1. Adherence to Nutritional Supplementation Determines Postoperative Vitamin D Status, but Not Levels of Bone Resorption Marker, in Sleeve-Gastrectomy Patients
- Author
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Huey-Mei Shaw, Wan-Ching Yang, Chi-Hsuan Lin, Wan-Lin Hsu, Yao-Cheng Lu, Pei-Min Chao, Chih-Kun Huang, Chin-Ching Wu, and Wen-Ling Liao
- Subjects
medicine.medical_specialty ,Nutritional Supplementation ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Parathyroid hormone ,030209 endocrinology & metabolism ,Gastroenterology ,Bone resorption ,Bone remodeling ,03 medical and health sciences ,0302 clinical medicine ,N-terminal telopeptide ,Gastrectomy ,Internal medicine ,Vitamin D and neurology ,medicine ,Humans ,Bone Resorption ,Vitamin D ,Nutrition and Dietetics ,biology ,business.industry ,Vitamin E ,Vitamin D Deficiency ,Obesity, Morbid ,Ferritin ,Parathyroid Hormone ,Dietary Supplements ,biology.protein ,030211 gastroenterology & hepatology ,Surgery ,business - Abstract
Taking advantage of isomeric form of vitamin E in the supplement, adherence to supplement could be evaluated by changes in circulating α- and γ-tocopherol concentrations. Accordingly, effects of supplementation on postoperative nutrition and bone metabolism were studied in terms of adherence. Thirty-eight SG patients were all prescribed a postoperative nutritional supplement containing a low dose of vitamin D (600 IU) and calcium (200 mg). Blood samples were collected prior to (M0) and 6 months after (M6) surgery and concentrations of nutrients and C-terminal telopeptide of type I collage (CTX), a marker of bone resorption, were measured. Adherence and non-adherence were stratified according to change (△, M6-M0) in serum α-tocopherol concentrations (> 0 vs. ≤ 0, respectively). When M0 and M6 were compared, there were significant increases in serum concentrations of 25(OH)D, α-tocopherol and selenium, whereas there were reductions in parathyroid hormone, ferritin, and γ-tocopherol. At M6, the prevalence of vitamin D insufficiency (25(OH)D < 30 ng/mL) and high CTX were 72 and 26%, respectively. When comparison was made between adherence and non-adherence, only △25(OH)D concentrations, but no other nutrients nor postoperative CTX differed. Multiple linear regression demonstrated that postoperative vitamin D status was independently associated with its preoperative concentrations (β = 0.85, p < 0.001) and adherence (β = 0.52, p < 0.05). SG patients’ adherence to supplementation, even with a low dose of vitamin D and calcium, determined vitamin D status but not bone resorption marker concentrations, at least within 6 months after surgery.
- Published
- 2021