Format

Send to

Choose Destination
Obes Surg. 2017 May;27(5):1196-1207. doi: 10.1007/s11695-016-2437-0.

Vitamin D3 Loading Is Superior to Conventional Supplementation After Weight Loss Surgery in Vitamin D-Deficient Morbidly Obese Patients: a Double-Blind Randomized Placebo-Controlled Trial.

Author information

1
Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
2
Special Institute for Preventive Cardiology and Nutrition-SIPCAN Save Your Life, Salzburg, Austria.
3
Institute of Social Medicine, Centre for Public Health, Medical University of Vienna, Vienna, Austria.
4
Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria. renate.kruschitz@meduniwien.ac.at.
5
Department of Medicine 1 and Karl Landsteiner Institute for Obesity and Metabolic Diseases, Rudolfstiftung Hospital, Juchgasse 25, 1030, Vienna, Austria. renate.kruschitz@meduniwien.ac.at.
6
Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria.
7
Division of General Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria.
8
Department of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria.
9
Division of Internal Medicine, Krankenhaus der Barmherzigen Brüder Salzburg, Salzburg, Austria.
10
Clinical Institute for Medical and Chemical Laboratory Diagnostics, Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria.
11
Department of Medicine 1 and Karl Landsteiner Institute for Obesity and Metabolic Diseases, Rudolfstiftung Hospital, Juchgasse 25, 1030, Vienna, Austria.

Abstract

BACKGROUND:

Bariatric patients often suffer from vitamin D deficiency (VDD), and both, morbid obesity and VDD, are related to non-alcoholic fatty liver disease. However, limited data are available regarding best strategies for treating VDD, particularly, in bariatric patients undergoing omega-loop gastric bypass (OLGB). Therefore, we examined the efficacy and safety of a forced vitamin D dosing regimen and intervention effects in liver fibrotic patients.

METHODS:

In this double-blind, randomized, placebo-controlled trial, 50 vitamin D-deficient patients undergoing OLGB were randomly assigned to receive, in the first month postoperatively, oral vitamin D3 (≤3 doses of 100,000 IU; intervention group) or placebo as loading dose (control group) with subsequent maintenance dose (3420 IU/day) in both groups until 6-month visit.

RESULTS:

Compared with control group, higher increase of 25(OH)D (67.9 (21.1) vs. 55.7 nmol/L (21.1); p = 0.049) with lower prevalence of secondary hyperparathyroidism (10 vs. 24 %; p = 0.045) was observed in intervention group. No (serious) adverse events related to study medication were found. The loading dose regimen was more effective in increasing 25(OH)D in patients with significant liver fibrosis while this was not the case for conventional supplementation (placebo with maintenance dose) (71.5 (20.5) vs. 22.5 nmol/L (13.8); p = 0.022; n = 14).

CONCLUSIONS:

Our findings indicate that a high vitamin D3 loading dose, in the first month postoperatively, with subsequent maintenance dose is effective and safe in achieving higher vitamin D concentrations in OLGB patients. Unexpectedly, it is more effective in patients with significant liver fibrosis which is of potentially high clinical relevance and requires further investigation.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT02092376.

KEYWORDS:

Gastric bypass; Liver fibrosis; Obesity; Omega-loop gastric bypass; Secondary hyperparathyroidism; Vitamin D; Vitamin D supplementation; Weight loss

PMID:
27837387
PMCID:
PMC5403855
DOI:
10.1007/s11695-016-2437-0
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center