Andrea Giustina, Luigi di Filippo, Antonio Facciorusso, Robert A Adler, Neil Binkley, Jens Bollerslev, Roger Bouillon, Felipe F Casanueva, Giulia Martina Cavestro, Marlene Chakhtoura, Caterina Conte, Lorenzo M Donini, Peter R Ebeling, Angelo Fassio, Stefano Frara, Claudia Gagnon, Giovanni Latella, Claudio Marcocci, Jeffrey I Mechanick, Salvatore Minisola, René Rizzoli, Ferruccio Santini, Joseph L Shaker, Christopher Sempos, Fabio Massimo Ulivieri, Jyrki K Virtanen, Nicola Napoli, Anne L Schafer, John P Bilezikian
{"title":"减肥手术前后维生素D的状况和补充:基于系统综述和荟萃分析的建议。","authors":"Andrea Giustina, Luigi di Filippo, Antonio Facciorusso, Robert A Adler, Neil Binkley, Jens Bollerslev, Roger Bouillon, Felipe F Casanueva, Giulia Martina Cavestro, Marlene Chakhtoura, Caterina Conte, Lorenzo M Donini, Peter R Ebeling, Angelo Fassio, Stefano Frara, Claudia Gagnon, Giovanni Latella, Claudio Marcocci, Jeffrey I Mechanick, Salvatore Minisola, René Rizzoli, Ferruccio Santini, Joseph L Shaker, Christopher Sempos, Fabio Massimo Ulivieri, Jyrki K Virtanen, Nicola Napoli, Anne L Schafer, John P Bilezikian","doi":"10.1007/s11154-023-09831-3","DOIUrl":null,"url":null,"abstract":"<p><p>Bariatric surgery is associated with a postoperative reduction of 25(OH) vitamin D levels (25(OH)D) and with skeletal complications. Currently, guidelines for 25(OH)D assessment and vitamin D supplementation in bariatric patients, pre- and post-surgery, are still lacking. The aim of this work is to analyse systematically the published experience on 25(OH)D status and vitamin D supplementation, pre- and post-surgery, and to propose, on this basis, recommendations for management. Preoperatively, 18 studies including 2,869 patients were evaluated. Prevalence of vitamin D insufficiency as defined by 25(OH)D < 30 ng/mL (75 nmol/L) was 85%, whereas when defined by 25(OH)D < 20 ng/mL (50 nmol/L) was 57%. The median preoperative 25(OH)D level was 19.75 ng/mL. After surgery, 39 studies including 5,296 patients were analysed and among those undergoing either malabsorptive or restrictive procedures, a lower rate of vitamin D insufficiency and higher 25(OH)D levels postoperatively were observed in patients treated with high-dose oral vitamin D supplementation, defined as ≥ 2,000 IU/daily (mostly D3-formulation), compared with low-doses (< 2,000 IU/daily). Our recommendations based on this systematic review and meta-analysis should help clinical practice in the assessment and management of vitamin D status before and after bariatric surgery. Assessment of vitamin D should be performed pre- and postoperatively in all patients undergoing bariatric surgery. Regardless of the type of procedure, high-dose supplementation is recommended in patients after bariatric surgery.</p>","PeriodicalId":21106,"journal":{"name":"Reviews in Endocrine & Metabolic Disorders","volume":null,"pages":null},"PeriodicalIF":6.9000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10698146/pdf/","citationCount":"0","resultStr":"{\"title\":\"Vitamin D status and supplementation before and after Bariatric Surgery: Recommendations based on a systematic review and meta-analysis.\",\"authors\":\"Andrea Giustina, Luigi di Filippo, Antonio Facciorusso, Robert A Adler, Neil Binkley, Jens Bollerslev, Roger Bouillon, Felipe F Casanueva, Giulia Martina Cavestro, Marlene Chakhtoura, Caterina Conte, Lorenzo M Donini, Peter R Ebeling, Angelo Fassio, Stefano Frara, Claudia Gagnon, Giovanni Latella, Claudio Marcocci, Jeffrey I Mechanick, Salvatore Minisola, René Rizzoli, Ferruccio Santini, Joseph L Shaker, Christopher Sempos, Fabio Massimo Ulivieri, Jyrki K Virtanen, Nicola Napoli, Anne L Schafer, John P Bilezikian\",\"doi\":\"10.1007/s11154-023-09831-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Bariatric surgery is associated with a postoperative reduction of 25(OH) vitamin D levels (25(OH)D) and with skeletal complications. Currently, guidelines for 25(OH)D assessment and vitamin D supplementation