Skip to main content

Advertisement

Log in

Micronutrient Deficiencies After Laparoscopic Gastric Bypass: Recommendations

  • Research Article
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

The aim of this study was to evaluate the changes of micronutrients in patients with morbid obesity after laparoscopic Roux-en-Y gastric bypass surgery (LRYGBP).

Methods

We retrospectively reviewed 121 patients diagnosed with morbid obesity who undertook LRYGBP and evaluated the serum iron (Fe), calcium (Ca), zinc (Zn), selenium (Se), vitamin A (VitA), 25-hydroxy vitamin D3 (VitD), vitamin B12 (VitB12), and parathormone (PTH) measured at 6, 12, and 24 months after LRYGBP.

Results

During a follow-up period of 69 months (June 1999 to February 2005), a cohort of 121 patients, 40 men and 81 women, underwent LRYGBP, a mean age of 46 years (range 22–67). The mean body mass index (BMI) before LRYGBP was 47.00 ± 7.15 kg/m2 (range 30.65–76.60 kg/m2). After 6 months of the surgery, the mean BMI was 33.79 ± 6.06 kg/m2 (range 21.70–52.76 kg/m2). The mean BMI decreased (P < 0.001) 6 months after the surgery. Within the following 2 years, the serum Fe, Ca, Zn, Se, VitA, VitD, and VitB12 had normalized. The serum Zn, Se, and VitA of some patients decreased but were nearly normal. In contrast, serum PTH remained continuously at a higher level than normal.

Conclusions

This study confirms that LRYGBP is a reliable and safe weight loss method for the patients suffering from morbid obesity. After surgery, serum Ca, Zn, and Se metabolisms and PTH levels are altered in these patients. Therefore, multi-vitamin and mineral supplementation are strongly recommended in all patients after LRYGBP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Gong K. Surgery for morbid obesity (review). Chinese J Minim Inv Surg. 2005;5:260–2.

    Google Scholar 

  2. Gong K, Gagner M, Bardaro S, et al. The procedure of mesh wrapping the gastric pouch in cadaver. Surg Endosc. 2007;21:2244–7.

    Article  PubMed  Google Scholar 

  3. Sugerman HJ, Kellum JM, Engle KM, et al. Gastric bypass for treating severe obesity. Am J Clin Nutr. 1992;55:560S–6S.

    PubMed  CAS  Google Scholar 

  4. Benotti PN, Forse RA. The role of gastric surgery in the multidisciplinary management of severe obesity. Am J Surg. 1995;169:361–7.

    Article  PubMed  CAS  Google Scholar 

  5. Alvarez-Leite JI. Nutritional deficiencies secondary to bariatric surgery. Curr Opin Clin Nutr Metab Care. 2004;7:569–75.

    Article  PubMed  Google Scholar 

  6. Bloomberg RD, Fleishman A, Nalle JE, et al. Nutritional deficienies following bariatric surgery: what have we learned? Obes Surg. 2005;15:145–54.

    Article  PubMed  Google Scholar 

  7. Vargas-Ruiz A,·Hernández-Rivera G, Herrera MF. Prevalence of iron, folate, and vitamin B12 deficiency anemia after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2008;18:288–93.

    Article  PubMed  Google Scholar 

  8. Buchwald H, Williams SE. Bariatric surgery worldwide 2003. Obes Surg. 2004;14:1157–64.

    Article  PubMed  Google Scholar 

  9. Deitel M, Shikora SA. The development of the surgical treatment of morbid obesity. J Am Coll Nutr. 2002;12:365–71.

    Google Scholar 

  10. El-kadre LJ, Savassi Rocha PR, de Almeida Tinoco AC, et al. Calcium metabolism in pre- and postmenopausal morbidly obese women at baseline and after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2004;14:1062–6.

    Article  PubMed  Google Scholar 

  11. Fujioka K. Follow-up of nutritional and metabolic problems after bariatric surgery. Diabetes Care. 2005;28:481–4.

    Article  PubMed  Google Scholar 

  12. MacLean LD, Rhode BM, Shizgal, et al. Nutrition following gastric operations for morbid obesity. Ann Surg. 1983;198:347–55.

    Article  PubMed  CAS  Google Scholar 

  13. Amaral JF, Thompson WR, Caldweu, MD, et al. Prospective hematologic evaluation of gastric exclusion surgery for morbid obesity. Ann Surg. 1985;201(2):186–93.

    Article  PubMed  CAS  Google Scholar 

  14. Cooper PL, Brearley LK, Jamieson AC, et al. Nutritional consequences of modified vertical gastroplasty in obese subjects. Int J Obes Relat Metab Disord. 1999;23:382–8.

    Article  PubMed  CAS  Google Scholar 

  15. Avinoah E, Ovnot A, Choruzi I, et al. Nutritional status seven years after Roux-en-Y gastric bypass surgery. Surgery. 1992;111:137–42.

    PubMed  CAS  Google Scholar 

  16. Institute of Medicine. Vitamin A. In: Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington: National Academy Press; 2001. p. 82–161.

    Google Scholar 

  17. Villaca Chaves G, Pereira SE, Saboya CJ, et al. Nutritional status of vitamin A in morbid obesity before and after Roux-en-Y gastric bypass. Obes Surg. 2007;17:970–6.

    Article  Google Scholar 

  18. Mott T. How effective is gastric bypass for weight loss? J Fam Pract. 2004;53:914–7.

    PubMed  Google Scholar 

  19. Slater GH, Ren CF, Siegel N, et al. Serum fat-soluble vitamin deficiency and abnormal calcium metabolism after malabsorptive bariatric surgery. J Gastrointest Surg. 2004;8:48–55.

    Article  PubMed  Google Scholar 

  20. Manzanares Castro W. Selenium in critically ill patients with systemic inflammatory response. Nutr Hosp. 2007;22:295–306.

    PubMed  CAS  Google Scholar 

  21. Piekutowski K, Makarewicz R, Zachara BA. The antioxidative role of selenium in pathogensis of cancer of the female reproductive system. Neoplasma. 2007;54:374–8.

    PubMed  CAS  Google Scholar 

  22. Prasad AS. Zinc: mechanisms of host defense. J Nutr. 2007;137:1345–9.

    PubMed  CAS  Google Scholar 

  23. Prasad AS. Zinc in human health: effect of zinc on immune cells. Mol Med. 2008;14(5–6):353–7.

    PubMed  CAS  Google Scholar 

  24. Mason E. Bone disease from duodenal exclusion. Obes Surg. 2000;10:585–6.

    Article  PubMed  CAS  Google Scholar 

  25. Rhode BM, Arsencau P, Cooper BA, et al. Vitamin B-12 deficiency after gastric surgery for obesity. Am J Clin Nutr. 1996;63:103–9.

    PubMed  CAS  Google Scholar 

  26. Perkes E. Nutritional management of patients after bariatric surgery. Am J Med Sci. 2006;331:207–13.

    Article  Google Scholar 

  27. Patel JA, Patel NA, Thomas RL, et al. Pregnancy outcomes after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2008;4:39–45.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ke Gong.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gong, K., Gagner, M., Pomp, A. et al. Micronutrient Deficiencies After Laparoscopic Gastric Bypass: Recommendations. OBES SURG 18, 1062–1066 (2008). https://doi.org/10.1007/s11695-008-9577-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-008-9577-9

Keywords

Navigation