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Hair Loss After Laparoscopic Sleeve Gastrectomy

Abstract

Aim

The aim of this study was to evaluate the prevalence of hair loss after laparoscopic sleeve gastrectomy (LSG). The effects of variables on the likelihood that patients developed hair loss were also examined.

Material and Methods

Fifty patients who underwent LSG were enrolled in this prospective study. Demographics, hematocrit, iron, zinc, folic acid, vitamin B12, total proteins, and albumin were evaluated preoperatively and 6 months postoperatively.

Results

Hair loss was observed in 56% of patients and particularly in 46% in females and in 10% in males. Analysis of variance indicated statistical differences for hair loss among the groups with and without hair loss concerning preoperative zinc (p < 0.001), postoperative zinc (p < 0.001), preoperative B12 (p < 0.001), postoperative B12 (p < 0.001), postoperative folic acid (p = 0.039), and postoperative use of supplements (p < 0.001). Patients with hair loss had lower values of zinc preoperatively and postoperatively compared to patients without hair loss (0.61 vs 0.81 mcg/ml) (0.46 vs 0.73 mcg/ml) and also lower values of vitamin B12 preoperatively and postoperatively compared to patients without hair loss (243.04 vs 337.41 pg/ml) (261.54 vs 325.68 pg/ml). Interestingly, the zinc levels were normal preoperatively and lower to normal levels postoperatively and the levels of vitamin B12 were lower than normal values preoperatively in patients with hair loss. Patients with hair loss had mean lower levels of postoperative folic acid of 8 ng/ml.

Conclusion

The prevalence of hair loss was 56% 6 months after LSG. Preoperative monitoring and counseling of these micronutrients may be a preventive and therapeutic measure.

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References

  1. 1.

    Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37. Review. Erratum in: JAMA. 2005 Apr 13;293(14):1728

  2. 2.

    Chang SH, Stoll CR, Song J, et al. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014;149(3):275–87. https://doi.org/10.1001/jamasurg.2013.3654. Review

  3. 3.

    Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351(26):2683–93.

  4. 4.

    Gletsu-Miller N, Wright BN. Mineral malnutrition following bariatric surgery. Adv Nutr. 2013 Sep 1;4(5):506–17. https://doi.org/10.3945/an.113.004341.

  5. 5.

    Folope V, Coëffier M, Déchelotte P. Nutritional deficiencies associated with bariatric surgery. Gastroenterol Clin Biol. 2007;31(4):369–77.

  6. 6.

    Ruiz-Tovar J, Llavero C, Zubiaga L, et al. Maintenance of multivitamin supplements after sleeve gastrectomy. Obes Surg. 2016;26(10):2324–30. https://doi.org/10.1007/s11695-016-2084-5.

  7. 7.

    Zacharoulis D, Sioka E, Papamargaritis D, et al. Influence of the learning curve on safety and efficiency of laparoscopic sleeve gastrectomy. Obes Surg. 2012;22(3):411–5. https://doi.org/10.1007/s11695-011-0436-8.

  8. 8.

    Wolff H, Fischer TW, Blume-Peytavi U. The diagnosis and treatment of hair and scalp diseases. Dtsch Arztebl Int. 2016;113(21):377–86. https://doi.org/10.3238/arztebl.2016.0377. Review

  9. 9.

    Thompson JM, Mirza MA, Park MK, et al. The role of micronutrients in alopecia areata: a review. Am J Clin Dermatol. 2017;18(5):663–79. https://doi.org/10.1007/s40257-017-0285-x.

  10. 10.

    Kil MS, Kim CW, Kim SS. Analysis of serum zinc and copper concentrations in hair loss. Ann Dermatol. 2013;25(4):405–9. https://doi.org/10.5021/ad.2013.25.4.405.

  11. 11.

    Gowda D, Premalatha V, Imtiyaz DB. Prevalence of nutritional deficiencies in hair loss among Indian participants: results of a cross-sectional study. Int J Trichology. 2017;9(3):101–4. https://doi.org/10.4103/ijt.ijt_48_16.

  12. 12.

    Papamargaritis D, Aasheim ET, Sampson B, et al. Copper, selenium and zinc levels after bariatric surgery in patients recommended to take multivitamin-mineral supplementation. J Trace Elem Med Biol. 2015;31:167–72. https://doi.org/10.1016/j.jtemb.2014.09.005.

  13. 13.

    Mahawar KK, Bhasker AG, Bindal V, et al. Zinc deficiency after gastric bypass for morbid obesity: a systematic review. Obes Surg. 2017;27(2):522–9. https://doi.org/10.1007/s11695-016-2474-8.

