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Zinc Deficiency after Gastric Bypass for Morbid Obesity: a Systematic Review

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Abstract

Up to 50% of patients have zinc deficiency before bariatric surgery. Roux-en-Y gastric bypass (RYGB) is the commonest bariatric procedure worldwide. It can further exacerbate zinc deficiency by reducing intake as well as absorption. The British Obesity and Metabolic Surgery Society, therefore, recommends that zinc level should be monitored routinely following gastric bypass. However, the American guidance does not recommend such monitoring for all RYGB patients and reserves it for patients with ‘specific findings’. This review concludes that clinically relevant Zn deficiency is rare after RYGB. Routine monitoring of zinc levels is hence unnecessary for asymptomatic patients after RYGB and should be reserved for patients with skin lesions, hair loss, pica, dysgeusia, hypogonadism or erectile dysfunction in male patients, and unexplained iron deficiency anaemia.

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Abbreviations

Zinc:

Zn

RYGB:

Roux-en-Y gastric bypass

BOMSS:

British Obesity and Metabolic Surgery Society

ASMBS:

American Society for Metabolic and Bariatric Surgery

Copper:

Cu

PRISMA:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses

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Authors’ Contributions

KM conceived the idea for the topic, performed the review, and wrote most of the manuscript. AB and VB critically reviewed the manuscript. All authors participated in discussions on the topic and contributed to manuscript writing. All authors have seen the final version and approve it.

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Authors and Affiliations

  1. Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK

    Kamal K. Mahawar, Yitka Graham & Peter K. Small

  2. Indian Bariatric Research Network, Kolkata, India

    Kamal K. Mahawar, Aparna Govil Bhasker & Vivek Bindal

  3. Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, SR1 3SD, UK

    Kamal K. Mahawar, Yitka Graham & Peter K. Small

  4. Centre for Obesity and Digestive Surgery, Mumbai, India and Institute of Minimal Invasive Surgical Sciences and Research Center, Saifee Hospital, Mumbai, India

    Aparna Govil Bhasker & Muffazal Lakdawala

  5. Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS) and Institute of Robotic Surgery (IRS), Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, 110060, India

    Vivek Bindal

  6. Super Specialty Paediatric Hospital and Post Graduate Training Institute, Sector 30, Noida, Uttar Pradesh, 201303, India

    Usha Dudeja

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  1. Kamal K. Mahawar
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  2. Aparna Govil Bhasker
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  7. Peter K. Small
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Correspondence to Kamal K. Mahawar.

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Mahawar, K.K., Bhasker, A.G., Bindal, V. et al. Zinc Deficiency after Gastric Bypass for Morbid Obesity: a Systematic Review. OBES SURG 27, 522–529 (2017). https://doi.org/10.1007/s11695-016-2474-8

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