Associations of Bariatric Interventions With Micronutrient and Endocrine Disturbances

Lee, Phong Ching; Kovalik, Jean‐Paul; Tham, Kwang Wei; Ong, Hock Soo; Chan, Weng Hoong; Tan, Chuen Seng; Lim, Chin Hong

doi:10.1001/jamanetworkopen.2020.5123

Cited by 22 publications

(16 citation statements)

References 54 publications

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“…al. [ 32 ]. In this study, both groups, over the 2-year period showed a significant reduction in mean values of protein, ferritin and vitamin D, however an improvement in mean values of CRP, insulin and FBGL.…”

Section: Discussionmentioning

confidence: 99%

Changes in Anthropometric Measures, Nutritional Indices and Gastrointestinal Symptoms Following One Anastomosis Gastric Bypass (OAGB) Compared with Roux-en-y Gastric Bypass (RYGB)

et al. 2021

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Purpose Bariatric surgery is an effective treatment for obesity with new procedures emerging. However, despite comparable weight loss and improvements in metabolic outcomes, research on nutritional and gastrointestinal symptoms remains limited. Here we compare clinical data on weight, nutritional disorders and gastrointestinal symptoms of patients before and following one anastomosis gastric bypass (OAGB) and Roux-en-Y gastric Bypass (RYGB). Materials and Methods In this retrospective study, data on anthropometry, nutritional indices, dietary intake and gastrointestinal symptoms were retrieved in cohorts of patients up to 2 years following OAGB and RYGB. Results Seventy-three patients had either a RYGB (28) or an OAGB (45), with 71% seeking these as a revisional procedure. Significant and higher weight loss was observed in the OAGB cohort at 1 year (%TWL 33.0 ± 8.5 vs. 26.6 ± 12.4), albeit comparable at 2 years postoperatively (%TWL 29.0 ± 11.1 vs. 34.1 ± 11.2). Disorders such as vitamin D, active B12, folate, homocystein (Hcy) and hyperparathyroidism were present following both surgeries. Levels of vitamin D, ferritin and total protein significantly worsened over time. Gastrointestinal symptoms of diarrhoea, steatorrhoea and reflux were higher in the OAGB cohort while the RYGB cohort reported more dumping syndrome (DS). Conclusion Significant and similar weight loss results are seen following both OAGB and RYGB. Nutritional disorders were common in both cohorts and increased over time. However, the OAGB patients reported more gastrointestinal side effects, which may contribute to poor quality of life and nutritional consequences. Prospective and longer-term studies investigating the nutritional and gastrointestinal health of patients undergoing OAGB is recommended.

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Section: Discussionmentioning

confidence: 99%

Changes in Anthropometric Measures, Nutritional Indices and Gastrointestinal Symptoms Following One Anastomosis Gastric Bypass (OAGB) Compared with Roux-en-y Gastric Bypass (RYGB)

et al. 2021

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“…Our initial search identified a total of 5234 potentially relevant citations. Following screening, a total of 49 studies with 12,880 patients were eligible for inclusion 4,6,21–67 . Of these, five were randomized controlled trials, 33 were retrospective cohort studies, 10 were prospective cohort studies, and one was a nested case–control study.…”

Section: Resultsmentioning

confidence: 99%

“…Forty percent (6/15) 23,29,37,41,62,67 and 52% (12/23) 3 of studies reported successful prevention of ID using their treatment regimen containing <45 mg and ≥45 mg of elemental iron, respectively.…”

Section: Resultsmentioning

confidence: 99%

Iron supplementation following bariatric surgery: A systematic review of current strategies

et al. 2021

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Summary Iron deficiency (ID) and iron deficiency anemia (IDA) are common following bariatric surgery; however, there are limited standardized treatment recommendations for their management. The purpose of this study was to review the current strategies for iron supplementation following bariatric surgery and assess their relative efficacy in managing ID and IDA. MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched to January 2021. Primary outcomes of interest were prevention or improvement in ID or IDA with iron supplementation. Forty‐nine studies with 12,880 patients were included. Most patients underwent Roux‐en‐Y gastric bypass (61.9%). Iron supplementation was most commonly administered orally for prevention of ID/IDA and was effective in 52% of studies. Both IV and oral iron were given for treatment of ID/IDA. Fifty percent (3/6) of the oral and 100% (3/3) of the IV supplementation strategies were effective at treating ID. Iron supplementation strategies employed following bariatric surgery are highly variable, and many do not provide sufficient iron to prevent the development of ID and IDA, potentially due to poor patient adherence. Further high‐quality prospective trials, particularly comparing intravenous and oral iron, are warranted in order to determine the ideal dosage, route, and duration of iron supplementation.

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“…On the other hand, a higher incidence of complications after RYGB have been reported, such as fall-related accidents, kidney stones and diseases, gastrointestinal disorders, micronutrient deficiencies, endocrine derangements [ 26 , 51 , 52 ] with respect to SG, which is considered to be a less technically demanding procedure. Furthermore, an increase in costs and hospitalization rates [ 26 , 29 , 30 , 38 , 39 , 41 , 53 ] were described after RYGB, with increased percentages of readmission, re-operation, and subsequent invasive procedures (frequently, complications due to the procedures, such as ventral hernia repair, small bowel obstruction, and gastric revision).…”

Section: Discussionmentioning

confidence: 99%

Effect of Bariatric Surgery on Survival and Hospitalizations in Patients with Severe Obesity. A Retrospective Cohort Study

et al. 2021

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Bariatric surgery (BS) confers a survival benefit in specific subsets of patients with severe obesity; otherwise, effects on hospital admissions are still uncertain. We assessed the long-term effect on mortality and on hospitalization of BS in patients with severe obesity. This was a retrospective cohort study, including all patients residing in Piedmont (age 18–60 years, BMI ³ 40 kg/m2) admitted during 2002–2018 to the Istituto Auxologico Italiano. Adjusted hazard ratios (HR) for BS were estimated for mortality and hospitalization, considering surgery as a time-varying variable. Out of 2285 patients, 331 (14.5%) underwent BS; 64.4% received sleeve gastrectomy (SG), 18.7% Roux-en-Y gastric bypass (RYGB), and 16.9% adjustable gastric banding (AGB). After 10-year follow-up, 10 (3%) and 233 (12%) patients from BS and non-BS groups died, respectively (HR = 0.52; 95%CI 0.27–0.98, by a multivariable Cox proportional-hazards regression model). In patients undergoing SG or RYGB, the hospitalization probability decreased significantly in the after-BS group (HR = 0.77; 0.68–0.88 and HR = 0.78; 0.63–0.98, respectively) compared to non-BS group. When comparing hospitalization risk in the BS group only, a marked reduction after surgery was found for all BS types. In conclusion, BS significantly reduced the risk of all-cause mortality and hospitalization after 10-year follow-up.

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Associations of Bariatric Interventions With Micronutrient and Endocrine Disturbances

Cited by 22 publications

References 54 publications

Changes in Anthropometric Measures, Nutritional Indices and Gastrointestinal Symptoms Following One Anastomosis Gastric Bypass (OAGB) Compared with Roux-en-y Gastric Bypass (RYGB)

Changes in Anthropometric Measures, Nutritional Indices and Gastrointestinal Symptoms Following One Anastomosis Gastric Bypass (OAGB) Compared with Roux-en-y Gastric Bypass (RYGB)

Iron supplementation following bariatric surgery: A systematic review of current strategies

Effect of Bariatric Surgery on Survival and Hospitalizations in Patients with Severe Obesity. A Retrospective Cohort Study

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