Obesity Surgery

, Volume 19, Issue 5, pp 590–594 | Cite as

Vitamin D Status Before Roux-en-Y and Efficacy of Prophylactic and Therapeutic Doses of Vitamin D in Patients After Roux-en-Y Gastric Bypass Surgery

  • Natalia Fendrikova Mahlay
  • Lisena G. VerkaEmail author
  • Kimberly Thomsen
  • Srinivas Merugu
  • Mark Salomone
Research Article



Literature regarding the effect of Roux-en-Y gastric bypass (RYGBP) on vitamin D level shows contradictory findings. Our goal was to determine preoperatively vitamin D levels, to evaluate the efficacy of therapeutic and prophylactic doses of vitamin D and to assess the relationship of 25-OH vitamin D level and body mass index (BMI).


We conducted a retrospective cross-sectional study of 72 patients who underwent RYGBP from April 2007 to October 2007 in Bariatric Surgery Department at Saint Vincent Charity Hospital.


Our study demonstrated that 80% of the obese patients undergoing RYGBP had serum 25-OH vitamin D levels of less than 32 ng/ml. Postoperative data show that 45% of these patients continue being vitamin D insufficient despite the treatment. We demonstrated that a statistically significant inverse correlation between BMI and 25-OH vitamin D levels (r = 0.464, p = 0.01) exists.


Our finding strongly supports the need for aggressive monitoring of vitamin D levels for long-term prevention of complications of vitamin D deficiency in gastric bypass patients. Identifying the factors that predict patient’s responses to vitamin D supplementation requires larger-scale studies and further analysis of these tendencies suggested by our findings.


Vitamin D deficiency Anastomosis Roux-en-Y Morbid obesity 



Special thanks to Aleece Caron for her contribution in developing and analyzing statistical data.


  1. 1.
    Mokdad AH, Serdula MK, Dieta WH, et al. The spread of the obesity epidemic in the United States, 1991–1998. JAMA 1999;282:1519–22.CrossRefGoogle Scholar
  2. 2.
    Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. JAMA 2004;294:1909–17.CrossRefGoogle Scholar
  3. 3.
    Prisco C, Levine SN. Metabolic bone disease after gastric bypass surgery for obesity. AM J Med Sci. 2005;329:57–61.CrossRefGoogle Scholar
  4. 4.
    Goldner WS, O’Dorisio TM, Dillon JS, et al. Severe metabolic bone disease as a long-term complication of obesity surgery. Obes Surg. 2002;12:685–92.CrossRefGoogle Scholar
  5. 5.
    Tovey FL, Hall ML, Ell PJ, et al. A review of post-gastrectomy bone disease. J Gastroenterol Hepatol 1992;7:639–45.CrossRefGoogle Scholar
  6. 6.
    Looker AC, Dawson-Huges B, Calso MS, et al. Serum 25-hydroxyvitamin D status of adolescents and adults in two seasonal subpopulations from NHANES III. Bone 2002;30:771–7.CrossRefGoogle Scholar
  7. 7.
    Carlin AM, Rao DS, Meslemani AM, et al. Prevalence of vitamin D depletion among morbidly obese patients seeking gastric bypass surgery. Surg Obes Relat Dis 2006;2:98–103.CrossRefGoogle Scholar
  8. 8.
    Compston JE, Verdi S, Ledger JE, et al. Vitamin D status and bone histomorphometry in gross obesity. Am J Clin Nutr 1981;34:2359–63.CrossRefGoogle Scholar
  9. 9.
    Hey H, Stokholm KH, Lund B, et al. Vitamin D deficiency in obese patients and changes in circulating vitamin D metabolites following jejunoileal bypass. Int J Obes 1982;6:473–9.PubMedGoogle Scholar
  10. 10.
    Bell NH, Epstein S, Greene A, et al. evidence for alteration of the vitamin D-endocrine system in obese subjects. J Clin Invest 1985;76:370–3.CrossRefGoogle Scholar
  11. 11.
    Liel Y, Ulmer E, Shary J, et al. Low circulating vitamin D in obesity. Calcif Tissue Int 1988;43:199–201.CrossRefGoogle Scholar
  12. 12.
    Hyldstrup L, Andersen T, McNair P, et al. Bine metabolism in obesity: changes related to severe overweight and dietary weight reduction. Acta Endocrinol (Coppenh) 1993;129:393–8.CrossRefGoogle Scholar
  13. 13.
    Wortsman J, Matsoka LY, Chen TC, et al. Decreased bioavailability of vitamin D in obesity. Am J Clin Nutr 2000;72:690–3.CrossRefGoogle Scholar
  14. 14.
    Parikh SJ, Edelman M, Uwaifo GI, et al. The relationship between obesity and serum 1,2-dihydroxy vitamin D concentrations in healthy adults. J Clin Endocrinol Metab 2004;89:1196–9.CrossRefGoogle Scholar
  15. 15.
    Buffington C, Walker B, Cowa GS Jr, et al. Vitamin D deficiency in the morbidly obese. Obes Surg 1993;3:421–4.CrossRefGoogle Scholar
  16. 16.
    DiGiorgi MF, Daud A, Bessler M. Effectiveness of vitamin D supplementation after gastric bypass. Obes Surg 2003;13:210–1.Google Scholar
  17. 17.
    Flancbaum L, Belsley S, Drake V, et al. Preoperative nutritional status of patients undergoing Roux-en-Y gastric bypass for morbid obesity. J Gastrointest Surg 2006;10:1033–7.CrossRefGoogle Scholar
  18. 18.
    Ybarra J, Sanchez-Hernandez J, Gich I, et al. Unchanged hypovitaminosis D and secondary hyperparathyroidism in morbid obesity after bariatric surgery. Obes Surg 2005;15:330–5.CrossRefGoogle Scholar
  19. 19.
    Wilson T, Drake VVI, Colarusso T, et al. Preoperative nutritional status of patients undergoing Roux-en-Y gastric bypass for morbid obesity [abstract]. Gastroenterology 2004;126(suppl 2):A–813.Google Scholar
  20. 20.
    Hollick MF. Vitamin D: photobiology, metabolism, mechanism of action, and clinical applications. In: Favis MJ, editor. Primer on the metabolic bone diseases and disorders of mineral metabolism, 4th ed. Philadelphia: Lippincott Williams and Wilkins; 1999. p. 92–8.Google Scholar
  21. 21.
    Holick MF. Vitamin D deficiency in obesity and health consequences. Curr Opin Endocrinol Diabetes. 2006;13:412–8.CrossRefGoogle Scholar
  22. 22.
    Holick MF. High prevalence of vitamin D inadequacy and implications for health. Mayo Clin Proc 2006;81:353–73.CrossRefGoogle Scholar
  23. 23.
    Malabanan A, Veronikis IE, Holick MF. Redefining vitamin D insufficiency. Lancet 1998;351:805–6.CrossRefGoogle Scholar
  24. 24.
    Michael F. Holick, M.D., Ph.D. Vitamin D deficiency. NEJM 2007;357:266–81.CrossRefGoogle Scholar
  25. 25.
    Coates PS, et al. Gastric bypass surgery for morbid obesity leads to an increase in bone turnover and a decrease in bone mass. J Clin Endocrinol Metab 2004;89:1061–5.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Natalia Fendrikova Mahlay
    • 1
  • Lisena G. Verka
    • 1
    Email author
  • Kimberly Thomsen
    • 1
  • Srinivas Merugu
    • 1
  • Mark Salomone
    • 1
  1. 1.Saint Vincent Charity HospitalClevelandUSA

Personalised recommendations