袖状胃切除术后补充维生素 D 对维生素 D 状态和身体组成的影响:日本患者的回顾性研究

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摘要

方法从病历中收集了83名接受袖带胃切除术(SG)的患者(中位年龄44岁,体重指数40.4 kg/m2)的临床数据,并进行了回顾性分析。在这 83 名患者中,37 人在手术前至术后 12 个月期间接受了持续的本地维生素 D3 补充指导,被定义为维生素 D 补充(VDS)组,46 人未接受此类指导,被定义为对照组。术前和术后就诊时,由营养师提供原生维生素 D3 补充剂。结果在 VDS 组中,血液中 25- 羟基维生素 D(25OHD)的水平从基线时的 18.5 显著增加到术后 3 个月时的 29.7 纳克/毫升,然后趋于稳定,而对照组的 25OHD 水平仍然很低。在包括两组的分析中,25OHD水平从基线到术后12个月的变化与维生素D平均摄入量(r = 0.596,p <0.001)和SG术后12个月/基线的下肢骨骼肌质量百分比比(r = 0.469,p <0.05)显著相关。多元回归分析发现,25OHD水平的变化和平均运动时间是与12个月SG后/基线下肢骨骼肌质量百分比比值独立相关的重要因素。
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Effects of native vitamin D supplementation on vitamin D status and body composition after sleeve gastrectomy: A retrospective study in Japanese patients

Introduction

The effect of vitamin D status after bariatric surgery on postoperative skeletal muscle condition has not been adequately studied.

Methods

Clinical data from 83 patients (median age 44 years, BMI 40.4 kg/m2) who underwent sleeve gastrectomy (SG) were collected from medical records and analyzed retrospectively. Of the 83 patients, 37 who received continuous guidance on native vitamin D3 supplementation from before to 12 months after surgery were defined as the vitamin D supplementation (VDS) group, and 46 patients who did not receive such guidance as the control group. Native vitamin D3 supplement was provided by a dietitian at preoperative and postoperative visits. The supplementation dose was prescribed at 3000 IU/day after SG.

Results

In VDS group, blood 25-hydroxyvitamin D (25OHD) level increased significantly from 18.5 at baseline to 29.7 ng/mL at 3 months after surgery and plateaued, while 25OHD level remained low in the control group. In the analysis that included both groups, change in 25OHD level from baseline to 12 months after surgery correlated significantly with mean vitamin D intake (r = 0.596, p < 0.001) and 12-month post-SG/baseline ratio of percent lower limb skeletal muscle mass (r = 0.469, p < 0.05). Multiple regression analysis identified change in 25OHD level and mean exercise time as significant factors independently associated with 12-month post-SG/baseline ratio of percent lower limb skeletal muscle mass.

Conclusion

Vitamin D3 supplementation after SG is useful for improving vitamin D status that may be associated with prevention of postoperative lower limb skeletal muscle mass loss.
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