Micronutrients deficiences in patients after bariatric surgery

Gasmi, Amin; Bjørklund, Geir; Mujawdiya, Pavan Kumar; Semenova, Yuliya; Peana, Massimiliano; Doşa, Alexandru; Piscopo, Salva; Benahmed, Asma Gasmi; Costea, Daniel Ovidiu

doi:10.1007/s00394-021-02619-8

Cited by 85 publications

(60 citation statements)

References 97 publications

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“…According to the China Bariatric Metabolic Surgery Database Annual Report 2020, the actual total number of bariatric surgery cases nationwide is projected to be about 14,037 [ 8 ], and the acceptance of bariatric surgery by the general public is gradually increasing. However, weight loss surgery has strict criteria, international recommendations for body mass index (BMI) > 40 or BMI in the range of 35-39.9 and suffer from one of the metabolic complications associated with obesity, surgery is recommended, BMI in about 30 to consider surgery [ 9 ]. According to the ethnic characteristics and differences of the East Asian population, surgery is actively recommended in China for BMI ≥ 37.5 kg/m 2 ; to 32.5 kg/m 2 ≤ BMI < 37.5 kg/m 2 , surgery is recommended; for 27.5 kg/m 2 ≤ BMI < 32.5 kg/m 2 , which is difficult to control with lifestyle changes and medical treatment and at least 2 components of metabolic syndrome are met or comorbidities exist [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

“…Nutritional deficiency is the most frequent postoperative complication of bariatric surgery and is associated with anemia [ 12 ], secondary hyperparathyroidism, and metabolic bone disease [ 13 ]. Nutritional deficiencies in bariatric surgery can be related to partial gastrectomy or foods, bypassing key nutrient absorption sites (e.g., duodenum/jejunum proximal), which limits dietary intake and decreases nutrient uptake [ 9 , 14 ]. The results of related studies [ 15 , 16 ] suggest that nutritional deficiencies in bariatric surgery can be improved through perioperative lifestyle interventions, long-term nutritional monitoring and postoperative follow-up, and increased patient awareness through a guided collaborative/participatory nurse-patient model to reduce postoperative nutritional deficiency complications and significantly improve patient compliance.…”

Section: Introductionmentioning

confidence: 99%

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Visual Analysis of Nutrient Deficiency and Treatment Protocols in Bariatric Surgery Based on VOSviewer

Tang

et al. 2022

BioMed Research International

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Objective. To analyze the global literature on nutritional deficiencies in bariatric surgery (BS) since January 1, 1985, and to discuss the current status of research, research hotspots, and new development trend and treatment of nutritional deficiency in bariatric surgery. It provides ideas and basis for promoting the development of bariatric surgery and new alternative therapy or treatment protocols. Methods. The Web of Science (WOS) database core collection was used as the data source, and VOSviewer 1.6.17 software was used to search the literature on the topic of “nutritional deficiencies in bariatric surgery.” The number of published literature, the distribution of authors, institutions, and countries, keyword cooccurrences, and journal cocitations were visualized and analyzed. Results. A total of 1015 relevant publications was obtained after searching and screening, and the overall trend of literature published was on the rise. The most published countries, institutions, and authors were USA, University of Sao Paulo, Ramalho, Andrea; Obesity Surgery has been the most frequently cited journal (7943 citations), and the top 10 journals had high impact factors. Keyword cooccurrence analysis showed that “bariatric surgery” and “nutritional deficiencies” are the hot topics of research in this field. Conclusion. There is an urgent need for bariatric surgery issuing institutions and authors to strengthen cross-institutional, cross-team, and multicenter and multidisciplinary cooperation, to promote and facilitate the exchange and cooperation in the field of bariatric surgery between developed countries in Europe and America and developing countries in Asia, Africa, and Latin America, to draw the attention of developing countries to the health problems caused by obesity, and to encourage and support the development of developing countries in this field. Bariatric surgery, obesity, weight loss, Y-type gastric bypass, gastric bypass, and nutritional deficiency are the hot research topics in the field of nutritional deficiency in bariatric surgery, and metabolic surgery, single anastomosis gastric bypass, micronutrient supplementation, micronutrient deficiency, intestinal microbiology, and guidelines are the new trends in this field.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Visual Analysis of Nutrient Deficiency and Treatment Protocols in Bariatric Surgery Based on VOSviewer

Tang

et al. 2022

BioMed Research International

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“…Bariatric surgery is reasonable for patients with a BMI of >40 kg/m 2 or >35 kg/m 2 with additional comorbidities who were unsuccessful with conventional therapies [14]. Malabsorption of micronutrients has been described following bariatric surgery [15,16]. Thus, morbidly obese patients undergoing surgery are at risk of exacerbating already existing micronutrient deficiencies [15].…”

