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Cross-sectional long-term micronutrient deficiencies after sleeve gastrectomy versus Roux-en-Y gastric bypass: a pilot study.

Abstract

BACKGROUND

Nutritional deficiencies are highly prevalent in obese patients. Bariatric surgery has been associated with adverse effects on homeostasis of significant vitamins and micronutrients, mainly after gastric bypass. The aim of the present study was to compare the extent of long-term postsurgical nutritional deficiencies between Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).

METHODS

This cross-sectional, pilot study included 95 patients who underwent RYGB or SG surgery with a mean follow-up of 4 years. Demographic, anthropometric, and biochemical parameters were compared according to the type of surgery.

RESULTS

Both types of surgery were associated with significant nutritional deficiencies. Vitamin B12 deficiency was significantly higher in patients with RYGB compared with SG (42.1% versus 5%, P = .003). The type of surgery was associated neither with anemia nor with iron or folate deficiency (SG versus RYGB: anemia, 54.2% versus 64.3%, P = .418; folate deficiency, 20% versus 18.4%, P = .884; iron deficiency, 30% versus 36.4%, P = .635).

CONCLUSION

During a mean follow up period of 4 years postRYGB or SG, patients were identified with several micronutrient deficiencies, including vitamin D, folate, and vitamin B12. SG may have a more favorable effect on the metabolism of vitamin B12 compared with RYGB, being associated with less malabsorption. Adherence to supplemental iron and vitamin intake is of primary significance in all cases of bariatric surgery.

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  • Authors+Show Affiliations

    ,

    1st Department of Surgery, Laiko Athens General Hospital, University of Athens, 17 Agiou Thoma St, GR-11527 Athens, Greece.

    ,

    2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens.

    ,

    Biochemical and Hormonal Laboratory, Aretaieio Hospital, University of Athens.

    ,

    2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens.

    ,

    1st Department of Surgery, Laiko Athens General Hospital, University of Athens, 17 Agiou Thoma St, GR-11527 Athens, Greece.

    2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens. Electronic address: ilambrinoudaki@aretaieio.uoa.gr.

    Source

    MeSH

    Adult
    Cross-Sectional Studies
    Female
    Follow-Up Studies
    Gastrectomy
    Gastroplasty
    Greece
    Humans
    Incidence
    Male
    Malnutrition
    Micronutrients
    Obesity, Morbid
    Pilot Projects
    Postoperative Complications
    Retrospective Studies
    Time Factors

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    24182446

    Citation

    Alexandrou, Andreas, et al. "Cross-sectional Long-term Micronutrient Deficiencies After Sleeve Gastrectomy Versus Roux-en-Y Gastric Bypass: a Pilot Study." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 10, no. 2, 2014, pp. 262-8.
    Alexandrou A, Armeni E, Kouskouni E, et al. Cross-sectional long-term micronutrient deficiencies after sleeve gastrectomy versus Roux-en-Y gastric bypass: a pilot study. Surg Obes Relat Dis. 2014;10(2):262-8.
    Alexandrou, A., Armeni, E., Kouskouni, E., Tsoka, E., Diamantis, T., & Lambrinoudaki, I. (2014). Cross-sectional long-term micronutrient deficiencies after sleeve gastrectomy versus Roux-en-Y gastric bypass: a pilot study. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 10(2), pp. 262-8. doi:10.1016/j.soard.2013.07.014.
    Alexandrou A, et al. Cross-sectional Long-term Micronutrient Deficiencies After Sleeve Gastrectomy Versus Roux-en-Y Gastric Bypass: a Pilot Study. Surg Obes Relat Dis. 2014;10(2):262-8. PubMed PMID: 24182446.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Cross-sectional long-term micronutrient deficiencies after sleeve gastrectomy versus Roux-en-Y gastric bypass: a pilot study. AU - Alexandrou,Andreas, AU - Armeni,Eleni, AU - Kouskouni,Evangelia, AU - Tsoka,Evangelia, AU - Diamantis,Theodoros, AU - Lambrinoudaki,Irene, Y1 - 2013/08/12/ PY - 2013/04/10/received PY - 2013/07/22/revised PY - 2013/07/25/accepted PY - 2013/11/5/entrez PY - 2013/11/5/pubmed PY - 2014/12/15/medline KW - Bariatric surgery KW - Nutritional deficiency KW - Roux-en-Y gastric bypass KW - Sleeve gastrectomy SP - 262 EP - 8 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 10 IS - 2 N2 - BACKGROUND: Nutritional deficiencies are highly prevalent in obese patients. Bariatric surgery has been associated with adverse effects on homeostasis of significant vitamins and micronutrients, mainly after gastric bypass. The aim of the present study was to compare the extent of long-term postsurgical nutritional deficiencies between Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). METHODS: This cross-sectional, pilot study included 95 patients who underwent RYGB or SG surgery with a mean follow-up of 4 years. Demographic, anthropometric, and biochemical parameters were compared according to the type of surgery. RESULTS: Both types of surgery were associated with significant nutritional deficiencies. Vitamin B12 deficiency was significantly higher in patients with RYGB compared with SG (42.1% versus 5%, P = .003). The type of surgery was associated neither with anemia nor with iron or folate deficiency (SG versus RYGB: anemia, 54.2% versus 64.3%, P = .418; folate deficiency, 20% versus 18.4%, P = .884; iron deficiency, 30% versus 36.4%, P = .635). CONCLUSION: During a mean follow up period of 4 years postRYGB or SG, patients were identified with several micronutrient deficiencies, including vitamin D, folate, and vitamin B12. SG may have a more favorable effect on the metabolism of vitamin B12 compared with RYGB, being associated with less malabsorption. Adherence to supplemental iron and vitamin intake is of primary significance in all cases of bariatric surgery. SN - 1878-7533 UR - https://www.unboundmedicine.com/medline/citation/24182446/Cross_sectional_long_term_micronutrient_deficiencies_after_sleeve_gastrectomy_versus_Roux_en_Y_gastric_bypass:_a_pilot_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(13)00245-1 DB - PRIME DP - Unbound Medicine ER -