in bariatric patients, pre- and post-surgery, are still lacking. The aim of this work is to analyse systematically the published experience on 25(OH)D status and vitamin D supplementation, pre- and post-surgery, and to propose, on this basis, recommendations for management. Preoperatively, 18 studies including 2,869 patients were evaluated. Prevalence of vitamin D insufficiency as defined by 25(OH)D < 30 ng/mL (75 nmol/L) was 85%, whereas when defined by 25(OH)D < 20 ng/mL (50 nmol/L) was 57%. The median preoperative 25(OH)D level was 19.75 ng/mL. After surgery, 39 studies including 5,296 patients were analysed and among those undergoing either malabsorptive or restrictive procedures, a lower rate of vitamin D insufficiency and higher 25(OH)D levels postoperatively were observed in patients treated with high-dose oral vitamin D supplementation, defined as ≥ 2,000 IU/daily (mostly D3-formulation), compared with low-doses (< 2,000 IU/daily). Our recommendations based on this systematic review and meta-analysis should help clinical practice in the assessment and management of vitamin D status before and after bariatric surgery. Assessment of vitamin D should be performed pre- and postoperatively in all patients undergoing bariatric surgery. 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Vitamin D status and supplementation before and after Bariatric Surgery: Recommendations based on a systematic review and meta-analysis.
Bariatric surgery is associated with a postoperative reduction of 25(OH) vitamin D levels (25(OH)D) and with skeletal complications. Currently, guidelines for 25(OH)D assessment and vitamin D supplementation in bariatric patients, pre- and post-surgery, are still lacking. The aim of this work is to analyse systematically the published experience on 25(OH)D status and vitamin D supplementation, pre- and post-surgery, and to propose, on this basis, recommendations for management. Preoperatively, 18 studies including 2,869 patients were evaluated. Prevalence of vitamin D insufficiency as defined by 25(OH)D < 30 ng/mL (75 nmol/L) was 85%, whereas when defined by 25(OH)D < 20 ng/mL (50 nmol/L) was 57%. The median preoperative 25(OH)D level was 19.75 ng/mL. After surgery, 39 studies including 5,296 patients were analysed and among those undergoing either malabsorptive or restrictive procedures, a lower rate of vitamin D insufficiency and higher 25(OH)D levels postoperatively were observed in patients treated with high-dose oral vitamin D supplementation, defined as ≥ 2,000 IU/daily (mostly D3-formulation), compared with low-doses (< 2,000 IU/daily). Our recommendations based on this systematic review and meta-analysis should help clinical practice in the assessment and management of vitamin D status before and after bariatric surgery. Assessment of vitamin D should be performed pre- and postoperatively in all patients undergoing bariatric surgery. Regardless of the type of procedure, high-dose supplementation is recommended in patients after bariatric surgery.
期刊介绍:
Reviews in Endocrine and Metabolic Disorders is an international journal dedicated to the field of endocrinology and metabolism. It aims to provide the latest advancements in this rapidly advancing field to students, clinicians, and researchers. Unlike other journals, each quarterly issue of this review journal focuses on a specific topic and features ten to twelve articles written by world leaders in the field. These articles provide brief overviews of the latest developments, offering insights into both the basic aspects of the disease and its clinical implications. This format allows individuals in all areas of the field, including students, academic clinicians, and practicing clinicians, to understand the disease process and apply their knowledge to their specific areas of interest. The journal also includes selected readings and other essential references to encourage further in-depth exploration of specific topics.