  14. 14.

    Ruiz-Tovar J, Oller I, Llavero C, et al. Hair loss in females after sleeve gastrectomy: predictive value of serum zinc and iron levels. Am Surg. 2014;80(5):466–71.

  15. 15.

    Belfiore A, Cataldi M, Minichini L, et al. Short-term changes in body composition and response to micronutrient supplementation after laparoscopic sleeve gastrectomy. Obes Surg. 2015;25(12):2344–51. https://doi.org/10.1007/s11695-015-1700-0.

  16. 16.

    Rojas P, Gosch M, Basfi-fer K, et al. Alopecia in women with severe and morbid obesity who undergo bariatric surgery. Nutr Hosp. 2011;26(4):856–62. https://doi.org/10.1590/S0212-16112011000400028.

  17. 17.

    Torkanlou K, Bibak B, Abbaspour A, et al. Reduced serum levels of zinc and superoxide dismutase in obese individuals. Ann Nutr Metab. 2016;69(3–4):232–6. https://doi.org/10.1159/000454894.

  18. 18.

    Marreiro DN, Fisberg M, Cozzolino SM. Zinc nutritional status and its relationships with hyperinsulinemia in obese children and adolescents. Biol Trace Elem Res. 2004;100:137–49.

  19. 19.

    Habib SA, Saad EA, Elsharkawy AA, et al. Pro-inflammatory adipocytokines, oxidative stress, insulin, Zn and Cu: interrelations with obesity in Egyptian non-diabetic obese children and adolescents. Adv Med Sci. 2015;60(2):179–85. https://doi.org/10.1016/j.advms.2015.02.002.

  20. 20.

    Olechnowicz J, Tinkov A, Skalny A, et al. Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism. J Physiol Sci. 2018;68(1):19–31. https://doi.org/10.1007/s12576-017-0571-7.

  21. 21.

    Cruz KJ, Morais JB, de Oliveira AR, et al. The effect of zinc supplementation on insulin resistance in obese subjects: a systematic review. Biol Trace Elem Res. 2017;176(2):239–43. https://doi.org/10.1007/s12011-016-0835-8.

  22. 22.

    Langer FB, Reza Hoda MA, Bohdjalian A, et al. Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels. Obes Surg. 2005;15(7):1024–9.

  23. 23.

    Hatipoğlu N, Atabek ME, Kurtoğlu S, et al. The relationship between serum ghrelin levels and hair zinc concentrations in children. J Clin Res Pediatr Endocrinol. 2008;1(1):1–7. https://doi.org/10.4008/jcrpe.v1i1.14.

  24. 24.

    Shin H, Choi SJ, Cho AR, et al. Acute stress-induced changes in follicular dermal papilla cells and mobilization of mast cells: implications for hair growth. Ann Dermatol. 2016;28(5):600–6.

  25. 25.

    Thom E. Stress and the hair growth cycle: cortisol-induced hair growth disruption. J Drugs Dermatol. 2016;15(8):1001–4.

  26. 26.

    Marreiro DD, Cruz KJ, Morais JB, Beserra JB, Severo JS, de Oliveira AR. Zinc and oxidative stress: current mechanisms. Antioxidants (Basel). 2017;6(2). https://doi.org/10.3390/antiox6020024. Review.

  27. 27.

    Bawahab MA, Assiri AS, Maksoud WA, et al. Effects of weight reduction after sleeve gastrectomy on metabolic variables in Saudi obese subjects in Aseer Province of Kingdom of Saudi Arabia. Obes Surg. 2017;27(8):2005–14. https://doi.org/10.1007/s11695-017-2579-8.

  28. 28.

    Gletsu-Miller N, Hansen JM, Jones DP, et al. Loss of total and visceral adipose tissue mass predicts decreases in oxidative stress afterweight-loss surgery. Obesity (Silver Spring). 2009;17(3):439–46. https://doi.org/10.1038/oby.2008.542.

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Author information

Correspondence to Dimitrios Zacharoulis.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Cite this article

Katsogridaki, G., Tzovaras, G., Sioka, E. et al. Hair Loss After Laparoscopic Sleeve Gastrectomy. OBES SURG 28, 3929–3934 (2018). https://doi.org/10.1007/s11695-018-3433-3

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Keywords

  • Hair loss
  • Laparoscopic sleeve gastrectomy
  • Bariatric surgery
  • Obesity surgery
  • Nutrition
  • Zinc
  • Obesity