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Micronutrient Status in Morbidly Obese Patients Prior to Laparoscopic Sleeve Gastrectomy and Micronutrient Changes 5 years Post-surgery

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Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) has become more popular in recent years. The aim of this study was to determine the vitamin and mineral status in patients up to 5 years after LSG and to explore changes that occurred from pre-operatively to 1, 2 and 5 years after surgery.

Methods

Data reviewed included age, sex, weight and body mass index (BMI), micronutrient supplements consumed and blood levels of 25 hydroxyvitamin D (25 (OH) D), PTH (parathyroid hormone), ferritin, haemoglobin, folate and vitamin B12, prior to and post-LSG. Data was collated from medical records of morbidly obese patients who had undergone LSG surgery.

Results

There were a maximum of 336 patients with pre-operative and 1 year after surgery values, n = 272 for 2 years and n = 116 for 5 years after surgery. At 5 years, only 54 % (58/107) of patients reported taking daily multivitamin supplements. Whilst most patients had values within the reference range for haemoglobin, vitamin B12, folate and vitamin D 5 years after LSG, 36 % (34/94) of the patients had serum ferritin below reference value.

Conclusion

This study has highlighted a low micronutrient supplementation adherence. Ferritin levels decreased over time even with multivitamin supplementation. To improve micronutrient guidelines prior to and after LSG, more research, including controlled supplementation studies, are necessary.

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References

  1. World Health Organization. Obesity: preventing and managing the global epidemic. Geneva: World Health Organization; 2000.

    Google Scholar 

  2. Sjöström L. Review of the key results from the Swedish Obese Subjects (SOS) trial—a prospective controlled intervention study of bariatric surgery. J Intern Med. 2013;273(3):219–34.

    Article  PubMed  Google Scholar 

  3. Boido A, Ceriani V, Cetta F, et al. Bariatric surgery and prevention of cardiovascular events and mortality in morbid obesity: mechanisms of action and choice of surgery. Nutr Metab Cardiovasc Dis. 2015;25(5):437–43.

    Article  CAS  PubMed  Google Scholar 

  4. Leung M, Xie M, Durmush E, et al. Weight loss with sleeve gastrectomy in obese type 2 diabetes mellitus: impact on cardiac function. Obes Surg. 2015;26:321–26.

  5. Arterburn DE, Olsen MK, Smith VA, et al. Association between bariatric surgery and long-term survival. JAMA. 2015;313(1):62–70.

    Article  CAS  PubMed  Google Scholar 

  6. Kwok CS, Pradhan A, Khan MA, et al. Bariatric surgery and its impact on cardiovascular disease and mortality: a systematic review and meta-analysis. Int J Cardiol. 2014;173(1):20–8.

    Article  PubMed  Google Scholar 

  7. Damms-Machado A, Friedrich A, Kramer KM, et al. Pre-and postoperative nutritional deficiencies in obese patients undergoing laparoscopic sleeve gastrectomy. Obes Surg. 2012;22(6):881–9.

    Article  PubMed  Google Scholar 

  8. van Rutte P, Aarts E, Smulders J, et al. Nutrient deficiencies before and after sleeve gastrectomy. Obes Surg. 2014;24(10):1639–46.

    Article  PubMed  Google Scholar 

  9. Hakeam HA, O’Regan PJ, Salem AM, et al. Impact of laparoscopic sleeve gastrectomy on iron indices: 1 year follow-up. Obes Surg. 2009;19(11):1491–6.

    Article  PubMed  Google Scholar 

  10. Gehrer S, Kern B, Peters T, et al. Fewer nutrient deficiencies after laparoscopic sleeve gastrectomy (LSG) than after laparoscopic Roux-Y-gastric bypass (LRYGB)—a prospective study. Obes Surg. 2010;20(4):447–53.

    Article  PubMed  Google Scholar 

  11. Ruiz-Tovar J, Oller I, Tomas A, et al. Mid-term effects of sleeve gastrectomy on calcium metabolism parameters, vitamin D and parathormone (PTH) in morbid obese women. Obes Surg. 2012;22(5):797–801.

    Article  PubMed  Google Scholar 

  12. Vage V, Sande VA, Mellgren G, et al. Changes in obesity-related diseases and biochemical variables after laparoscopic sleeve gastrectomy: a two-year follow-up study. BMC Surg. 2014;14:8. 2482-14-8.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Dagan SS, Zelber-Sagi S, Webb M, Keidar A, Raziel A, Sakran N, et al. Nutritional status prior to laparoscopic sleeve gastrectomy surgery. Obes Surg. 2016:1–8.

