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Evidence for the necessity to systematically assess micronutrient status prior to bariatric surgery.
Obes Surg 2009; 19(1):66-73OS

Abstract

BACKGROUND

Bariatric surgery has been proven the most effective treatment of morbid obesity, but micronutrient deficiency following bariatric surgery is a major concern. Increasing evidence points to a generally poor micronutrient status in obese subjects.

METHODS

We assessed micronutrient status in 232 morbidly obese subjects (BMI > or = 35 kg/m(2)) prior to bariatric surgery. Serum albumin, calcium, phosphate, magnesium, ferritin, hemoglobin, zinc, folate, vitamin B(12), 25-OH vitamin D(3), and intact parathormone (iPTH) were determined. In a sub-sample of 89 subjects, we additionally assessed copper, selenium, vitamin B(1), B(3), B(6), A, and E levels.

RESULTS

Deficiencies were found in 12.5% of the subjects for albumin, 8.0% for phosphate, 4.7% for magnesium, 6.9% for ferritin, 6.9% for hemoglobin, 24.6% for zinc, 3.4% for folate, and 18.1% for vitamin B(12). In addition, 25.4% showed a severe 25-OH vitamin D(3) deficiency, which was accompanied by a secondary hyperparathyroidism in 36.6% cases. Prevalence of albumin deficiency (p < 0.007) and of anemia (p < 0.003; in women only) significantly increased with BMI. Of note, 48.7% of the subjects showed at least one of the most prevalent deficiencies, i.e., vitamin B(12), zinc and severe 25-OH vitamin D(3) deficiency. In the sub-sample, 32.6% showed a selenium, 5.6% a vitamin B(3), 2.2% a vitamin B(6), and 2.2% a vitamin E deficiency. Copper, vitamin B(1), and vitamin A deficiency was found in none of the subjects.

CONCLUSION

Data indicate a high prevalence of micronutrient deficiencies in morbidly obese subjects. Based on these results, we strongly recommend a systematic assessment of the micronutrient status in all candidates for bariatric surgery.

Authors+Show Affiliations

Interdisciplinary Obesity Center, Kantonsspital St. Gallen, CH-9400, Rorschach, Switzerland.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18491197

Citation

Ernst, Barbara, et al. "Evidence for the Necessity to Systematically Assess Micronutrient Status Prior to Bariatric Surgery." Obesity Surgery, vol. 19, no. 1, 2009, pp. 66-73.
Ernst B, Thurnheer M, Schmid SM, et al. Evidence for the necessity to systematically assess micronutrient status prior to bariatric surgery. Obes Surg. 2009;19(1):66-73.
Ernst, B., Thurnheer, M., Schmid, S. M., & Schultes, B. (2009). Evidence for the necessity to systematically assess micronutrient status prior to bariatric surgery. Obesity Surgery, 19(1), pp. 66-73. doi:10.1007/s11695-008-9545-4.
Ernst B, et al. Evidence for the Necessity to Systematically Assess Micronutrient Status Prior to Bariatric Surgery. Obes Surg. 2009;19(1):66-73. PubMed PMID: 18491197.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evidence for the necessity to systematically assess micronutrient status prior to bariatric surgery. AU - Ernst,Barbara, AU - Thurnheer,Martin, AU - Schmid,Sebastian M, AU - Schultes,Bernd, Y1 - 2008/05/20/ PY - 2008/02/26/received PY - 2008/04/16/accepted PY - 2008/5/21/pubmed PY - 2009/4/1/medline PY - 2008/5/21/entrez SP - 66 EP - 73 JF - Obesity surgery JO - Obes Surg VL - 19 IS - 1 N2 - BACKGROUND: Bariatric surgery has been proven the most effective treatment of morbid obesity, but micronutrient deficiency following bariatric surgery is a major concern. Increasing evidence points to a generally poor micronutrient status in obese subjects. METHODS: We assessed micronutrient status in 232 morbidly obese subjects (BMI > or = 35 kg/m(2)) prior to bariatric surgery. Serum albumin, calcium, phosphate, magnesium, ferritin, hemoglobin, zinc, folate, vitamin B(12), 25-OH vitamin D(3), and intact parathormone (iPTH) were determined. In a sub-sample of 89 subjects, we additionally assessed copper, selenium, vitamin B(1), B(3), B(6), A, and E levels. RESULTS: Deficiencies were found in 12.5% of the subjects for albumin, 8.0% for phosphate, 4.7% for magnesium, 6.9% for ferritin, 6.9% for hemoglobin, 24.6% for zinc, 3.4% for folate, and 18.1% for vitamin B(12). In addition, 25.4% showed a severe 25-OH vitamin D(3) deficiency, which was accompanied by a secondary hyperparathyroidism in 36.6% cases. Prevalence of albumin deficiency (p < 0.007) and of anemia (p < 0.003; in women only) significantly increased with BMI. Of note, 48.7% of the subjects showed at least one of the most prevalent deficiencies, i.e., vitamin B(12), zinc and severe 25-OH vitamin D(3) deficiency. In the sub-sample, 32.6% showed a selenium, 5.6% a vitamin B(3), 2.2% a vitamin B(6), and 2.2% a vitamin E deficiency. Copper, vitamin B(1), and vitamin A deficiency was found in none of the subjects. CONCLUSION: Data indicate a high prevalence of micronutrient deficiencies in morbidly obese subjects. Based on these results, we strongly recommend a systematic assessment of the micronutrient status in all candidates for bariatric surgery. SN - 0960-8923 UR - https://www.unboundmedicine.com/medline/citation/18491197/Evidence_for_the_necessity_to_systematically_assess_micronutrient_status_prior_to_bariatric_surgery_ L2 - https://dx.doi.org/10.1007/s11695-008-9545-4 DB - PRIME DP - Unbound Medicine ER -