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Prevalence of Micronutrient Deficiencies in Geriatric Bariatric Patients

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Abstract

Obese individuals have high prevalence of thiamine deficiency and hypovitaminosis D. Our hypothesis is that geriatric, bariatric surgery patients are at risk for micronutrient deficiencies. In this retrospective study, 3 males and 30 females (gastric bypass: n = 27; vertical sleeve gastrectomy: n = 6) individuals were evaluated. Eight micronutrients are measured using commercial blood testing. Mean age is 70 yr, mean body mass index is 35 kg/m2, with a mean of 11 years after bariatric surgery. Hypovitaminosis D is identified in 32 of 33 patients. Low vitamin B12 is identified in 32%, low vitamin A in 16%, low vitamin E in 31%, low zinc in 22%, and low iron in 35%. Twenty patients (61%) have clinical thiamine deficiency. Geriatric patients have multiple micronutrient deficiencies after bariatric surgery. Focusing on deficiencies of thiamine, vitamin B12, vitamin D, and iron in geriatric, bariatric patients could enforce treatments designed to prevent development of disabling deficiency syndromes.

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REFERENCES

  1. Angrisani, L., Santonicola, A., Iovino, P., Vitiello, A., Higa, K., Himpens, J., Buchwald, H., and Scopinaro, N., IFSO worldwide survey 2016: primary, endoluminal, and revisional procedures, Obes. Surg., 2018, vol. 28, no. 12, pp. 3783–3794.

    Article  Google Scholar 

  2. Bal, B.S., Finelli, F.C., and Koch, T.R., Origins of and recognition of micronutrient deficiencies after gastric bypass surgery, Curr. Diabetes Rep., 2011, vol. 11, pp. 136–141.

    Article  Google Scholar 

  3. Bjelakovic, G., Gluud, L.L., Nikolova, D., Whitfield, K., Wetterslev, J., Simonetti, R.G., Bjelakovic, M., and Gluud, C., Vitamin D supplementation for prevention of mortality in adults, Cochrane Database Syst. Rev., 2014, vol. 1, art. ID CD007470. https://doi.org/10.1002/14651858.CD007470.pub3

    Article  Google Scholar 

  4. Butterworth, R., Thiamin, in Modern Nutrition in Health and Disease, Shils, M.E., Shike, M., and Ross, A.C., Eds., New York: Lipincott Williams and Wilkins, 2006, pp. 426–433.

    Google Scholar 

  5. Deng, Y., Wang, D., Wang, K., and Kwok, T., High serum folate is associated with brain atrophy in older diabetic people with vitamin B12 deficiency, J. Nutr. Health Aging, 2017, vol. 21, no. 9, pp. 1065–1071.

    Article  CAS  Google Scholar 

  6. Global Burden of Disease 2015 Obesity Collaborators, et al., Health effects of overweight and obesity in 195 countries over 25 years, N. Engl. J. Med., 2017, vol. 377, no. 1, pp. 13–27.

  7. Halsted, J.A., Megaloblastic anemia, associated with surgically produced gastrointestinal abnormalities, Calif. Med., 1955, vol. 83, pp. 212–217.

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Hill, T.R., Granic, A., and Aspray, T.J., Vitamin D and ageing, Subcell. Biochem., 2018, vol. 90, pp. 191–220.

    Article  CAS  Google Scholar 

  9. Kaplan, U., Penner, S., Farrokhyar, F., Andruszkiewicz, N., Breau, R., Gmora, S., Hong, D., and Anvari, M., Bariatric surgery in the elderly is associated with similar surgical risks and significant long-term health benefits, Obes. Surg., 2018, vol. 28, no. 8, pp. 2165–2170.

    Article  Google Scholar 

  10. Kennel, K.A., Drake, M.T., and Hurley, D.L., Vitamin D deficiency in adults: When to test and how to treat, Mayo Clin. Proc., 2010, vol. 85, no. 8, pp. 752–758.

    Article  Google Scholar 

  11. Kimmons, J.E., Blanck, H.M., Tohill, B.C., Zhang, J., and Khan, L.K., Associations between body mass index and the prevalence of low micronutrient levels among US adults, Med. Gen. Med., 2006, vol. 8, no. 4, p. 59.

    Google Scholar 

  12. Koh, C.Y., Inaba, C.S., Sujatha-Bhaskar, S., and Nguyen, N.T., Outcomes of laparoscopic bariatric surgery in the elderly population, Am. Surg., 2018, vol. 84, no. 10; pp. 1600–1603.

    Article  Google Scholar 

  13. Lakhani, S.V., Shah, H.N., Alexander, K., Finelli, F.C., Kirkpatrick, J.R., and Koch, T.R., Small intestinal bacterial overgrowth and thiamine deficiency after Roux-en-Y gastric bypass surgery in obese patients, Nutr. Res., 2008, vol. 28, no. 5, pp. 293–298.

    Article  CAS  Google Scholar 

  14. Mason, E.E. and Ito, C., Gastric bypass in obesity, Surg. Clin. North Am., 1967, vol. 47, pp. 1345–1351.

    Article  CAS  Google Scholar 

  15. Maxwell, R.W., Chieffi, M., and Kirk, J.E., Vitamin studies in middle-aged and old individuals. VII. Roentgenological studies of the gastrointestinal tract in patients with hypovitaminosis B1, Gastroenterology, 1952, vol. 20, pp. 309–314.

