Two-Year Nutrition Data in Terms of Vitamin D, Vitamin B12, and Albumin After Bariatric Surgery and Long-term Fracture Data Compared with Conservatively Treated Obese Patients: a Retrospective Cohort Study

Javanainen, Mervi; Pekkarinen, Tuula; Mustonen, Harri; Scheinin, Tom; Leivonen, Marja

doi:10.1007/s11695-018-3336-3

Cited by 24 publications

(18 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These divergent results might be partly explained by different reference values and surgical procedures performed. The present data is in line with a report by Javanainen et al who observed a prevalence of vitamin B 12 deficiency in 1 to 3% of patients 2 years after bariatric surgery when using a comparable reference value (138 pmol/l) [25].…”

Section: Discussionsupporting

confidence: 93%

Psychopharmacological Medication Has No Influence on Vitamin Status After Bariatric Surgery in Long-term Follow-up

et al. 2020

View full text Add to dashboard Cite

Context A substantial number of patients undergoing bariatric surgery are prescribed psychopharmacological medication. However, the impact of concomitant psychopharmacological medication on the frequency of relevant vitamin deficiencies in postoperative follow-up is not known. Methods Five hundred twenty-four patients with obesity who underwent bariatric surgery (January 2004 to September 2018) with follow-up of at least 12 months, were included in retrospective analysis. Postoperative follow-up visits between January 2015 and September 2019 were analyzed. Anthropometric and laboratory data were analyzed at the first documented follow-up visit after on average 39.5 ± 37.3 months and at every following visit during the observation period. Patients with prescribed psychopharmacological drugs (PD) were compared with patients without (control group, CON). Results Psychopharmacological medication was documented in 25% (132) of patients. In 59 patients documented prescription of more than one psychiatric drug was found, whereas psychopharmacological monotherapy was found in 73 patients. Frequencies of vitamin deficiencies were comparable between PD and CON (vitamin A: p = 0.852; vitamin D: p = 0.622; vitamin E: p = 0.901; folic acid: p = 0.941). Prevalence of vitamin B12 deficiency was rare (6% CON, 1% PD) but was significantly higher in CON (p = 0.023). A comparison of CON and POLY also showed no significant differences between the groups concerning prevalence of vitamin deficiencies. Conclusions Intake of psychopharmacological medication is highly prevalent in patients after bariatric surgery. Patients with psychopharmacological medication, who participate in structured follow-up care after bariatric surgery, are not at higher risk for vitamin deficiencies compared with controls.

show abstract

Section: Discussionsupporting

confidence: 93%

Psychopharmacological Medication Has No Influence on Vitamin Status After Bariatric Surgery in Long-term Follow-up

et al. 2020

View full text Add to dashboard Cite

show abstract

“…The authors also found that calcium and vitamin D supplementation was independent of fracture risk after gastric bypass surgery, which is in agreement with recent data showing that vitamin D status after bariatric surgery was not a risk factor for fractures . Indeed, these findings are compatible with results from a prospective study including obese premenopausal women with either type of bariatric surgery, sleeve gastrectomy or Roux‐en‐Y gastric bypass, that the latter type caused significantly larger bone loss in the femoral neck, but not the lumbar spine, compared with the former type as expected, whereas both types markedly and similarly reduced calcium absorption in the gut .…”

supporting

confidence: 88%

Bariatric Surgery, Physical Activity, and Fracture Risk

Sugiyama

2018

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

In a large retrospective cohort study using Swedish national databases, Axelsson and colleagues (1) recently showed that gastric bypass surgery was associated with an increased risk of fractures, which appeared to become significant over time and is consistent with longer-term results of another recent study (2) in the US. Fracture risk after bariatric surgery is a timely and important issue, and these significant findings, including an increased risk of falls, (1) should be considered when reviewing the latest meta-analysis on this topic. (3)(4)(5)(6) Here, I would like to discuss two commonly proposed mechanisms of bone loss after bariatric surgery, reduced mechanical loading and calcium/ vitamin D malabsorption, on the basis of the authors' results. (1) As has been previously pointed out, no relationship between weight loss and fracture risk was observed. (1) This does not necessarily suggest that reduced mechanical loading is not the mechanism by which gastric bypass surgery resulted in an increased risk of fractures because mechanical loading during physical activity is engendered not only by gravitational force but also by muscle contraction. Of note, effects of skeletal loading essentially depend on mechanical strain-related stimuli; for example, strain rate is one of the key determinants and bones respond to dynamic, but not static, mechanical loading. (7) Accordingly, longer-term bone loss compared with weight loss and bone loss in the non-weight-bearing regions can be both explained, at least in part, by the functional muscle-bone unit, (8) and physical activity (5) rather than weight loss after bariatric surgery could be linked to fracture risk that appeared to increase with time. (1) The authors also found that calcium and vitamin D supplementation was independent of fracture risk after gastric bypass surgery, (1) which is in agreement with recent data showing that vitamin D status after bariatric surgery was not a risk factor for fractures. (9) Indeed, these findings are compatible with results from a prospective study including obese premenopausal women with either type of bariatric surgery, sleeve gastrectomy or Roux-en-Y gastric bypass, that the latter type caused significantly larger bone loss in the femoral neck, but not the lumbar spine, compared with the former type as expected, whereas both types markedly and similarly reduced calcium absorption in the gut. (10) Here, it should be paid attention that physical activity (11) can also provide an insight into such limited effects of calcium/vitamin D malabsorption after bariatric surgery. Nevertheless, adequate intakes of calcium/vitamin D as well as protein have been generally recommended for patients who have had bariatric surgery, (12) and randomized controlled trials are expected to identify the optimal doses of calcium/vitamin D supplementation in the near future.

show abstract

“…Sugiyama further concludes that our results agree with a recent study reporting that vitamin D status was not a predictor of fracture in patients who had undergone gastric bypass surgery . We do not believe that the study by Javanainen and colleagues is particularly strong in terms of finding determinants of fracture risk because the power in the analysis was rather insufficient, with only 31 fractures in the RYGB group and 17 among the controls.…”

supporting

confidence: 86%

Reply to: Bariatric Surgery, Physical Activity, and Fracture Risk

Axelsson

Lorentzon

2018

Journal of Bone and Mineral Research

View full text Add to dashboard Cite

Two-Year Nutrition Data in Terms of Vitamin D, Vitamin B12, and Albumin After Bariatric Surgery and Long-term Fracture Data Compared with Conservatively Treated Obese Patients: a Retrospective Cohort Study

Abstract: Vitamin 25(OH)D, B12, and albumin levels were mainly within recommended levels during the 2 years after bariatric surgery. The cumulative fracture risk was higher in bariatric patients.

Cited by 24 publications

References 37 publications

Psychopharmacological Medication Has No Influence on Vitamin Status After Bariatric Surgery in Long-term Follow-up

Psychopharmacological Medication Has No Influence on Vitamin Status After Bariatric Surgery in Long-term Follow-up

Bariatric Surgery, Physical Activity, and Fracture Risk

Reply to: Bariatric Surgery, Physical Activity, and Fracture Risk

Contact Info

Product

Resources

About