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Prevalence and Determinants of Nutritional Deficiencies at Mid-Term After Sleeve Gastrectomy

Obesity Surgery volume 30, pages 2165–2172 (2020)Cite this article

Abstract

Background

Several studies reported a risk of nutritional deficiencies after sleeve gastrectomy (SG). Systematic long-term multivitamin (MV) supplementation after SG is recommended by guidelines but not followed in practice in France.

Objectives

To assess the determinants of nutritional status at 2 years or more after SG in patients treated or not with MV.

Methods

Nutritional parameters were prospectively recorded in our database from 2004. All patients who came back in our institution for follow-up at 2 years or more after SG were included. The last visit available was selected. Systematic MV was stopped at 1 year after SG except if there is risk of malnutrition. A deficiency was defined by a biological deficit or the need for a specific supplement, prescribed in accordance with biological deficit.

Results

One hundred forty-seven patients were included with a mean follow-up of 44 ± 17 months: 39 were still taking MV and 108 had stopped MV. Caloric and protein intake was lower, and albumin deficiencies were more frequent in patients still taking MV, as expected. The total number of deficiencies was not significantly different before and after SG even in patients without MV (3.7 ± 1.8 vs. 3.5 ± 1.8), but patients without MV tended to have more group B vitamin deficiencies after surgery. The main determinants of postoperative deficiencies were preoperative concentrations.

Conclusion

Nutritional deficiencies are not more common after than before SG, even among patients who stopped MV. The interest of targeted supplementation in patients with deficiencies rather than systematic supplementation after SG needs to be confirmed by randomized studies.

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Acknowledgments

The authors thank Kelly Pinto and Maylis Bouteiller for dietary assessments, and Catherine Bogard for biological assessments.

Author information

Affiliations

  1. Service des Explorations Fonctionnelles, Centre Intégré Nord Francilien de l’Obésité (CINFO), Hôpital Louis Mourier, AP-HP, and INSERM UMR 1149, Université de Paris, Paris, France

    Muriel Coupaye, Ouidad Sami & Séverine Ledoux

  2. Service de Chirurgie, Centre Intégré Nord Francilien de prise en charge de l’Obésité (CINFO), Hôpital Louis Mourier, AP-HP, Université de Paris, Paris, France

    Daniela Calabrese

  3. Service des Explorations Fonctionnelles, Hôpital Bichat, AP-HP, Université de Paris, Paris, France

    Martin Flamant

Authors
  1. Muriel Coupaye
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  2. Ouidad Sami
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  3. Daniela Calabrese
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  4. Martin Flamant
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  5. Séverine Ledoux
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Correspondence to Muriel Coupaye.

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The authors declare that they have no conflict of interest.

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

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

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Coupaye, M., Sami, O., Calabrese, D. et al. Prevalence and Determinants of Nutritional Deficiencies at Mid-Term After Sleeve Gastrectomy. OBES SURG 30, 2165–2172 (2020). https://doi.org/10.1007/s11695-020-04425-3

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Keywords

  • Sleeve gastrectomy
  • Nutritional status
  • Deficiencies
  • Multivitamins