cirurgia bariátrica, deficiência de vitamina D, obesidade, suplementação
Resumo
Introdução: A obesidade é uma doença crônica, caracterizada pelo excesso de tecido adiposo. Diante dos casos severos, a cirurgia bariátrica é o tratamento mais eficaz para controle do quadro e das comorbidades associadas. O principal método cirúrgico atualmente é o bypass gástrico em Y-de-Roux com formação de uma bolsa gástrica na curvatura menor, criando um novo trânsito gastro-intestinal através da alça jejunal, excluindo a maior parte do estômago, do duodeno e jejuno principal. Isso culminará em alterações como perda ponderal e na redução da absorção de macro e micronutrientes, sendo necessário a suplementação e o acompanhamento dos pacientes submetidos a este procedimento. A hipovitaminose pode culminar em doenças inflamatórias crônicas ou autoimunes, osteoporose, doenças vasculares e entre outras. Objetivo: Identificar a importância da vitamina D em pacientes obesos submetidos à cirurgia bariátrica e analisar as consequências de sua deficiência. Material e métodos: Realizou-se uma revisão sistemática em bancos de dados como: Livraria Científica Online – SCIELO, Brazilian Journal of Development (BJD), Revista Brasileira de Videocirurgia, Revista Médica de Minas Gerais (RMMG). O período amostral entre 2005 e 2020. Resultados: Estudos demonstram que o déficit de vitamina D está relacionado com maior captação deste micronutriente pelos adipócitos e com o mecanismo de regulação do apetite, justificando sua presença em obesos antes do procedimento cirúrgico. A cirurgia bariátrica afeta diretamente a via de absorção desse micronutriente, pois ao excluir partes do trato gastrointestinal, dificulta sua absorção, repercutindo negativamente em seus níveis. Resultados de até 20 ng/mL indicam deficiência, entre 21-29 ng/mL corresponde a insuficiência e de 30-100 ng/mL, como suficiente, sendo este o alvo da suplementação implementada por via oral ou injetável. Caso os pacientes que realizam procedimentos que resultam em alterações disabsortivas, haverá deficiência de micronutrientes e consequentemente alterações músculo-esqueléticas como a osteoporose e a osteomalácia, além de colaborar para o desenvolvimento de malignidades, doenças inflamatórias e autoimunes. Conclusão: A deficiência de vitamina D em pacientes bariátricos é uma condição resultante da obesidade e da cirurgia que tem como terapêutica o acompanhamento dos níveis e sua suplementação pré e pós-operatória visando a manutenção da saúde e prevenção de agravos.
Publicado
2020-07-01
Como Citar
Rocha Assis, M. ., Taveira Azevedo, R. C. ., Chaves Barbosa, P., Almeida Brito, A. ., & Alves Silva, M. S. . (2020). CIRURGIA BARIÁTRICA E DEFICIÊNCIA DE VITAMINA D. Revista Multidisciplinar Em Saúde, 1(2), 60. Recuperado de http://editoraime.com.br/revistas/rems/article/view/249
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