Skip to main content

Advertisement

SpringerLink
Log in

Zinc and Copper Serum Levels of Morbidly Obese Patients Before and After Biliopancreatic Diversion: 4 Years of Follow-up

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Zinc and copper are two essential trace elements. However, few studies have been conducted specifically to investigate these deficiencies in patients who underwent bariatric surgery. The aim of our work was to describe the influence of biliopancreatic diversion (BPD) on serum copper and zinc levels during 4 years.

Methods

We have analyzed a consecutive series of 65 patients who have been followed-up for 4 years after undergoing open BPD.

Results

The final (4 years) initial excess weight percent loss was 63.5%. A significant improvement of BMI, weight, waist circumference, and fat mass was detected. The preoperative average zinc (42.2 ± 53.2 μg/dl) and copper (61.3 ± 58.6 μg/dl) levels are under the lower limit of the normal values. These data show a deficient micronutrient status in morbidly obese patients, 73.8% of patients had low basal zinc values and 67.8% low basal copper values. Values of both micronutrients at different times (6 months, 1, 2, 3, and 4 years) were lower than basal value.

Conclusion

BPD is an effective method of sustainable weight loss. Otherwise, a high prevalence of zinc and copper basal deficiencies in morbidly obese seeking bariatric surgery was detected. These deficiencies of copper and zinc increased during the 4 years of follow-up after BDP.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Fontaine KR, Redden DT, Wang C, Westfal AO, ALlison DB. Years of life lost due to obesity. JAMA 2003;289:187–193

    Article  PubMed  Google Scholar 

  2. Scopinaro N, Adami GF, Marinari GM: Biliopancreatic diversión. World J Surg 1998;22:936–946

    Article  PubMed  CAS  Google Scholar 

  3. Scopinaro N, Giannetta E, Adami GF. Biliopancreatic diversion for obesity at eighteen years. Surgery 1996;119:261–268.

    Article  PubMed  CAS  Google Scholar 

  4. Tuerk MJ, Fazel N. Zinc deficiency. Curr Opin Gastroenterol. 2009;25:136–43.

    Article  PubMed  CAS  Google Scholar 

  5. Arredondo M, Nunez MT. Iron and copper metabolism. Mol Aspects Med. 2005;26:313–27

    Article  PubMed  CAS  Google Scholar 

  6. Jaiser SR, Winston GP. Copper deficiency myelopathy. J Neurol. 2010;257:869–81

    Article  PubMed  CAS  Google Scholar 

  7. Cominetti C, Garrido A, Franciscato Zozzolino MF. Zinc nutritional status of morbidly obese patients before and after Roux-en-Y Gastric Byapss: A preliminary report. Obes Surg 2006;16:448–453

    Article  PubMed  Google Scholar 

  8. Madan A, Orth W, Tichansky DS, Ternovits CA. Vitamina d Trace mineral levels after laparoscopic gastric bypass. Obes Sur 2006;16:603–606.

    Article  Google Scholar 

  9. Balsa J, Botella J, Gomez Martin J, Peromingo R, Arrieta F, Santiuste C, Zamarron I, Vazquez C. Copper and zinc serum levels after derivate bariatric surgery: differences beteen roux en Y castric bypass and biliopancreatic diversion. Obes Surg 2011;21:744–750.

    Article  PubMed  Google Scholar 

  10. Klevay LM. Bariatric surgery and the assessment of copper and zinc nutriture. Obes Surg. 2010;20:672–3.

    Article  PubMed  Google Scholar 

  11. Elia M, Arribas D, Gracia JA, Artigas C, Jimenez A, Bielsa MA. Results of biliopancreatic diversion after five years. Obesity Surgery 2004;766–772

  12. Liuzzi JP, Lichten LA, Rivera S, Blanchard RK, Aydemir TB,Knutson MD et al. Interleukin-6 regulates the zinc transporter Zip-14 in liver and contributes to the hypozincemia in the acute-phase response. Proc Natl Acad Sci 2005; 102: 6843–48.

