Vitamin D3 Loading Is Superior to Conventional Supplementation After Weight Loss Surgery in Vitamin D-Deficient Morbidly Obese Patients: a Double-Blind Randomized Placebo-Controlled Trial
Obesity Surgery, pp 1–12 First Online: 12 Nov. 2016, DOI: 10.1007/s11695-016-2437-0
Maria Luger Renate Kruschitz Christian Kienbacher Stefan Traussnigg Felix B. Langer Gerhard Prager Karin Schindler Enikö Kallay Friedrich Hoppichle rMichael Trauner Michael Krebs Rodrig Marculescu Bernhard Ludvik
Bariatric Surgery followed by
3420 IU for 6 months with/without 300,000 IU loading dose
28% of bariatric surgery patients had non-alcoholic fatty liver disease
40% of seniors have non-alcoholic fatty liver disease as well - see below
See also VitaminDWiki
- Fatty liver disease associated with low level of vitamin D – Oct 2013
- Non-Alcoholic Fatty Liver Disease (NAFLD) treated by Vitamin D (20,000 IU weekly after loading dose) – RCT June 2016
Loading dose was 140,000 IU spread over 1 week - Strong association of non alcoholic fatty liver disease and low vitamin D
- Prior to Bariatric Surgery 96 percent were vitamin D deficient – July 2014
- Non-alcoholic Fatty Liver Disease (4 in 10 seniors) and Vitamin D
NAFLD in seniors as well as Obese - should seniors have loading dose as well? - Search for Fatty Liver in VitaminDWiki 193 items Nov 2016
- Overview Loading of vitamin D
Download the PDF from VitaminDWiki
Background
Bariatric patients often suffer from vitamin D deficiency (VDD), and both, morbid obesity and VDD, are related to non-alcoholic fatty liver disease. However, limited data are available regarding best strategies for treating VDD, particularly, in bariatric patients undergoing omega-loop gastric bypass (OLGB). Therefore, we examined the efficacy and safety of a forced vitamin D dosing regimen and intervention effects in liver fibrotic patients.
Methods
In this double-blind, randomized, placebo-controlled trial, 50 vitamin D-deficient patients undergoing OLGB were randomly assigned to receive, in the first month postoperatively, oral vitamin D3 (=3 doses of 100,000 IU; intervention group) or placebo as loading dose (control group) with subsequent maintenance dose (3420 IU/day) in both groups until 6-month visit.
Results
Compared with control group, higher increase of 25(OH)D (67.9 (21.1) vs. 55.7 nmol/L (21.1); p = 0.049) with lower prevalence of secondary hyperparathyroidism (10 vs. 24 %; p = 0.045) was observed in intervention group. No (serious) adverse events related to study medication were found. The loading dose regimen was more effective in increasing 25(OH)D in patients with significant liver fibrosis while this was not the case for conventional supplementation (placebo with maintenance dose) (71.5 (20.5) vs. 22.5 nmol/L (13.8); p = 0.022; n = 14).
Conclusions
Our findings indicate that a high vitamin D3 loading dose, in the first month postoperatively, with subsequent maintenance dose is effective and safe in achieving higher vitamin D concentrations in OLGB patients. Unexpectedly, it is more effective in patients with significant liver fibrosis which is of potentially high clinical relevance and requires further investigation.
Clinicaltrials.gov (NCT02092376) at https://clinicaltrials.gov/