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Monitoring for micronutrient deficiency after bariatric surgery—what is the risk?
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 micronutrien...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630125/ https://www.ncbi.nlm.nih.gov/pubmed/37550536 http://dx.doi.org/10.1038/s41430-023-01318-3 |
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author | Lewis, Carrie-Anne Osland, Emma J. de Jersey, Susan Hopkins, George Seymour, Matthew Webb, Lindsey Chatfield, Mark D. Hickman, Ingrid J. |
author_facet | Lewis, Carrie-Anne Osland, Emma J. de Jersey, Susan Hopkins, George Seymour, Matthew Webb, Lindsey Chatfield, Mark D. Hickman, Ingrid J. |
author_sort | Lewis, Carrie-Anne |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10630125 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-106301252023-11-09 Monitoring for micronutrient deficiency after bariatric surgery—what is the risk? Lewis, Carrie-Anne Osland, Emma J. de Jersey, Susan Hopkins, George Seymour, Matthew Webb, Lindsey Chatfield, Mark D. Hickman, Ingrid J. Eur J Clin Nutr Article 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. Nature Publishing Group UK 2023-08-07 2023 /pmc/articles/PMC10630125/ /pubmed/37550536 http://dx.doi.org/10.1038/s41430-023-01318-3 Text en © Crown 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Lewis, Carrie-Anne Osland, Emma J. de Jersey, Susan Hopkins, George Seymour, Matthew Webb, Lindsey Chatfield, Mark D. Hickman, Ingrid J. Monitoring for micronutrient deficiency after bariatric surgery—what is the risk? |
title | Monitoring for micronutrient deficiency after bariatric surgery—what is the risk? |
title_full | Monitoring for micronutrient deficiency after bariatric surgery—what is the risk? |
title_fullStr | Monitoring for micronutrient deficiency after bariatric surgery—what is the risk? |
title_full_unstemmed | Monitoring for micronutrient deficiency after bariatric surgery—what is the risk? |
title_short | Monitoring for micronutrient deficiency after bariatric surgery—what is the risk? |
title_sort | monitoring for micronutrient deficiency after bariatric surgery—what is the risk? |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10630125/ https://www.ncbi.nlm.nih.gov/pubmed/37550536 http://dx.doi.org/10.1038/s41430-023-01318-3 |
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