Section: Introductionmentioning

confidence: 99%

“…Malabsorption of micronutrients has been described following bariatric surgery [15,16]. Thus, morbidly obese patients undergoing surgery are at risk of exacerbating already existing micronutrient deficiencies [15]. Therefore, current clinical guidelines recommend assessing the nutritional status prior to bariatric surgery as well as supplementation of micronutrients post-surgery [14].…”

Section: Introductionmentioning

confidence: 99%

Pre-Operative Assessment of Micronutrients, Amino Acids, Phospholipids and Oxidative Stress in Bariatric Surgery Candidates

et al. 2022

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Obesity has been linked to lower concentrations of fat-soluble micronutrients and higher concentrations of oxidative stress markers as well as an altered metabolism of branched chain amino acids and phospholipids. In the context of morbid obesity, the aim of this study was to investigate whether and to which extent plasma status of micronutrients, amino acids, phospholipids and oxidative stress differs between morbidly obese (n = 23) and non-obese patients (n = 13). In addition to plasma, malondialdehyde, retinol, cholesterol and triglycerides were assessed in visceral and subcutaneous adipose tissue in both groups. Plasma γ-tocopherol was significantly lower (p < 0.011) in the obese group while other fat-soluble micronutrients showed no statistically significant differences between both groups. Branched-chain amino acids (all p < 0.008) and lysine (p < 0.006) were significantly higher in morbidly obese patients compared to the control group. Malondialdehyde concentrations in both visceral (p < 0.016) and subcutaneous (p < 0.002) adipose tissue were significantly higher in the morbidly obese group while plasma markers of oxidative stress showed no significant differences between both groups. Significantly lower plasma concentrations of phosphatidylcholine, phosphatidylethanolamine, lyso-phosphatidylethanolamine (all p < 0.05) and their corresponding ether-linked analogs were observed, which were all reduced in obese participants compared to the control group. Pre-operative assessment of micronutrients in patients undergoing bariatric surgery is recommended for early identification of patients who might be at higher risk to develop a severe micronutrient deficiency post-surgery. Assessment of plasma BCAAs and phospholipids in obese patients might help to differentiate between metabolic healthy patients and those with metabolic disorders.

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“…The operation results in a smaller gastric pouch to restrict oral intake and the construction of an intestinal limb where bile and pancreatic fluid are diverted from the proximal to distal intestine (Figure 1) to limit food absorption. Meanwhile, the digestion and absorption of nutrients change as well, often leading to nutritional deficiencies [5]. With this in mind, there is ample reason to suspect similar undesired effects of RYGB on the absorption of drugs [6,7].…”

Section: Introductionmentioning

confidence: 99%

Optimized In Silico Modeling of Drug Absorption after Gastric Bypass: The Case of Metformin

et al. 2021

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Bariatric surgery is an effective treatment for severe obesity and related comorbidities, such as type II diabetes. Gastric bypass surgery shortens the length of the intestine, possibly leading to altered drug absorption. Metformin, a first-line treatment for type II diabetes, has permeability-dependent drug absorption, which may be sensitive to intestinal anatomic changes during bypass surgery, including Roux-en-Y gastric bypass (RYGB). Previous computer simulation data indicate increased metformin absorption after RYGB. In this study, we experimentally determined the region-dependent permeability of metformin, using the rat single-pass intestinal perfusion method (SPIP), which we then implemented into GastroPlusTM to assess the contribution of our SPIP data to post-RYGB metformin absorption modeling. Previous simulations allowed a good fit with in vivo literature data on healthy and obese control subjects. However, it was revealed that for post-RYGB drug absorption predictions, simply excluding the duodenum/jejunum is insufficient, as the software underestimates the observed plasma concentrations post-RYGB. By implementing experimentally determined segmental-dependent permeabilities for metformin in the remaining segments post-surgery, GastroPlusTM proved to fit the observed plasma concentration profile, making it a useful tool for predicting drug absorption after gastric bypass. Reliable evaluation of the parameters dictating drug absorption is required for the accurate prediction of overall absorption after bariatric surgery.

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Micronutrients deficiences in patients after bariatric surgery

Cited by 85 publications

References 97 publications

Visual Analysis of Nutrient Deficiency and Treatment Protocols in Bariatric Surgery Based on VOSviewer

Visual Analysis of Nutrient Deficiency and Treatment Protocols in Bariatric Surgery Based on VOSviewer

Pre-Operative Assessment of Micronutrients, Amino Acids, Phospholipids and Oxidative Stress in Bariatric Surgery Candidates

Optimized In Silico Modeling of Drug Absorption after Gastric Bypass: The Case of Metformin

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