Risk of Malnutrition, Trace Metal, and Vitamin Deficiency Post Roux-en-Y Gastric Bypass—a Prospective Study of 20 Patients with BMI &lt;35 kg/m2

Billeter, Adrian T.; Probst, Pascal; Fischer, Lars; Senft, Jonas D; Kenngott, Hannes; Schulte, Thilo; Clemens, Gabriella; Zech, Ulrike; Büchler, Markus W.; Nawroth, Peter P.; Müller‐Stich, Beat P.

doi:10.1007/s11695-015-1676-9

Cited by 33 publications

(18 citation statements)

References 40 publications

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“…10 While studies have shown that nutritional deficiencies are usually prevalent beforehand in obese patients, bariatric surgery may exacerbate the problem and/or introduce new deficiencies. 15,23,24 According to a biochemical assessment of various nutritional parameters, approximately half of the patients in the current study were deficient in iron, haemoglobin and MCV, all of which are indicators of anaemia. A recent review article reported iron deficiency to be the most common nutritional deficiency following bariatric surgery.…”

Section: Discussionmentioning

confidence: 85%

Effect of Bariatric Surgery on Weight Loss, Nutritional Deficiencies, Postoperative Complications and Adherence to Dietary and Lifestyle Recommendations: A retrospective cohort study from Bahrain

Hasan

Freije

Abualsel

et al. 2020

Sultan Qaboos Univ Med J

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Objectives: This study aimed to investigate the effect of bariatric surgery on degree of weight loss, as well as the prevalence of nutritional deficiencies, postoperative complications and adherence to dietary and lifestyle recommendations in a cohort of patients from Bahrain. Methods: This retrospective cohort study took place between March and September 2018 at two hospitals in Bahrain. All adult patients who had undergone bariatric surgery between 2012–2017 were included. Sociodemographic and clinical information was collected from the patients’ medical records and during phone interviews. Results: A total of 341 patients participated in the study. The mean age was 39.82 ± 9.95 years and 67.7% were female. There was a significant relationship between postoperative body mass index and both the type of surgery and time since surgery (P = 0.025 and 0.008, respectively). While type of surgery had no significant effect on percent of excess weight loss (EWL) or percent of total weight loss (TWL), time since surgery significantly affected both of these weight loss measures (P = 0.006 and 0.001, respectively). Biochemical tests revealed haemoglobin, mean corpuscular volume, 25-hydroxy vitamin D, ferritin and iron deficiencies. Commonly reported complications included hair loss (59.5%), flatulence/abdominal pain (39.3%), dry skin (34.3%) and gastroesophageal reflux disease (33.1%). The level of adherence to dietary and lifestyle recommendations was high to moderate. Conclusion: Bariatric surgery was effective in accelerating EWL and TWL; however, it also resulted in complications such as nutritional deficiencies and gastrointestinal side-effects.Keywords: Bariatric Surgery; Obesity Management; Weight Loss; Gastric Bypass; Biliopancreatic Diversion; Avitaminosis; Iron-Deficiency Anemia; Bahrain.

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Section: Discussionmentioning

confidence: 85%

Effect of Bariatric Surgery on Weight Loss, Nutritional Deficiencies, Postoperative Complications and Adherence to Dietary and Lifestyle Recommendations: A retrospective cohort study from Bahrain

Hasan

Freije

Abualsel

et al. 2020

Sultan Qaboos Univ Med J

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“…Bariatric surgery is known to be extremely safe, with low peri-operative mortality and complication rates [ 55 – 57 ]. Although other long-term potential complications of bariatric surgery exist (including gastroesophageal reflux [ 58 ], internal herniation [ 59 ], and trace element malnutrition [ 60 ]), these issues are relatively uncommon in modern bariatric surgical practice, and management strategies are available to treat these conditions should they occur. Finally, from the perspective of statistical analysis, the Egger test was utilised to measure for the presence of potential bias.…”

