Nutritional deficiencies after sleeve gastrectomy: can they be predicted preoperatively?

Surg Obes Relat Dis. 2015 Sep-Oct;11(5):1029-36. doi: 10.1016/j.soard.2015.02.018. Epub 2015 Feb 25.

Abstract

Background: Nutritional deficiencies are common among morbidly obese patients. Data are scarce for patients who have undergone laparoscopic sleeve gastrectomy (LSG).

Objectives: The aim of the study is to clarify the prevalence of deficiencies and to identify risk factors for postoperative deficiencies.

Settings: Hebrew University, Israel.

Methods: Preoperative and 1-year postoperative data were collected. We included anthropometric parameters, obesity-related co-morbidities, and laboratory findings.

Results: There were 192 candidates. Seventy-seven of them completed follow-ups at 12 months. Before surgery, 15% had anemia. Deficiencies of iron, folate, and B12 were 47%, 32%, and 13%, respectively. Women were more deficient in iron (56% women, 26% men, P<.001). Before surgery, low levels of vitamin D and elevated parathyroid hormone (PTH) were 99% and 41%, respectively. One year postsurgery, the deficiencies of hemoglobin and vitamin B12 worsened (20% and 17%, P<.001, P = .048, respectively). One year postsurgery, deficiencies of iron, folate, vitamin D, and PTH improved (28%, 21%, 94%, and 10%, respectively). Deficiencies of hemoglobin, folate, and B12 before surgery were predictors for deficiencies 1 year after surgery (P = .006 OR = .090; P = .012 OR = .069; P = .062 OR = .165, respectively).

Conclusions: LSG had a modest effect on nutritional deficiencies in our patients at 1-year postsurgery. Focusing on the preoperative nutritional status and tailoring a specific supplemental program for each individual should prevent postoperative deficiencies.

Keywords: Bariatric surgery; Laparoscopic sleeve gastrectomy; Nutritional deficiencies; Obesity; Supplements.

MeSH terms

  • Adult
  • Age Distribution
  • Anthropometry
  • Avitaminosis / epidemiology
  • Avitaminosis / etiology*
  • Avitaminosis / physiopathology
  • Bariatric Surgery / adverse effects
  • Bariatric Surgery / methods
  • Body Mass Index
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Gastrectomy / adverse effects*
  • Gastrectomy / methods
  • Hospitals, University
  • Humans
  • Incidence
  • Israel
  • Laparoscopy / adverse effects*
  • Laparoscopy / methods
  • Male
  • Malnutrition / diagnosis*
  • Malnutrition / epidemiology
  • Malnutrition / etiology*
  • Middle Aged
  • Obesity, Morbid / diagnosis
  • Obesity, Morbid / surgery*
  • Predictive Value of Tests
  • Preoperative Care / methods
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Sex Distribution
  • Weight Loss / physiology