Hypozincaemia after jejuno-ileal bypass

Area of Science:

• Biochemistry
• Clinical Nutrition
• Surgical Outcomes

Background:

• Jejuno-ileal bypass surgery was historically used for morbid obesity.
• Nutritional deficiencies are a known complication of bariatric surgery.
• Divalent cations like zinc, calcium, and magnesium are crucial for numerous physiological processes.

Purpose of the Study:

• To investigate serum levels of zinc, calcium, and magnesium in patients who underwent jejuno-ileal shunt surgery.
• To determine the binding status of serum zinc to albumin and alpha 2-macroglobulin.
• To assess the prevalence of hypozincaemia, hypocalcaemia, and hypomagnesaemia post-surgery.

Main Methods:

• Serum samples were collected from 39 patients following jejuno-ileal shunt surgery.
• Measurements included total serum zinc, albumin, alpha 2-macroglobulin, calcium, and magnesium.
• Calculations were performed to determine the binding of serum zinc to albumin and alpha 2-macroglobulin.

Main Results:

• Patients exhibited highly significant hypozincaemia (P < 0.001).
• Reduced albumin-bound serum zinc was identified as the primary cause of hypozincaemia (P < 0.001).
• Significant hypocalcaemia (P < 0.001) and hypomagnesaemia (P < 0.001) were also observed.

Conclusions:

• Jejuno-ileal bypass surgery is associated with significant deficiencies in essential divalent cations.
• Reduced serum zinc, particularly albumin-bound zinc, is a critical finding in these patients.
• Clinical monitoring for deficiencies in zinc, calcium, and magnesium is recommended for patients with a history of jejuno-ileal bypass.