Oxidative Stress, Micronutrient Deficiencies and Coagulation Disorders After Bariatric Surgery: A Systematic Review

Area of Science:

• Endocrinology and Metabolism
• Hematology
• Nutritional Science

Background:

• Metabolic bariatric surgery (MBS) significantly impacts metabolic, inflammatory, and nutritional states.
• These changes can influence hemostatic balance via redox-dependent pathways.
• Understanding these alterations is key to managing postoperative complications.

Purpose of the Study:

• To systematically review coagulation disturbances following MBS.
• To emphasize the roles of oxidative stress and micronutrient deficiencies.
• To evaluate their impact on hemostatic balance.

Main Methods:

• Systematic literature search of PubMed, Scopus, and Web of Science (2000-2025).
• Inclusion criteria applied to 1707 identified records, with 21 studies meeting requirements.
• Analysis focused on coagulation parameters, oxidative stress markers, and nutrient status.

Main Results:

• MBS often reduces inflammation and oxidative burden, but some patients experience persistent redox imbalance.
• Elevated D-dimer or von Willebrand Factor (vWF) and delayed fibrinolysis normalization were observed.
• Common micronutrient deficiencies (Vitamins K, B12, folate, Se, Zn, Cu) contribute to thrombotic and hemorrhagic risks.

Conclusions:

• Oxidative stress, nutritional status, and hemostasis are interconnected after MBS.
• Individualized thromboprophylaxis and routine micronutrient monitoring are essential.
• Long-term biochemical monitoring and standardized biomarker panels are needed for improved strategies.