Section: Discussionmentioning

confidence: 99%

Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: A systematic review and meta-analysis

et al. 2020

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Background Previous clinical trials and institutional studies have demonstrated that surgery for the treatment of obesity (termed bariatric or metabolic surgery) reduces all-cause mortality and the development of obesity-related diseases such as type 2 diabetes mellitus (T2DM), hypertension, and dyslipidaemia. The current study analysed large-scale population studies to assess the association of bariatric surgery with long-term mortality and incidence of newonset obesity-related disease at a national level. Methods and findings A systematic literature search of Medline (via PubMed), Embase, and Web of Science was performed. Articles were included if they were national or regional administrative database cohort studies reporting comparative risk of long-term mortality or incident obesity-related diseases for patients who have undergone any form of bariatric surgery compared with an appropriate control group with a minimum follow-up period of 18 months. Meta-analysis of hazard ratios (HRs) was performed for mortality risk, and pooled odds ratios (PORs) were calculated for discrete variables relating to incident disease. Eighteen studies were identified as suitable for inclusion. There were 1,539,904 patients included in the analysis, with 269,818 receiving bariatric surgery and 1,270,086 control patients. Bariatric surgery was associated with a reduced rate of all-cause mortality (POR 0.62, 95% CI 0.55 to 0.69, p < 0.001) and cardiovascular mortality (POR 0.50, 95% CI 0.35 to 0.71, p < 0.001). Bariatric surgery was strongly associated with reduced incidence of T2DM (POR 0.39, 95% CI 0.18 to 0.83, p = 0.010), hypertension (POR 0.36, 95% CI 0.32 to 0.40, p < 0.001), dyslipidaemia (POR 0.33, 95% CI 0.14 to 0.80, p = 0.010), and ischemic heart disease (POR 0.46, 95% CI 0.29 to 0.73, p = 0.001). Limitations of the study include that it was not possible to account for unmeasured variables, which may not have been equally distributed between patient

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“…Although common micronutrient and macronutrient deficiencies (e.g. protein, iron, vitamins A, B12, C, D) in patients after gastric bypass are widely reported in the nutritional and gastroenterological literature [13], there are limited data on the prevalence, timing, and symptoms of zinc deficiency (as well as pyridoxine, selenium, and fatty acid deficiencies) after gastric bypass [1,14].…”

Section: Discussionmentioning

confidence: 99%

Acquired acrodermatitis enteropathica after gastric bypass surgery responsive to IV supplementation

Rana

Plovanich²,

Wallace³

et al. 2016

Dermatology Online Journal

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Nutritional deficiency is rare in developed countries, but can be acquired from decreased nutrient intake, reduced absorption, and increased gastrointestinal excretion. We report a patient with acquired acrodermatitis enteropathica (AE) who exhibited low plasma zinc levels and concurrent nutritional deficiencies (pyridoxine, selenium and fatty acids). Our patient had undergone Roux-en-Y gastric bypass 13 years prior to presentation. The rash, consistent with AE clinically and histologically, nearly resolved one week after starting IV zinc supplementation, total parenteral nutrition, and micronutrient supplements. This case highlights the importance of long-term post-operative follow-up for gastric bypass patients who are at high risk for micronutrient and macronutrient deficiencies and illustrates the potential for rapid improvement with IV supplementation.

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Risk of Malnutrition, Trace Metal, and Vitamin Deficiency Post Roux-en-Y Gastric Bypass—a Prospective Study of 20 Patients with BMI <35 kg/m2

Abstract: This is the first prospective cohort to investigate malnutrition after RYGB in nonseverely obese patients. These patients are at risk of developing iron, selenium, and zinc deficiencies within 24 months, as well as osteopenia despite an increase in bone formation.

Cited by 33 publications

References 40 publications

Effect of Bariatric Surgery on Weight Loss, Nutritional Deficiencies, Postoperative Complications and Adherence to Dietary and Lifestyle Recommendations: A retrospective cohort study from Bahrain

Effect of Bariatric Surgery on Weight Loss, Nutritional Deficiencies, Postoperative Complications and Adherence to Dietary and Lifestyle Recommendations: A retrospective cohort study from Bahrain

Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: A systematic review and meta-analysis

Acquired acrodermatitis enteropathica after gastric bypass surgery responsive to IV supplementation

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