Abstract
Summary
Vitamin D deficiency has been reported in patients with gastrointestinal disorders. Little is known on the potentially deleterious effect of cholecystectomy on vitamin D levels and osteoporosis. We found that 25-hydroxyvitamin D levels and bone mineral density were lower in patients with prior cholecystectomy.
Purpose
The influence of bile salts on vitamin D absorption is well-known, and increased incidence of vitamin D deficiency has been reported in patients with gastrointestinal disorders. Little is known on the potentially deleterious effect of cholecystectomy on vitamin D levels and osteoporosis. Herein, we aimed to investigate the effects of cholecystectomy on vitamin D levels and osteoporosis in postmenopausal women.
Methods
The study group comprised 50 postmenopausal women who had previously undergone cholecystectomy; the control group comprised 50 age-matched postmenopausal women. Serum vitamin D, calcium, and phosphorus levels were determined. Bone mineral density (BMD) was determined using dual-energy X-ray absorptiometry.
Results
The study group had significantly higher parathyroid hormone levels (94.4 ± 45.1 vs. 69.2 ± 37.5, p < 0.001) but significantly lower 25-hydroxyvitamin D levels (16.3 ± 7.6 vs. 19.8 ± 8.7, p = 0.03). Compared with the control group, the BMDs of both the lumbar spine (− 1.5 ± 1.0 vs. − 0.9 ± 1.0, p = 0.004) and femur (− 0.5 ± 0.8 vs. 0.19 ± 1.1, p = 0.001) were significantly lower in the study group. Body mass index [B = 0.81 (CI 0.67–0.98), p = 0.03] and prior cholecystectomy [B = 7.9 (CI 1.0–71.7), p = 0.04] were independent predictors of osteoporosis.
Conclusion
In postmenopausal women, prior cholecystectomy is associated with lower serum 25-hydroxyvitamin D levels and BMD.
Similar content being viewed by others
References
Kanis JA (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group Osteoporos Int 4:368–381
Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141
Hernlund E, Svedbom A, Ivergård M, Compston J, Cooper C, Stenmark J, McCloskey EV, Jönsson B, Kanis JA (2013) Osteoporosis in the European Union: medical management, epidemiology and economic burden. A report prepared in collaboration with the International Osteoporosis Foundation (IOF) and the European Federation of Pharmaceutical Industry Associations (EFPIA). Arch Osteoporos 8:136
Guillemin F, Martinez L, Calvert M, Cooper C, Ganiats T, Gitlin M, Horne R, Marciniak A, Pfeilschifter J, Shepherd S, Tosteson A, Wade S, Macarios D, Freemantle N (2013) Fear of falling, fracture history, and comorbidities are associated with health-related quality of life among European and US women with osteoporosis in a large international study. Osteoporos Int 24:3001–3010
Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A (2007) Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. J Bone Miner Res 22:465–475
Phetfong J, Sanvoranart T, Nartprayut K et al (2016) Osteoporosis: the current status of mesenchymal stem cell-based therapy. Cell Mol Biol Lett 12:21
Bilkle DD (1992) Bone disease due to nutritional, gastrointestinal, and hepatic disorders. In: Coe FL, Farus MJ (eds) Disorders of bone and mineral metabolism. Raven Press, New York, pp 951–971
Glasgow RE, Mulvihill SJ (2010) Treatment of gallstone disease. In: Feldman M, Friedman LS, Brandt LJ (eds) Sleisenger and Fordtran’s gastrointestinal and liver disease, 9th edn. Saunders Elsevier, Philadelphia
Stoker GE, Buchowski JM, Stoker ME (2012) Prior cholecystectomy as a predictor of preoperative vitamin D deficiency in adults undergoing spine surgery. Arch Surg 147:577–578
Schüle S, Rossel JB, Frey D, Biedermann L, Scharl M, Zeitz J, Freitas-Queiroz N, Kuntzen T, Greuter T, Vavricka SR, Rogler G, Misselwitz B, Swiss IBD cohort study (2017) Widely differing screening and treatment practice for osteoporosis in patients with inflammatory bowel diseases in the Swiss IBD cohort study. Medicine (Baltimore) 96(22):e6788. https://doi.org/10.1097/MD.0000000000006788.
Skare TL (2007) Reumatologia: princípios e prática. Guanabara Koogan, Rio de Janeiro
Lacativa PGS, Farias MLF (2010) Osteoporosis and inflammation. Arq Bras Endocrinol Metabol 54:123–132
Weinstein RS (2011) Glucocorticoid-induced bone disease. N Engl J Med 365:62–70
Marcinowska-Suchowierska EB, Tałałaj MJ, Włodarcyzk AW, Bielecki K, Zawadzki JJ, Brzozowski R (1995) Calcium/phosphate/vitamin D homeostasis and bone mass in patients after gastrectomy, vagotomy, and cholecystectomy. World J Surg 19:597–601 discussion 601–2
Rao DS, Kleerekoper M, Rogers M (1984) In: Osteoporosis CC, Overgaard K (eds) Is gastrectomy a risk factor for osteoporosis? Osteopress ApS, Copenhagen, pp 775–777
Kotze LM, Costa CT, Cavassani MF, Nisihara RM (2017) Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease. Rev Assoc Med Bras 63:13–17
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
This cross-sectional analytical study was approved by the Research Ethics Committee of the Recep Tayyip Erdogan University Hospital. All participants provided written informed consent before participating in the study.
Conflicts of interest
None.
Rights and permissions
About this article
Cite this article
Polat, H.B., Beyazal, M.S. The effect of cholecystectomy on 25-hydroxyvitamin D levels and bone mineral density in postmenopausal women. Arch Osteoporos 13, 61 (2018). https://doi.org/10.1007/s11657-018-0458-0
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s11657-018-0458-0