    Article  CAS  Google Scholar 

  16. Nath, A., Shope, T.R., Brebbia, J.S., and Koch, T.R., Bowel symptoms are associated with hypovitaminosis D in individuals with medically complicated obesity, Nutr. Res., 2019, vol. 63, pp. 70–75.

    Article  CAS  Google Scholar 

  17. Nath, A., Tran, T., Shope, T.R., and Koch, T.R., Prevalence of clinical thiamine deficiency in individuals with medically complicated obesity, Nutr. Res., 2017, vol. 37, no. 1, pp. 29–36.

    Article  CAS  Google Scholar 

  18. O’Keeffe, S.T., Tormey, W.P., Glasgow, R., and Lavan, J.N., Thiamine deficiency in hospitalized elderly patients, Gerontology, 1994, vol. 40, no. 1, pp. 18–24.

    Article  Google Scholar 

  19. Pourhassan, M., Biesalski, H.K., Angersbach, B., Lueg, G., Klimek, C., and Wirth, R., Prevalence of thiamine deficiency in older hospitalized patients, Clin. Interventions Aging, 2018, vol. 13, pp. 2247–2250.

    Article  CAS  Google Scholar 

  20. Prinzo, Z.W., Thiamine deficiency and its prevention and control in major emergencies, WHO/NHD/99/13, 1999, pp. 1–52. http://www.who.int/iris/handle/10665/66139. Accessed December 9, 2015.

  21. Rashti, F., Gupta, E., Shope, T.R., and Koch, T.R., Overview of nutritional deficiencies after bariatric surgery, in Diet and Nutrition in Critical Care, Rajendram, R., Preedy, V.R., and Patel, V.B., Eds., London: Springer, 2015, pp. 1079–1092.

    Google Scholar 

  22. Risch, M., Meier, D.W., Sakem, B., Medina Escobar, P., Risch, C., Nydegger, U., and Risch, L., Vitamin B12 and folate levels in healthy Swiss senior citizens: a prospective study evaluating reference intervals and decision limits, BMC Geriatr., 2015, vol. 15, p. 82.

    Article  Google Scholar 

  23. Selhub, J. and Rosenberg, I.H., Excessive folic acid intake and relation to adverse health outcome, Biochimie, 2016, vol. 126, pp. 71–78.

    Article  CAS  Google Scholar 

  24. Shah, H.N., Bal, B.S., Finelli, F.C., and Koch, T.R., Constipation in patients with thiamine deficiency after Roux-en-Y gastric bypass surgery, Digestion, 2013, vol. 88, pp. 119–124.

    Article  CAS  Google Scholar 

  25. Vinan-Vega, M., Diaz Vico, T., and Elli, E.F., Bariatric surgery in the elderly patient: safety and short-time outcome. A case match analysis, Obes. Surg., 2019, vol. 29, no. 3, pp. 1007–1011.

    Article  Google Scholar 

  26. Wallace, T.C., Frankenfeld, C.L., Frei, B., Shah, A.V., Yu, C.R., van Klinken, B.J., and Adeleke, M., Multivitamin/multimineral supplement use is associated with increased micronutrient intakes and biomarkers and decreased prevalence of inadequacies and deficiencies in middle-aged and older adults in the United States, J. Nutr. Gerontol. Geriatr., 2019, vol. 38, no. 4, pp. 307–328.

    Article  Google Scholar 

  27. Wong, C.W., Vitamin B12 deficiency in the elderly: is it worth screening?, Hong Kong Med. J., 2015, vol. 21, no. 2, pp. 155–164.

    CAS  PubMed  Google Scholar 

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ACKNOWLEDGMENTS

The authors would like to thank Marsha Brown, R.N. for her assistance in organizing and in providing required parenteral nutritional supplements.

Funding

This study received financial support from MedStar Health only.

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Authors and Affiliations

  1. Division of Gastroenterology, MedStar Georgetown University Hospital, 20007, Washington, DC, USA

    A. Nath

  2. Georgetown University School of Medicine, Center for Advanced Laparoscopic and Bariatric Surgery, 20010, Washington, DC, USA

    T. R. Shope & T. R. Koch

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  1. A. Nath
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  2. T. R. Shope
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  3. T. R. Koch
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Contributions

All of the authors contributed to the design of the study. Anand Nath led the data analysis and drafted the abstract section of the manuscript. Timothy Koch drafted the introduction and discussion sections of the manuscript. All authors reviewed, revised, and approved the final manuscript.

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Correspondence to T. R. Koch.

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Conflict of interests. The authors declare that they have no conflict of interest.

Statement of compliance with standards of research involving humans as subjects. Approval for human studies was obtained from the MedStar Research Institute (Hyattsville, MD) Human Studies Subcommittee on December 15, 2018 and on December 16, 2019. The Human Studies Subcommittee decided that this was a minimal risk protocol and granted a waiver of informed consent for this research study.

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Nath, A., Shope, T.R. & Koch, T.R. Prevalence of Micronutrient Deficiencies in Geriatric Bariatric Patients. Adv Gerontol 11, 70–76 (2021). https://doi.org/10.1134/S207905702101046X

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  • DOI: https://doi.org/10.1134/S207905702101046X

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