Hipovitaminosis D y obesidad mórbida: efectos de la cirugía bariátrica
There is scarce and flawed data regarding vitamin D status in morbidly obese patients. More often than not, vitamin D deficits have been linked with bariatric surgery not considering that the deficit may well precede surgery. Moreover, there are several patho-physiological mechanisms well described in non-surgical morbidly obese patients which partially explain vitamin D deficits including the negative feedback on hepatic 25-OH-Vitamin D synthesis, sunlight underexposure and diminished bio-availability of Vitamin D due to enhanced uptake by adipose tissue.
On the other hand, the association between vitamin D deficits and secondary hyperparathyroidism in morbidly obese patients has been reported prior to and after bariatric surgery. The studies carried out in this Thesis suggest that this surgery is unlikely to cause vitamin D deficits. This latter line of thought contradicts the well established health-belief stating that hypovitaminosis D was frequently encountered after bariatric surgery and indicates that in the vast majority of patients undergoing these procedures, hypovitaminosis D preceded surgery.
In conclusion, taken into account the elevated prevalence of vitamin D deficits in morbidly obese patients, its associated co-morbidity and the efficacy and low-cost of its treatment to restore normal serum values of 25 (OH) Vitamin D, it seems advisable to recommend routine monitoring of serum calcium, phosphorus, and 25-OH-vitamin D levels in morbidly obese patients and implement calcium and vitamin D supplementation whenever necessary.
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Advisor:Pérez Pérez, Antonio; De Leiva Hidalgo, Alberto
School:Universitat Autónoma de Barcelona
Source Type:Master's Thesis
Keywords:417 departament de medicina
Date of Publication:01/31/2007