Page 28 - WJOLS - Journal of Laparoscopic Surgery

WJOLS

Hypocalcemia and Vitamin D Deficiency in Patients Post-bariatric Surgery
Types of Outcome finally debilitating the bones and then leading to the
likelihood of fractures in the postoperative period.
Essential outcome was engaged in vitamin D and calcium 21
inadequacy; nonetheless, conceivable bone fractures Avgerinos et al in their essential prospective cohort
were investigated after bariatric surgery. As auxiliary in people of the two sexual orientations for a period of
outcomes, connection between the kind of supplement 2 years have demonstrated the significance of vitamin D
administration and the body’s capability in engrossing supplementation to prevent the decline of calcium in
the administered medication was looked at; and the the bones.
dosages and their consequences for the maintenance or Research investigated women in pre- and postmeno-
recuperation of bone resorption after bariatric surgery pausal stages demonstrating that there was no critical dif-
were observed. ference between them in calcium absorption inadequacy
and even the differences in relationship to the sort of

Search Strategy surgery were not present. 17,18,23
As per this review, the sort of administration and
PubMed/Medline, Lilacs, Scielo, and Cochrane were dosage had no relationship or significance over time on
utilized with the headings “bariatric surgery,” “bone,” drug treatment. Nonetheless, no direct connection to the
“stoutness,” “vitamin D,” “calcium,” “AND” “assimila- postoperative bone loss was demonstrated. Vasconcelos
tion.” Following the collection of data, examination of the et al considered the calcium intake in the eating routine
18
title, perusing of the theoretical abstracts, the complete of 600 mg and supplemented with 200 mg as tablet form
perusing of the articles was made.
during the 22 months in the operated group. Although
the intake was fundamentally higher than in the nonop-
RESULTS
erated group, it was still lower than the prescribed levels
Table 1 shows the methodological characteristics of the for these patients, which ought to be between 1,000 and
selected studies. Of the five articles, three corresponded to 1,800 mg/day. 24-26
prospective cohort studies; 18-22 two used the laparoscopic Intake of vitamin D (500 IU) was likewise beneath
approach and one enrolled only women; there was one the prescribed levels. It can be deduced from the post-
case report and one case series. All assessed the nutri- operative vitamin supplementation that it ought not just
tional status and bone fractures, routes of administration, comprise multivitamins, since most do not contain the
as well as the respective dosage of vitamin D and calcium; calcium and vitamin D required and prescribed to be
one article evaluated the parathyroid hormone and its taken each day. The above changes may increase the
influence on bone reabsorption in RYGB. postoperative and preoperative screening; care ought
to be taken to prevent the changes in bone metabolism.
DISCUSSION Reasonable supplementation of vitamins and minerals is

The results of this systematic review are based on five basic to avoid or limit bone metabolic intricacies that can
publications. The research did not identify bone fractures happen after RYGB. 27
in patients undergoing bariatric surgery; nonetheless, Another important factor apart from vitamin D
there appeared high inadequacies in vitamin D and supplementation and calcium that may influence bone
calcium in the bones. The studies demonstrated the change in these patients is age, other than the differences
diverse ways of administration and the results, noting the in between women in premenopausal and postmeno-
different answers regarding insufficiencies that emerge pausal women that need particular approach. There are
in the bone tissue because of dose and adequacy, as different elements that can impact straightforwardly and
indicated by the route of administration. After bariatric add to bone resorption, which include lack of vitamin D,
surgery, all investigations pronounced outcomes with deficient calcium intake, and secondary hyperparathyroi-
deficiency in the bones of patients, paying little heed to dism, present sometimes in the obese. The parathyroid
the kind of bariatric surgery. All studies specified admin- hormone additionally increases the activity of osteoclasts,
istration of vitamin D and calcium by means of tablets or prompting bone cortical destruction to make up for the
infusions in various doses. abatement of serum calcium. 10
None of them exhibited complete loss of bone calcium, In connection with bone density and fracture preva-
yet demonstrated a critical distinction in bone resorp- lence, no significant differences in the studies were
tion, fundamentally by parathyroid hormone. Parathy- found. It is conceivable that the generally short follow-up
roid hormone increases the movement of osteoclasts, contributed to the lack of identification of bone fracture.
prompting the devastation of the cortical bone, indicat- Future research is needed to better elucidate the bone
ing a likewise marked inadequacy of vitamin D, 15,19 complications in these patients.
World Journal of Laparoscopic Surgery, September-December 2017;10(3):108-111 109