Prevalence of nutrient deficiencies in bariatric patients

Toh, Seok Yee; Zarshenas, Nazy; Jorgensen, John

doi:10.1016/j.nut.2009.03.012

Cited by 265 publications

(167 citation statements)

References 41 publications

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“…Anemia has been reported to occur in up to 60% of patients after partial gastrectomy [12,13] . The incidence of anemia after bypass surgery has been reported as from 5% to 64% [7][8][9][14][15][16][17] . A recent study of postsurgical anemia after gastrectomy reported that the incidence of anemia was 37.9%, 33.5% and 34.7% at 3, 6 and 12 mo after surgery, respectively [18] .…”

Section: Discussionmentioning

confidence: 99%

“…The incidence of gastric bypass surgery for morbid obesity is increasing, and anemia after bypass surgery has been reported [7][8][9][10][11] . Dietary life after gastric surgery in patients with gastric cancer may differ from that in patients with morbid obesity: in contrast to patients with obesity, patients having gastrectomy for gastric cancer do not restrict their dietary intake for weight reduction.…”

Section: Introductionmentioning

confidence: 99%

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Anemia after gastrectomy for early gastric cancer: Long-term follow-up observational study

Lim

Kim²,

Kim³

et al. 2012

WJG

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AIM:To identify the incidence and etiology of anemia after gastrectomy in patients with long-term follow-up after gastrectomy for early gastric cancer. METHODS:The medical records of those patients with early gastric adenocarcinoma who underwent curative gastrectomy between January 2006 and October 2007 were reviewed. Patients with anemia in the preoperative workup, cancer recurrence, undergoing systemic chemotherapy, with other medical conditions that can cause anemia, or treated during follow up with red cell transfusions or supplements for anemia were excluded. Anemia was defined by World Health Organization criteria (Hb < 12 g/dL in women and < 13 g/dL in men). Iron deficiency was defined as serum ferritin < 20 μg/dL. Vitamin B12 deficiency was defined as serum vitamin B12 < 200 pg/mL. Iron deficiency anemia was defined as anemia with concomitant iron deficiency. Anemia from vitamin B12 deficiency was defined as megaloblastic anemia (mean cell volume > 100 fL) with vitamin B12 deficiency. The profile of anemia over 48 mo of follow-up was analyzed. RESULTS:One hundred sixty-one patients with gastrectomy for early gastric cancer were analyzed. The incidence of anemia was 24.5% at 3 mo after surgery and increased up to 37.1% at 48 mo after surgery. The incidence of iron deficiency anemia increased during the follow up and became the major cause of anemia at 48 mo after surgery. Anemia of chronic disease and megaloblastic anemia were uncommon. The incidence of anemia in female patients was significantly higher than in male patients at 12 (40.0% vs 22.0%, P = 0.033), 24 (45.0% vs 25.0%, P = 0.023), 36 (55.0% vs 28.0%, P = 0.004), and 48 mo (52.0% vs 31.0%, P = 0.022) after surgery. Patients with total gastrectomy showed significantly higher incidence of anemia than patients with subtotal gastrectomy at 48 mo after surgery (60.7% vs 31.3%, P = 0.008). The incidence of iron deficiency was significantly higher in female patients than in male patients at 6 (35.4% vs 13.3%, P = 0.002), 12 (45.8% vs 16.8%, P < 0.001), 18 (52.1% vs 22.3%, P < 0.001), 24 (60.4% vs 20.9%, P < 0.001), 36 (62.5% vs 29.2%, P < 0.001), and 48 mo (66.7% vs 34.7%, P = 0.001) after surgery. CONCLUSION:Anemia was frequent after gastrectomy for early gastric cancer, with iron deficiency being the major cause. Evaluation for anemia including iron status should be performed after gastrectomy and appropriate iron replacement should be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anemia after gastrectomy for early gastric cancer: Long-term follow-up observational study

Lim

Kim²,

Kim³

et al. 2012

WJG

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“…Os estudos disponíveis na literatura acerca da deficiên cia de 25OHD e hiperparatiroidismo secundá-rio em indivíduos submetidos à DGYR mostraram que essas alterações podem ocorrer em obesos graves não submetidos à cirurgia (17), preceder a cirurgia (18,19), persistir por período de um a três anos (20) ou mesmo piorar após o procedimento (19).…”