  14. Damms-Machado A, Bischoff SC. Chapter 31—nutritional deficiencies in obese sleeve gastrectomy patients. In: Watson RR, editor. Nutrition in the prevention and treatment of abdominal obesity. San Diego: Academic Press; 2014. p. 341–8.

    Chapter  Google Scholar 

  15. Capoccia D, Coccia F, Paradiso F, et al. Laparoscopic gastric sleeve and micronutrients supplementation: our experience. J Obes. 2012;672162.

  16. Snyder-Marlow G, Taylor D, Lenhard MJ. Nutrition care for patients undergoing laparoscopic sleeve gastrectomy for weight loss. J Am Diet Assoc. 2010;110(4):600–7.

    Article  PubMed  Google Scholar 

  17. Aarts EO, Janssen IM, Berends FJ. The gastric sleeve: losing weight as fast as micronutrients? Obes Surg. 2011;21(2):207–11.

    Article  PubMed  Google Scholar 

  18. Kehagias I, Karamanakos SN, Argentou M, et al. Randomized clinical trial of laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy for the management of patients with BMI < 50 kg/m2. Obes Surg. 2011;21(11):1650–6.

    Article  PubMed  Google Scholar 

  19. Saif T, Strain GW, Dakin G, et al. Evaluation of nutrient status after laparoscopic sleeve gastrectomy 1, 3, and 5 years after surgery. Surg Obes Relat Dis. 2012;8(5):542–7.

    Article  PubMed  Google Scholar 

  20. Grundy S, Barondess J, Bellegie N, et al. Gastrointestinal surgery for severe obesity. Ann Intern Med. 1991;115(12):956–61.

    Article  Google Scholar 

  21. Himpens J, Dapri G, Cadière GB. A prospective randomized study between laparoscopic gastric banding and laparoscopic isolated sleeve gastrectomy: results after 1 and 3 years. Obes Surg. 2006;16(11):1450–6.

    Article  PubMed  Google Scholar 

  22. Miller AD, Smith KM. Medication and nutrient administration considerations after bariatric surgery. Am J Health Syst Pharm. 2006;63(19):1852–7.

    Article  PubMed  Google Scholar 

  23. Lecube A, Hernandez C, Pelegri D, et al. Factors accounting for high ferritin levels in obesity. Int J Obes. 2008;32(11):1665–9.

    Article  CAS  Google Scholar 

  24. Careaga M, Moizé V, Flores L, et al. Inflammation and iron status in bariatric surgery candidates. Surg Obes Relat Dis. 2015;11(4):906–11.

    Article  PubMed  Google Scholar 

  25. Aaseth E, Fagerland M, Aas A, et al. Vitamin concentrations 5 years after gastric bypass. Eur J Clin Nutr. 2015.

  26. Blum M, Dolnikowski G, Seyoum E, et al. Vitamin D3 in fat tissue. Endocrine. 2008;33(1):90–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

We acknowledge Ronny Gåsdal, Eli Natvik and Lisbeth Schjeldrup for collecting data.

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Authors and Affiliations

  1. Health Sciences Research Centre, University of Roehampton, London, UK

    Sandra Gillon & Yvonne M. Jeanes

  2. Centre of Health Research, Førde Hospital Trust, Førde, Norway

    John Roger Andersen & Villy Våge

  3. Department of Surgery, Voss Hospital, Helse Bergen Health Trust, Voss, Norway

    Villy Våge

Authors
  1. Sandra Gillon
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  2. Yvonne M. Jeanes
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  3. John Roger Andersen
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  4. Villy Våge
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Corresponding author

Correspondence to Yvonne M. Jeanes.

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Funding

No external funding was received.

Statements Regarding Ethics and Consent

Data was extracted from the database for bariatric surgery at Førde Central Hospital. This is a database approved by the Norwegian Data Inspectorate and patient inclusion is based on written informed consent allowing data to be used for surveillance. All procedures performed in this study were in accordance with the procedures of the University of Roehampton Ethics committee and with the 1964 Declaration of Helsinki and its later amendments.

Conflict of Interest Statement

All authors have no conflicts of interest to disclose.

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Gillon, S., Jeanes, Y.M., Andersen, J.R. et al. Micronutrient Status in Morbidly Obese Patients Prior to Laparoscopic Sleeve Gastrectomy and Micronutrient Changes 5 years Post-surgery. OBES SURG 27, 606–612 (2017). https://doi.org/10.1007/s11695-016-2313-y

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  • DOI: https://doi.org/10.1007/s11695-016-2313-y

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