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Changes in Nutritional Outcomes After Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis

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Abstract

Background

Bariatric surgery (BS) is the most effective treatment for severe obesity and it has beneficial effects on glycemic control and metabolism outcomes. However, the effects of BS on nutritional outcomes are controversial. Therefore, we aimed to evaluate the changes in several nutritional outcomes after Roux-en-Y gastric bypass (RYGB).

Methods

A comprehensive search was performed using the following databases: PubMed, Embase, Web of Science, Cochrane Library, WanFang and Chinese National Knowledge Infrastructure. The following outcomes were evaluated: vitamin A, 25-hydroxyvitamin D [25(OH)D], calcium, phosphorus, parathormone (PTH), iron, ferritin, vitamin B12, folate, and zinc. The pooled outcomes were expressed as standard mean difference (SMD) and 95% confidence interval (CI) using a random effects model.

Results

Fifty-six studies including 5645 individuals with obesity met the inclusion criteria. Serum 25(OH)D (SMD = 0.78, 95%CI 0.38 to 1.20, P < 0.001), phosphorus (SMD = 0.48, 95%CI 0.22 to 0.74, P < 0.001), PTH (SMD = 0.35, 95%CI 0.11 to 0.59, P = 0.005), vitamin B12 (SMD = 1.11, 95%CI 0.41 to 1.80, P = 0.002), and folate (SMD = 1.53, 95%CI 0.77 to 2.28, P < 0.001) significantly increased after RYGB compared with the baseline. Serum ferritin (SMD =  − 1.67, 95%CI − 2.57 to − 0.77, P < 0.001), vitamin A (SMD =  − 0.64, 95%CI − 0.99 to − 0.29, P < 0.001), and plasma zinc (SMD =  − 0.58, 95%CI − 1.09 to − 0.06, P = 0.027) significantly decreased after RYGB. No significant changes in serum calcium (SMD =  − 0.14, 95%CI − 0.40 to 0.11, P = 0.219) and iron (SMD = 0.26, 95%CI − 0.11 to 0.64, P = 0.165) were observed after RYGB.

Conclusions

Despite the increased levels of 25(OH)D, phosphorus, vitamin B12 and folate, this meta-analysis revealed the unfavorable nutritional consequences after RYGB.

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Data Availability

This study did not generate any new or original data. The data used in this publication are readily available from original source papers included in the meta-analysis.

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Authors and Affiliations

  1. Department of Medical Services, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan, China

    Leizhen Duan

  2. Public Health and Preventive Medicine Teaching and Research Center, Henan University of Chinese Medicine, Zhengzhou, China

    Yan Wang

  3. Huajing Town Community Health Service Center, Xuhui District, Shanghai, 200231, China

    Lingling Cheng

  4. Department of Clinical Nutrition, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Tongbai North Road 16, Zhengzhou, 450001, Henan, China

    Jun Wang

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Key Points

• Serum 25(OH)D, phosphorus, PTH, vitamin B12, and folate levels increased after RYGB.

• Serum ferritin, vitamin A, and plasma zinc levels decreased after RYGB.

• No significant changes in serum calcium and iron were observed.

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Duan, L., Wang, Y., Cheng, L. et al. Changes in Nutritional Outcomes After Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis. OBES SURG 34, 2116–2129 (2024). https://doi.org/10.1007/s11695-024-07232-2

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