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Adolescent surgery

Study urges Vitamin D deficiency screening

45% of adolescents undergoing evaluation for weight-loss surgery were vitamin D deficient, according to Censani.
Majority of adolescents preparing for surgery were deficient in vitamin D
African Americans most likely to be deficient

Adolescents should undergo vitamin D deficiency screening before having bariatric surgery, according to research presented at The Endocrine Society's 94th Annual Meeting.

The study, carried out researchers at Columbia University Medical Center, New York, found that the majority of adolescents preparing for surgery were deficient in vitamin D.

“This is particularly important prior to bariatric surgery where weight loss and decreased calcium and vitamin D absorption in some procedures may place these patients at further risk particularly as they have not reached their peak bone mass,” said study lead author Dr Marisa Censani, pediatric endocrinology fellow at Columbia.

“These results provide insight into prevalence and risk factors for pre-existing vitamin D deficiency in obese adolescents prior to bariatric surgery.”

While previous studies have found an increased risk of vitamin D deficiency among adults evaluated for weight-loss surgery, whether this deficiency also occurred among morbidly obese adolescents remained unclear. The investigators conducted the study to determine the prevalence of vitamin D deficiency in morbidly obese adolescents evaluated for bariatric surgery

Study

Investigators analysed the medical records of 236 adolescents who were being considered for bariatric surgery between March 2006 and June 2011. Of these patients, 219 provided medical records that included data on vitamin D levels. 65% were female, their average age was 16 years and a mean BMI 48.2. 43% were Caucasian, 35% were Hispanic and 15% were African American.

The study defined levels of serum 25OHD as:

  • Adequate >30ng/mL
  • Insufficient 20-29 ng/mL
  • Deficient <20ng/mL
  • Severely deficient <10ng/mL

Censani and her co-investigators found that 45% of adolescents undergoing evaluation for weight-loss surgery were vitamin D deficient and 9% had severe deficiencies (totalling 54% of the patient group). 29% and 17% had insufficient and adequate vitamin D levels, respectively.

They also reported that patients with the highest BMIs were the most likely to be vitamin deficient, with each kilogram increase in BMI correlating with a 0.2ng decrease in 25OHD levels.

The investigators also identified several racial differences and reported that African Americans (82%) were the most likely to be vitamin D deficient, followed by Hispanics (59%), while Caucasians (37%) were the least likely to have a deficiency.

"These results support screening all morbidly obese adolescents for vitamin D deficiency, and treating those who are deficient, particularly prior to bariatric procedures that could place these patients at further risk," Censani said.

The NIH National Institute of Diabetes and Digestive and Kidney Diseases funded the study.

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