Vitamin D Levels After Bariatric Surgery in Women Below and Above 45 Years
Overview
This study evaluated vitamin D status before and after metabolic bariatric surgery (MBS) in women under and over 45 years of age. Vitamin D levels increased significantly after surgery in both groups but remained consistently lower in women under 45 years at 12 and 24 months. Calcium levels decreased over time, and parathyroid hormone (PTH) levels were lower in younger women at baseline.
Background
Obesity is linked to decreased circulating vitamin D due to factors such as sequestration in adipose tissue and reduced sun exposure. Vitamin D deficiency can lead to bone disorders, muscle weakness, and insulin resistance. Metabolic bariatric surgery is effective for severe obesity but may worsen vitamin D deficiency by reducing dietary intake and absorption. Calcium and vitamin D status are particularly important in women of childbearing age and postmenopausal women due to differing physiological demands and hormonal influences.
Data Highlights
Parameter
Wu45 (Mean ± SD)
Wo45 (Mean ± SD)
p-value
Baseline BMI (kg/m2)
50.4 ± 8.1
49.2 ± 6.9
ns
Vitamin D baseline (nmol/L)
33.7 ± 23.2
37.4 ± 27.0
ns
Vitamin D at 12 months (nmol/L)
53.9
60.0
0.02
Vitamin D at 24 months (nmol/L)
51.9
60.7
0.03
Adjusted Calcium baseline (mmol/L)
2.32 ± 0.10
2.34 ± 0.10
ns
BMI at 24 months (kg/m2)
33.9
32.7
ns
Key Findings
Both age groups experienced significant weight loss after bariatric surgery with no significant difference in BMI at 24 months.
Vitamin D levels increased significantly within 4 months post-surgery in all women.
Women under 45 had significantly lower vitamin D levels at 12 and 24 months compared to women over 45.
Serum adjusted calcium levels decreased over 24 months in both groups.
Baseline PTH levels were lower in women under 45 years compared to those over 45.
Clinical Implications
Post-bariatric surgery vitamin D supplementation is critical, especially in women under 45 who may remain at risk for lower vitamin D levels despite supplementation. Monitoring calcium and PTH levels is important to prevent bone-related complications. Tailored supplementation strategies may be needed based on age and menopausal status to optimize bone health and metabolic outcomes.
Conclusion
Metabolic bariatric surgery improves vitamin D status in women with severe obesity, but younger women remain at risk for lower vitamin D levels postoperatively. Ongoing monitoring and supplementation are essential to address age-related differences in vitamin D metabolism after surgery.
References
Author/Source/Year -- Evaluation of Vitamin D Concentrations Following Metabolic Bariatric Surgery in Women Aged Below and Above 45 Years
A long-term cohort study found that obesity was not associated with worse patient-reported outcomes or higher reoperation rates following total ankle replacement in optimized surgical candidates.
A four-factor staging system stratified response rates from 90.9% to 37.5% in a retrospective cohort study, although the model showed only moderate discrimination (C statistic, 0.68) and requires external validation
