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Nutritional Risks in Adolescents After Bariatric Surgery.

Stavra A Xanthakos1, Jane C Khoury2, Thomas H Inge3

  • 1Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|November 10, 2019
PubMed
Summary

Adolescents undergoing bariatric surgery, particularly Roux-en-Y gastric bypass (RYGB), face high rates of nutritional deficiencies, especially iron and vitamin B12, within five years. Ongoing monitoring and supplementation are crucial post-surgery.

Keywords:
BMILong-TermOutcomePTH

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Area of Science:

  • Pediatric Endocrinology
  • Nutritional Science
  • Bariatric Surgery Outcomes

Background:

  • Nutritional deficiencies are poorly understood in adolescents post-metabolic bariatric surgery.
  • A 5-year prospective cohort study was conducted to investigate these deficiencies.

Purpose of the Study:

  • To determine the prevalence and risk factors of nutritional deficiencies in adolescents following bariatric surgery.
  • To compare outcomes between Roux-en-Y gastric bypass (RYGB) and vertical sleeve gastrectomy (VSG).

Main Methods:

  • A prospective cohort study of 226 adolescents (161 RYGB, 65 VSG) over 5 years.
  • Serum levels of ferritin, folate, vitamins A, B1, B12, D, and parathyroid hormone were measured annually.
  • General linear mixed models analyzed changes and associated risk factors.

Main Results:

  • Significant decreases in vitamin B12 and increases in parathyroid hormone were observed post-RYGB, not VSG.
  • Hypoferritinemia rose from 2.5% to 71% post-RYGB and 11% to 45% post-VSG.
  • By 5 years, 59% of RYGB and 27% of VSG recipients had multiple deficiencies, with surgery type, sex, race, and supplementation intake as risk factors.

Conclusions:

  • Nutritional deficiencies, particularly iron and B12, are common 5 years after adolescent bariatric surgery, especially RYGB.
  • Surgery type, supplementation, sex, and race influence deficiency risk.
  • Continuous nutrient monitoring and supplementation are recommended for all adolescent bariatric surgery patients.