle S, Rossel JB, Frey D, Biedermann L, Scharl M, Zeitz J, Freitas-Queiroz N, Kuntzen T, Greuter T, Vavricka SR, Rogler G, Misselwitz B, Swiss IBD cohort study (2017) Widely differing screening and treatment practice for osteoporosis in patients with inflammatory bowel diseases in the Swiss IBD cohort study. Medicine (Baltimore) 96(22):e6788. CrossRefGoogle Scholar
  11. 11.
    Skare TL (2007) Reumatologia: princípios e prática. Guanabara Koogan, Rio de JaneiroGoogle Scholar
  12. 12.
    Lacativa PGS, Farias MLF (2010) Osteoporosis and inflammation. Arq Bras Endocrinol Metabol 54:123–132CrossRefGoogle Scholar
  13. 13.
    Weinstein RS (2011) Glucocorticoid-induced bone disease. N Engl J Med 365:62–70CrossRefGoogle Scholar
  14. 14.
    Marcinowska-Suchowierska EB, Tałałaj MJ, Włodarcyzk AW, Bielecki K, Zawadzki JJ, Brzozowski R (1995) Calcium/phosphate/vitamin D homeostasis and bone mass in patients after gastrectomy, vagotomy, and cholecystectomy. World J Surg 19:597–601 discussion 601–2CrossRefGoogle Scholar
  15. 15.
    Rao DS, Kleerekoper M, Rogers M (1984) In: Osteoporosis CC, Overgaard K (eds) Is gastrectomy a risk factor for osteoporosis? Osteopress ApS, Copenhagen, pp 775–777Google Scholar
  16. 16.
    Kotze LM, Costa CT, Cavassani MF, Nisihara RM (2017) Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease. Rev Assoc Med Bras 63:13–17CrossRefGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Hatice Beyazal Polat
    • 1
    Email author
  • Munevver Serdaroglu Beyazal
    • 2
  1. 1.Department of Internal MedicineRecep Tayyip Erdogan University HospitalRizeTurkey
  2. 2.Department of Physical Medicine and Rehabilitation TrainingRecep Tayyip Erdogan University HospitalRizeTurkey

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