Obesity Surgery

, Volume 20, Issue 12, pp 1660–1670 | Cite as

Zinc Deficiency: A Frequent and Underestimated Complication After Bariatric Surgery

  • Agnès SalléEmail author
  • Delphine Demarsy
  • Anne Lise Poirier
  • Bénédicte Lelièvre
  • Philippe Topart
  • Gérard Guilloteau
  • Guillaume Bécouarn
  • Vincent Rohmer
Clinical Research



Although zinc deficiency is common after bariatric surgery, its incidence is underestimated. The objective was to monitor zinc and nutritional status before and 6, 12 and 24 months (M6, M12 and M24) after gastric bypass (Roux-en-Y gastric bypass), sleeve gastrectomy and biliopancreatic diversion with duodenal switch (DS) in patients receiving systematised nutritional care.


Data for 324 morbidly obese patients (mean body mass index 46.2 ± 7.3 kg/m2) were reviewed retrospectively. The follow-up period was 6 months for 272 patients, 12 months for 175, and 24 months for 70. Anthropometric, dietary and serum albumin, prealbumin, zinc, iron and transferrin saturation measures were determined at each timepoint.


Nine percent of patients had zinc deficiency pre-operatively. Zinc deficiency was present in 42.5% of the population at M12 and then remained stable. Zinc deficiency was significantly more frequent after DS, with a prevalence of 91.7% at M12. Between M0 and M6, variation in plasma prealbumin, surgery type and zinc supplementation explained 27.2% of the variance in plasma zinc concentration. Surgery type explained 22.1% of this variance between M0 and M24. Mean supplemental zinc intake was low (22 mg/day). The percentage of patients taking zinc supplementation at M6, M12 and M24 was 8.9%, 20.6% and 29%, respectively.


Reduced protein intake, impaired zinc absorption and worsening compensatory mechanisms contribute to zinc deficiency. The mechanisms involved differ according to the type of surgery and time since surgery. Zinc supplementation is necessary early after bariatric surgery, but this requirement is often underestimated or is inadequate.


Zinc deficiency Morbid obesity Gastric bypass Sleeve gastrectomy Biliopancreatic diversion 


Conflict of interest

All authors declare no conflict of interest.


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Copyright information

© Springer Science + Business Media, LLC 2010

Authors and Affiliations

  • Agnès Sallé
    • 1
    • 5
    Email author
  • Delphine Demarsy
    • 1
  • Anne Lise Poirier
    • 2
  • Bénédicte Lelièvre
    • 3
  • Philippe Topart
    • 4
  • Gérard Guilloteau
    • 1
  • Guillaume Bécouarn
    • 4
  • Vincent Rohmer
    • 1
  1. 1.Pôle de Médecine Interne et des Maladies MétaboliquesCentre Hospitalier UniversitaireAngersFrance
  2. 2.Centre Paul PapinAngersFrance
  3. 3.Laboratoire de PharmacologieCentre Hospitalier UniversitaireAngersFrance
  4. 4.Société de ChirurgieClinique de l’AnjouAngersFrance
  5. 5.Département d’Endocrinologie-Diabétologie-NutritionCHU AngersAngers cedex 09France

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