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Preoperative and Postoperative Assessments of Biochemical Parameters in Patients with Severe Obesity Undergoing Laparoscopic Sleeve Gastrectomy

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Abstract

Background

The study aim was to determine the prevalence of abnormal serum biochemistries associated with micronutrient deficiencies before and after laparoscopic sleeve gastrectomy (LSG).

Methods

Two hundred and one patients had LSG surgery between May 2011 and May 2014. Using a prospective cohort study design, data were collected on ferritin, hemoglobin (Hgb), mean cell volume (MCV), calcium, albumin, 25-hydroxyvitamin D (25-OH-D), PTH, and vitamin B12 with follow-up of 75.6% (n = 152), 63.7% (n = 128), 52.7% (n = 106), and 40.3% (n = 81) at 6, 12, 18, and 24 months, respectively.

Results

Patients were female (81.6%) with mean ± SD, BMI (48.8 ± 6.8 kg/m2), weight (135.1 ± 23.6 kg), and age (44.0 ± 9.6 years). Mean values for all biochemical parameters pre- and post-LSG were within reference limits. After adjusting for age, weight, and supplement use, trend tests post-LSG were significant for mean differences in ferritin (p = 0.002), calcium (p = 0.017), and vitamin B12 (p = 0.034). Pre-LSG, the proportion of patients with values below reference limits included 25-OH-D (20.4%), ferritin (12.3%), and Hgb (10.0%), while the proportion above reference limits included PTH (29.1%) and ferritin (17.4%). After adjustment, hypoalbuminemia was more prevalent after 1 year; the proportion of patients with PTH levels in the upper reference limit was higher 6 months post-LSG (p < 0.05). Multivitamin use increased presurgery from 44 to 88% 2 years postsurgery. Vitamin B12 supplementation increased from 7% before surgery to 32% 2 years postsurgery.

Conclusion

Abnormal serum biochemistries indicative of micronutrient deficiencies were prevalent before surgery; reduced abnormal values were observed after surgery, likely due to an increased use of multivitamins.

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Acknowledgements

We would like to acknowledge Raleen Murphy (Nurse Practitioner) Bariatric Surgery Program, Kim Manning (Research Nurse), and Aimee Roebothan (Research Assistant) for collecting the data. We would like to thank all patients who so willingly gave of their time to participate in this research.

Funding

The Newfoundland and Labrador Centre for Applied Health Research funded this study (#208100).

Author information

Authors and Affiliations

  1. Faculty of Medicine, Memorial University of Newfoundland, M-4135, 300 Prince Philip Drive, St. John’s, NL, A1B 3V6, Canada

    Deborah M. Gregory, Laurie K. Twells, Kendra K. Lester, William K. Midodzi, Mette Rode Pedersen, David Pace, Chris Smith & Darrell Boone

  2. School of Pharmacy, Memorial University of Newfoundland, St. John’s, NL, A1B 3V6, Canada

    Laurie K. Twells

  3. Faculty of Medicine-Surgery, Memorial University, St. John’s, NL, A1B 3V6, Canada

    David Pace, Chris Smith & Darrell Boone

  4. Department of Laboratory Medicine, Memorial University of Newfoundland, St. John’s, NL, A1B 3V6, Canada

    Edward W Randell

  5. Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John’s, NL, A1B 3V6, Canada

    Christopher S. Kovacs

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  1. Deborah M. Gregory
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Correspondence to Laurie K. Twells.

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The authors declare that they have no conflicts of interest.

Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Provincial Human Research Ethics Authority and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Statement Regarding Ethics and Consent

Patients recruited to take part in this study provided written, informed consent for data collection after ethical approval was received from the Health Research Ethics Authority.

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Gregory, D.M., Twells, L.K., Lester, K.K. et al. Preoperative and Postoperative Assessments of Biochemical Parameters in Patients with Severe Obesity Undergoing Laparoscopic Sleeve Gastrectomy. OBES SURG 28, 2261–2271 (2018). https://doi.org/10.1007/s11695-017-3007-9

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