Laparoscopic sleeve gastrectomy and nutritional deficiency: A comprehensive longitudinal analysis

Laparoscopic sleeve gastrectomy (LSG) represents a cornerstone in the surgical management of morbid obesity. While the procedure effectively reduces weight and improves obesity-related comorbidities, the anatomical alterations inherent to LSG can lead to significant nutritional challenges. These modifications in gastrointestinal physiology may result in various micronutrient deficiencies, particularly affecting iron, Vitamin B12 and folate status.

We conducted a prospective cohort study of 70 patients undergoing LSG at our tertiary care centre. Participants underwent comprehensive nutritional assessment at baseline and regular intervals postoperatively (6, 12 and 24 months). We measured serum levels of key micronutrients, including iron, Vitamin B12 and folate, while simultaneously tracking supplement adherence. Statistical analysis incorporated both univariate and multivariate approaches to identify patterns and risk factors for nutritional deficiencies.

Our analysis revealed distinct gender-specific patterns in nutritional deficiencies. Female patients demonstrated significantly higher rates of iron deficiency throughout the study period, with prevalence rates of 58%, 50% and 36% at 6, 12 and 24 months, respectively. Vitamin B12 deficiency showed a progressive increase in both genders, while supplement adherence declined markedly from 96% at 6 months to 42% at 24 months. Multivariate analysis identified female gender, younger age and poor supplement adherence as significant risk factors for nutritional deficiencies.

Post-LSG nutritional deficiencies present a significant clinical challenge, particularly for female patients. Our findings emphasise the critical importance of long-term nutritional monitoring and the need for targeted supplementation and adherence-enhancing intervention strategies to improve supplement adherence.