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Nutrient Deficiencies Before and After Sleeve Gastrectomy

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Abstract

Background

Obesity is associated with nutritional deficiencies. Bariatric surgery could worsen these deficiencies. Fewer nutritional deficiencies would be seen after sleeve gastrectomy compared to the Roux-en-Y gastric bypass, but sleeve gastrectomy would also cause further deterioration of the deficiencies. The aim of this study was to determine the amount of pre-operative nutrient deficiencies in sleeve gastrectomy patients and assess the evolution of the nutritional status during the first post-operative year.

Methods

Four hundred seven sleeve gastrectomy patients were assigned to a standardized follow-up program. Data of interest were weight loss, pre-operative nutrient status and evolution of nutrient deficiencies during the first post-operative year. Deficiencies were supplemented when found.

Results

Two hundred patients completed blood withdrawal pre-operatively and in the first post-operative year. pre-operatively, 5 % of the patients were anemic, 7 % had low serum ferritin and 24 % had low folic acid. Hypovitaminosis D was present in 81 %. Vitamin A had excessive levels in 72 %. One year post-operatively, mean excess weight loss was 70 %. Anemia was found in 6 %. Low-ferritin levels were found in 8 % of the patients. Folate deficiency decreased significantly and hypovitaminosis D was still found in 36 %.

Conclusions

In this study, a considerable amount of patients suffered from a deficient micronutrient status pre-operatively. One year after surgery, micronutrient deficiencies persisted or were found de novo in a considerable amount of patients, despite significant weight loss and supplementation. Significant reductions were seen only for folate and vitamin D.

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Conflicts of Interest

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Authors and Affiliations

  1. Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands

    P. W. J. van Rutte, J. F. Smulders & S. W. Nienhuijs

  2. Department of Surgery, Rijnstate Hospital, Arnhem, The Netherlands

    E. O. Aarts

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  1. P. W. J. van Rutte
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  2. E. O. Aarts
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  3. J. F. Smulders
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  4. S. W. Nienhuijs
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Correspondence to P. W. J. van Rutte.

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van Rutte, P.W.J., Aarts, E.O., Smulders, J.F. et al. Nutrient Deficiencies Before and After Sleeve Gastrectomy. OBES SURG 24, 1639–1646 (2014). https://doi.org/10.1007/s11695-014-1225-y

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  • DOI: https://doi.org/10.1007/s11695-014-1225-y

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