Nutritional Status of Obese Taiwanese Before Bariatric-Metabolic Surgery and Their Serum 25-Hydroxyvitamin D Concentrati
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ORIGINAL CONTRIBUTIONS
Nutritional Status of Obese Taiwanese Before Bariatric-Metabolic Surgery and Their Serum 25-Hydroxyvitamin D Concentrations for Maximal Suppression of Parathyroid Hormone Chi-Hsuan Lin 1,2 & Wen-Ling Liao 3,4 & Chin-Ching Wu 5 & Huey-Mei Shaw 6 & Wan-Lin Hsu 2 & Yao-Cheng Lu 2 & Jyun-Siang Yang 6 & Chih-Kun Huang 2 & Pei-Min Chao 1 Received: 07 May 2020 / Revised: 31 May 2020 / Accepted: 31 May 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background This is the first report from Taiwan using laboratory tests to assess nutritional status of patients with obesity before bariatric-metabolic surgery. Moreover, the 25(OH)D threshold for maximal suppression of parathyroid hormone (PTH) was evaluated to offer a reference value for preoperative nutritional care. Methods Inclusion criteria were Taiwanese, 18–65 years old, and with BMI ≥ 27.5 kg/m2 awaiting bariatric-metabolic surgery. Anthropometric data and blood samples were collected before surgery. Serum concentrations of protein; vitamins B1, B12, folate, A, D, and E; calcium; iron; zinc; copper; selenium; PTH; and erythrocyte glutathione reductase activity coefficient (vitamin B2 status) were measured. Results For 52 participants with a mean BMI 37.6 ± 6.4 kg/m2, vitamin D deficiency (25(OH)D < 20 ng/mL) and insufficiency (20 < 25(OH)D < 30 ng/mL) were at 73 and 22% prevalence, respectively. Secondary hyperparathyroidism (PTH ≧ 65 pg/mL) was 24% and hypocalcemia was 50% (ionized Ca < 4.5 mg/dL). Deficiency of other nutrients was sporadic (< 10%) or nil. When participants were stratified according to 25(OH)D concentrations (< 10, 10–15, 15–20, and ≥ 20 ng/mL), PTH increased at 25(OH)D < 10 ng/mL (β = 48.34, p = 0.001) after adjusting for age, gender, and BMI. Conclusion For patients with obesity before bariatric-metabolic surgery, vitamin D/calcium deficiency was the only nutritional issue that needs to be addressed in Taiwan. However, a lower cutoff point of 25(OH)D, i.e., 10 ng/mL, for vitamin D deficiency may be considered for patients before surgery. Trial Registration ClinicalTrials.gov Identifier: NCT03915158
Chi-Hsuan Lin and Wen-Ling Liao contributed equally to this work. * Chih-Kun Huang [email protected] * Pei-Min Chao [email protected]
Jyun-Siang Yang [email protected] 1
Department of Nutrition, China Medical University, 91 Hsueh-Shih Road, Taichung 404, Taiwan
2
Body Science and Metabolic Disorders International (B.M.I.) Medical Center, China Medical University Hospital, 2 Yude Road, Taichung 404, Taiwan
3
Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
4
Center for Personalized Medicine, China Medical University Hospital, Taichung, Taiwan
Wan-Lin Hsu [email protected]
5
Department of Public Health, China Medical University, Taichung, Taiwan
Yao-Cheng Lu [email protected]
6
Department of Health and Nutrition, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan
Chi-Hsuan Lin [email protected] Wen-Ling L
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