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Nutrient deficiencies before and after sleeve gastrectomy.

P W J van Rutte1, E O Aarts, J F Smulders

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Sleeve gastrectomy patients often have pre-operative nutrient deficiencies. Post-surgery, many deficiencies persist or emerge, despite weight loss and supplementation, with only folate and vitamin D showing significant improvement.

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Area of Science:

  • Bariatric Surgery
  • Nutritional Science
  • Endocrinology

Background:

  • Obesity frequently coexists with nutritional deficiencies.
  • Bariatric surgery, while effective for weight loss, can exacerbate existing nutrient deficits.
  • Sleeve gastrectomy presents a unique profile of nutritional challenges compared to other bariatric procedures.

Purpose of the Study:

  • To quantify pre-operative micronutrient deficiencies in patients undergoing sleeve gastrectomy.
  • To evaluate the longitudinal changes in nutritional status during the first year after sleeve gastrectomy.
  • To assess the impact of sleeve gastrectomy on common nutrient deficiencies and the effectiveness of supplementation.

Main Methods:

  • A cohort of 407 sleeve gastrectomy patients was enrolled in a structured follow-up protocol.
  • Pre-operative and one-year post-operative nutritional status was assessed through blood analysis.
  • Weight loss, nutrient levels, and deficiency prevalence were monitored, with supplementation provided as needed.

Main Results:

  • Pre-operatively, significant deficiencies included hypovitaminosis D (81%), low folic acid (24%), and anemia (5%).
  • One year post-surgery, mean excess weight loss was 70%, but deficiencies in vitamin D persisted (36%), and new deficiencies emerged.
  • Folate levels improved significantly, and anemia prevalence slightly decreased, while vitamin A levels were often excessive pre-operatively.

Conclusions:

  • A substantial proportion of sleeve gastrectomy patients exhibit pre-operative micronutrient deficiencies.
  • Despite weight loss and supplementation, micronutrient deficiencies remain a significant concern one year post-sleeve gastrectomy.
  • Folate and vitamin D deficiencies showed notable improvement, highlighting the need for targeted monitoring and intervention.