Zinc and Copper Serum Levels of Morbidly Obese Patients Before and After Biliopancreatic Diversion: 4 Years of Follow-up

Luis, Daniel Antonio de; Pacheco, David; Izaola, Olatz; Terroba, M. C.; Cuéllar, L; Martín, Tomás

doi:10.1007/s11605-011-1647-y

Cited by 42 publications

(19 citation statements)

References 26 publications

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“…These have compared serum levels in cohorts of patients treated with different procedures and have included RYGB, sleeve gastrectomy (SG), BPD ± DS, and adjustable gastric band procedures. The duration of follow-up was generally short, with 16 studies covering 1-3 years, 69-82 3 studies 4-5 years [83][84][85] and 1 study 7 years. 86 The study of longest duration documented no deficiency states in patients with restrictive procedures but no malabsorptive component; however, the others have documented an increased risk of deficiency of iron, copper, zinc, selenium, thiamine, folate, and Vitamins B 12 and D as compared with preoperative populations.…”

Section: Question 4: In Obese Patients Who Have Had Malabsorptive or mentioning

confidence: 99%

A.S.P.E.N. Clinical Guidelines

Choban

Dickerson

Malone

et al. 2013

J Parenter Enteral Nutr

136

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Background: Due to the high prevalence of obesity in adults, nutrition support clinicians are encountering greater numbers of obese patients who require nutrition support during hospitalization. The purpose of this clinical guideline is to serve as a framework for the nutrition support care of adult patients with obesity. Method: A systematic review of the best available evidence to answer a series of questions regarding management of nutrition support in patients with obesity was undertaken and evaluated using concepts adopted from the Grading of Recommendations, Assessment, Development and Evaluation working group. A consensus process, that includes consideration of the strength of the evidence together with the risks and benefits to the patient, was used to develop the clinical guideline recommendations prior to multiple levels of external and internal review and approval by the A.S.P.E.N. Board of Directors. Questions: (1) Do clinical outcomes vary across levels of obesity in critically ill or hospitalized non−intensive care unit (ICU) patients? (2) How should energy requirements be determined in obese critically ill or hospitalized non‐ICU patients? (3) Are clinical outcomes improved with hypocaloric, high protein diets in hospitalized patients? (4) In obese patients who have had a malabsorptive or restrictive surgical procedure, what micronutrients should be evaluated?

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Section: Question 4: In Obese Patients Who Have Had Malabsorptive or mentioning

confidence: 99%

A.S.P.E.N. Clinical Guidelines

Choban

Dickerson

Malone

et al. 2013

J Parenter Enteral Nutr

136

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“…The EL 3 evidence base supporting the high prevalence rates and need for systematic preoperative assessment and treatment of nutrient insufficiencies/deficiencies is primarily represented by surveillance studies, case series, and case reports. Additions to this evidence base since the 2008 AACE-TOS-ASMBS CPG (7 [EL 4, CPG]) support this recommendation (240 [EL 3, SS]; 241 [EL 3]; 242 [EL 3, SS]; 243 [EL 3, SS]; 244 [EL 3, SS]; 245 [EL 3, SS]; 246 [EL 3, SS]; 247 [EL 3, SS]; 248 [EL 3, SS]; 249 [EL 3, SS]; 250 [EL 3, SS]; 251 [EL 3, SS]; 252 [EL 3, SS]). The length of intestinal bypass is directly related to the extent of risk for nutritional deficiencies (253 [EL 1, RCT]).…”

Section: Evidence Basementioning

confidence: 80%

Clinical Practice Guidelines For The Perioperative Nutritional, Metabolic, And Nonsurgical Support Of The Bariatric Surgery Patient2013 Update: Cosponsored By American Association Of Clinical Endocrinologists, The Obesity Society, And American Society For Metabolic & Bariatric Surgery

et al. 2013

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The development of these updated guidelines was commissioned by the AACE, TOS, and ASMBS Board of Directors and adheres to the AACE 2010 protocol for standardized production of clinical practice guidelines (CPG). Each recommendation was re-evaluated and updated based on the evidence and subjective factors per protocol. Examples of expanded topics in this update include: the roles of sleeve gastrectomy, bariatric surgery in patients with type-2 diabetes, bariatric surgery for patients with mild obesity, copper deficiency, informed consent, and behavioral issues. There are 74 recommendations (of which 56 are revised and 2 are new) in this 2013 update, compared with 164 original recommendations in 2008. There are 403 citations, of which 33 (8.2%) are EL 1, 131 (32.5%) are EL 2, 170 (42.2%) are EL 3, and 69 (17.1%) are EL 4. There is a relatively high proportion (40.4%) of strong (EL 1 and 2) studies, compared with only 16.5% in the 2008 AACE- TOS-ASMBS CPG. These updated guidelines reflect recent additions to the evidence base. Bariatric surgery remains a safe and effective intervention for select patients with obesity. A team approach to perioperative care is mandatory with special attention to nutritional and metabolic issues.

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“…Eventually, nutritional deficiencies occur. Blood tests and biochemical analysis on bariatric surgery candidates preoperatively revealed an astonishingly high occurrence of micronutrient and macronutrient deficiencies, particularly vitamin B12, 25-OH vitamin D3, zinc, albumin, and iron, with the latter two increasing significantly with BMI [132–136]. Other nutritional deficiencies amongst bariatric surgery candidates include folic acid, ferritin, phosphorus, calcium, magnesium, vitamin A, vitamin B6, vitamin C, and copper [133–135, 137, 138].…”

Section: Discussionmentioning

confidence: 99%

Obesity and Surgical Wound Healing: A Current Review

et al. 2014

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Objective. The correlation between obesity and deficient wound healing has long been established. This review examines the current literature on the mechanisms involved in obesity-related perioperative morbidity. Methods. A literature search was performed using Medline, PubMed, Cochrane Library, and Internet searches. Keywords used include obesity, wound healing, adipose healing, and bariatric and surgical complications. Results. Substantial evidence exists demonstrating that obesity is associated with a number of postoperative complications. Specifically in relation to wound healing, explanations include inherent anatomic features of adipose tissue, vascular insufficiencies, cellular and composition modifications, oxidative stress, alterations in immune mediators, and nutritional deficiencies. Most recently, advances made in the field of gene array have allowed researchers to determine a few plausible alterations and deficiencies in obese individuals that contribute to their increased risk of morbidity and mortality, especially wound complications. Conclusion. While the literature discusses how obesity may negatively affect health on various of medical fronts, there is yet to be a comprehensive study detailing all the mechanisms involved in obesity-related morbidities in their entirety. Improved knowledge and understanding of obesity-induced physiological, cellular, molecular, and chemical changes will facilitate better assessments of surgical risks and outcomes and create efficient treatment protocols for improved patient care of the obese patient population.

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Zinc and Copper Serum Levels of Morbidly Obese Patients Before and After Biliopancreatic Diversion: 4 Years of Follow-up

Abstract: BPD is an effective method of sustainable weight loss. Otherwise, a high prevalence of zinc and copper basal deficiencies in morbidly obese seeking bariatric surgery was detected. These deficiencies of copper and zinc increased during the 4 years of follow-up after BDP.

Cited by 42 publications

References 26 publications

A.S.P.E.N. Clinical Guidelines

A.S.P.E.N. Clinical Guidelines

Clinical Practice Guidelines For The Perioperative Nutritional, Metabolic, And Nonsurgical Support Of The Bariatric Surgery Patient2013 Update: Cosponsored By American Association Of Clinical Endocrinologists, The Obesity Society, And American Society For Metabolic & Bariatric Surgery

Obesity and Surgical Wound Healing: A Current Review

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