Monitoring for micronutrient deficiency after bariatric surgery-what is the risk?
© 2023. Crown..
BACKGROUND: Bariatric surgery may increase the risk of micronutrient deficiencies; however, confounders including preoperative deficiency, supplementation and inflammation are rarely considered.
OBJECTIVE: To examine the impact of bariatric surgeries, supplementation and inflammation on micronutrient deficiency.
SETTING: Two public hospitals, Australia.
METHODS: Participants were recruited to an observational study monitoring biochemical micronutrient outcomes, supplementation dose, inflammation and glycaemic control, pre-operatively and at 1-3, 6 and 12 months after gastric bypass (GB; Roux-en-Y Gastric Bypass and Single Anastomosis Gastric Bypass; N = 66) or sleeve gastrectomy (SG; N = 144). Participant retention at 12 months was 81%.
RESULTS: Pre-operative micronutrient deficiency was common, for vitamin D (29-30%), iron (13-22%) and selenium (39% GB cohort). Supplement intake increased after surgery; however, dose was <50% of target for most nutrients. After SG, folate was vulnerable to deficiency at 6 months (OR 13 [95% CI 2, 84]; p = 0.007), with folic acid supplementation being independently associated with reduced risk. Within 1-3 months of GB, three nutrients had higher deficiency rates compared to pre-operative levels; vitamin B1 (21% vs. 6%, p < 0.01), vitamin A (21% vs. 3%, p < 0.01) and selenium (59% vs. 39%, p < 0.05). Vitamin B1 deficiency was independently associated with surgery and inflammation, selenium deficiency with improved glycaemic control after surgery and inflammation, whilst vitamin A deficiency was associated with inflammation only.
CONCLUSION: In the setting of prophylactic post-surgical micronutrient prescription, few nutrients are at risk of de novo deficiency. Although micronutrient supplementation and monitoring remains important, rationalising high-frequency biochemical testing protocols in the first year after surgery may be warranted.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:77 |
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| Enthalten in: |
European journal of clinical nutrition - 77(2023), 11 vom: 07. Nov., Seite 1071-1083 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lewis, Carrie-Anne [VerfasserIn] |
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| Links: |
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| Themen: |
H6241UJ22B |
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| Anmerkungen: |
Date Completed 09.11.2023 Date Revised 29.11.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1038/s41430-023-01318-3 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM360501907 |
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| 100 | 1 | |a Lewis, Carrie-Anne |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Monitoring for micronutrient deficiency after bariatric surgery-what is the risk? |
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| 500 | |a Date Revised 29.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. Crown. | ||
| 520 | |a BACKGROUND: Bariatric surgery may increase the risk of micronutrient deficiencies; however, confounders including preoperative deficiency, supplementation and inflammation are rarely considered | ||
| 520 | |a OBJECTIVE: To examine the impact of bariatric surgeries, supplementation and inflammation on micronutrient deficiency | ||
| 520 | |a SETTING: Two public hospitals, Australia | ||
| 520 | |a METHODS: Participants were recruited to an observational study monitoring biochemical micronutrient outcomes, supplementation dose, inflammation and glycaemic control, pre-operatively and at 1-3, 6 and 12 months after gastric bypass (GB; Roux-en-Y Gastric Bypass and Single Anastomosis Gastric Bypass; N = 66) or sleeve gastrectomy (SG; N = 144). Participant retention at 12 months was 81% | ||
| 520 | |a RESULTS: Pre-operative micronutrient deficiency was common, for vitamin D (29-30%), iron (13-22%) and selenium (39% GB cohort). Supplement intake increased after surgery; however, dose was <50% of target for most nutrients. After SG, folate was vulnerable to deficiency at 6 months (OR 13 [95% CI 2, 84]; p = 0.007), with folic acid supplementation being independently associated with reduced risk. Within 1-3 months of GB, three nutrients had higher deficiency rates compared to pre-operative levels; vitamin B1 (21% vs. 6%, p < 0.01), vitamin A (21% vs. 3%, p < 0.01) and selenium (59% vs. 39%, p < 0.05). Vitamin B1 deficiency was independently associated with surgery and inflammation, selenium deficiency with improved glycaemic control after surgery and inflammation, whilst vitamin A deficiency was associated with inflammation only | ||
| 520 | |a CONCLUSION: In the setting of prophylactic post-surgical micronutrient prescription, few nutrients are at risk of de novo deficiency. Although micronutrient supplementation and monitoring remains important, rationalising high-frequency biochemical testing protocols in the first year after surgery may be warranted | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
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| 650 | 7 | |a Micronutrients |2 NLM | |
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| 650 | 7 | |a Thiamine |2 NLM | |
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| 700 | 1 | |a Osland, Emma J |e verfasserin |4 aut | |
| 700 | 1 | |a de Jersey, Susan |e verfasserin |4 aut | |
| 700 | 1 | |a Hopkins, George |e verfasserin |4 aut | |
| 700 | 1 | |a Seymour, Matthew |e verfasserin |4 aut | |
| 700 | 1 | |a Webb, Lindsey |e verfasserin |4 aut | |
| 700 | 1 | |a Chatfield, Mark D |e verfasserin |4 aut | |
| 700 | 1 | |a Hickman, Ingrid J |e verfasserin |4 aut | |
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