    Article  PubMed  CAS  Google Scholar 

  13. Kim JR, Ryu HH, Chung HJ, Lee JH, Kim SW, Kwun WH et al.Association of anti-obesity activity of N-acetylcysteine with metallothionein-II down-regulation. Exp Mol Med 2006; 38: 162–72.

    PubMed  CAS  Google Scholar 

  14. Schroeder JJ, Cousins RJ. Interleukin 6 regulates metallothionein gene expression and zinc metabolism in hepatocyte monolayer cultures. Proc Natl Acad Sci 1990; 87: 3137–41.

    Article  PubMed  CAS  Google Scholar 

  15. Hashim Z, Woodhouse L, King JC. Interindividual variation in circulating zinc concentrations among healthy adult men and women. Int J Food Sci Nutr. 1996;47:383–90.

    Article  PubMed  CAS  Google Scholar 

  16. Hyun TH, Barrett-Connor E, Milne DB. Zinc intakes and plasma concentrations in men with osteoporosis: the Rancho Bernardo Study. Am J Clin Nutr. 2004;80:715–21

    PubMed  CAS  Google Scholar 

  17. Newbury L, Dolan K, Hatzifotis M. Calcium and vitamin D depletion and elevated parathyroid hormone following biliopancreatic diversion. Obs Surg 2003;13:893–895

    Article  Google Scholar 

  18. Hatizifotis M, Dolan K, newbury L. Symptomatic vitamin A deficiency following biliopancreatic diversion. Obes Surg 2003:13:655–657

    Article  PubMed  Google Scholar 

  19. Sternlieb I, Janowitz HD. Absorption of copper in malabsorption syndrome. J Clin Invest. 1964;43:1049–55.

    Article  PubMed  CAS  Google Scholar 

  20. Lee HH, Prasad AS, Brewer GJ, et al. Zinc absorption in human small intestine. Am J Physiol. 1989;256:G87–91.

    PubMed  CAS  Google Scholar 

  21. Prasad AS. Zinc deficiency. BMJ. 2003;326:409–10

    Article  PubMed  Google Scholar 

  22. Mechanick JI, Kushner RF, Sugerman HJ, et al. American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic and Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient. Endocr Pract. 2008;14:1–83

    PubMed  Google Scholar 

  23. Pournaras DJ, Le Roux CW. After bariatric surgery, what vitamins should be measured and what supplements should be given? Clin Endocrinol. 2009;71:322–5.

    Article  CAS  Google Scholar 

  24. Hess SY, Peerson JM, King JC. Use of serum zinc concentration as an indicator of population zinc status. Food Nutr Bull 2007;28:S403–S29

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Valladolid Institute of Endocrinology and Nutrition, Medicine School, Unit of Investigation, and Endocrinology Department. Hospital Rio Hortega, C/Los perales 16, Simancas, 47130, Valladolid, Spain

    Daniel A. de Luis, Olatz Izaola, Maria Concepcion Terroba, Luis Cuellar & Tomas Martin

  2. University of Valladolid Division Institute of Endocrinology and Nutrition, Medicine School, Unit of Investigation, Surgical Department. Hospital Rio Hortega, C/Los perales 16, Simancas, 47130, Valladolid, Spain

    David Pacheco

Authors
  1. Daniel A. de Luis
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. David Pacheco
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Olatz Izaola
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Maria Concepcion Terroba
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Luis Cuellar
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tomas Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel A. de Luis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

de Luis, D.A., Pacheco, D., Izaola, O. et al. Zinc and Copper Serum Levels of Morbidly Obese Patients Before and After Biliopancreatic Diversion: 4 Years of Follow-up. J Gastrointest Surg 15, 2178–2181 (2011). https://doi.org/10.1007/s11605-011-1647-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11605-011-1647-y

Keywords

Search

Navigation