Section: Discussionunclassified

“…As mulheres foram submetidas, pela manhã e após jejum de 12 horas, à coleta de 20 Metabolismo ósseo em mulheres após Y-Roux rpm e congeladas a -20ºC. Foi obtida, também no mesmo dia, uma amostra isolada (30-50 mL) de urina em jejum que foi aliquotada.…”

Section: Sujeitos E Métodosunclassified

Alterações de parâmetros relacionados ao metabolismo ósseo em mulheres submetidas à derivação gástrica em Y de Roux

Santos

Souza

Fonseca

et al. 2012

Arq Bras Endocrinol Metab

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RESUMOObjetivo: Avaliar o metabolismo ósseo e a densidade mineral óssea (DMO) em mulheres adultas pós-derivação gástrica em Y de Roux (DGYR). Sujeitos e métodos: Estudo transversal com 48 mulheres submetidas a DGYR há três anos e 41 saudáveis. Dados obtidos: índice de massa corporal (IMC), atividade física, consumo alimentar e DMO da coluna lombar, colo e fêmur total. Dosagem de cálcio, fósforo, magnésio, albumina, fosfatase alcalina, telopeptídeo-C (CTX), paratormônio (PTH), 25-hidroxivitamina D (25OHD), osteocalcina e cálcio urinário. Resultados: Maiores alterações no grupo DGYR observadas nos níveis de osteocalcina (p < 0,001), CTX (p < 0,001) e PTH (p < 0,001). Deficiência de 25OHD foi a mais frequente no grupo DGYR (p = 0,010). Deficiência/insuficiência de 25OHD associou-se com hiperparatiroidismo secundário (p = 0,025). Não houve diferença entre os grupos em relação à DMO. A ingestão de energia (p = 0,036) e proteína (p = 0,004) foi maior no grupo controle. Conclusão: Em mulheres pós-DGYR, encontraram-se alta frequência de deficiência de vitamina D, hiperparatireoidismo secundário e elevação nos marcadores de remodelação óssea, sem alteração na DMO quando comparado com o grupo controle não obeso. Arq Bras Endocrinol Metab. 2012;56(6):376-82 Descritores Cirurgia bariátrica; densidade mineral óssea; vitamina D; hiperparatiroidismo secundário; anastomose em-Y de Roux ABSTRACT Objective: To evaluate bone turnover markers and bone mineral density (BMD) in women after Roux-en-Y (RYGB) gastric bypass. Subjects and methods: In a cross-sectional study, 48 women post-RYGB after three years, and 41 healthy women were evaluated. Evaluations: body mass index (BMI); physical activity; food intake; serum levels of calcium, phosphorus, magnesium, alkaline phosphatase, C-terminal telopeptide (CTX), intact parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD), osteocalcin, urinary calcium and BMD. Results: Significantly higher levels were observed for osteocalcin (p < 0.001), CTX (p < 0.001), and PTH (p < 0.001) in the RYGB group when compared with the control group; 25OHD deficiency/insufficiency was more frequent in the RYGB group (p = 0.010), even after adjusted for nutritional status, and it was associated with secondary hyperparathyroidism (p = 0.025); there was no difference in BMD between the groups. Energy (p = 0.036) and protein intake (p = 0.004) were lower in the RYGB group. Conclusion: Patients submitted to RYGB showed a significantly higher frequency of vitamin D deficiency, secondary hyperparathyroidism, and increase in bone remodeling markers, with no difference in BMD status. Arq Bras Endocrinol Metab. 2012;56(6):376-82

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“…60 Iron deficiency occurs in 6-29% of these patients, with 3-18% being vitamin B 12 deficient. 61,62 There is also a significant risk of folate, zinc, selenium, magnesium, and thiamine deficiencies.…”

Section: Nutrition Status In Obesitymentioning

confidence: 99%

Perioperative management of the severely obese patient: a selective pathophysiological review

Cullen

Ferguson

2012

Can J Anesth/J Can Anesth

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Prevalence of nutrient deficiencies in bariatric patients

Cited by 265 publications

References 41 publications

Anemia after gastrectomy for early gastric cancer: Long-term follow-up observational study

Anemia after gastrectomy for early gastric cancer: Long-term follow-up observational study

Alterações de parâmetros relacionados ao metabolismo ósseo em mulheres submetidas à derivação gástrica em Y de Roux

Perioperative management of the severely obese patient: a selective pathophysiological review

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