Serum Vitamin B12, Iron and Folic Acid Deficiencies in Obese Individuals Submitted to Different Bariatric Techniques

Abstract

Background: Different surgical techniques to combat obesity combine malabsorption with restrictive procedures and can lead to metabolic problems, such as micronutrient deficiencies. Aim: Assess vitamin B12, iron and folic acid deficiencies associated with the lifestyle of obese individuals having been submitted to different bariatric techniques. Methods: A retrospective analysis was performed using the electronic charts of patients submitted to bariatric surgery involving adjustable gastric banding and Roux-en-Y gastric bypass at the São João Hospital Center in the city of Porto, Portugal, between 2005 and 2010. The following data were collected: surgical technique, sex, age, marital status, serum concentrations of vitamin B12, iron and folic acid and postoperative lifestyle. A 5% significance level was used for the statistical analysis (p<0.05). Results: Among 286 individuals evaluated, females accounted for 90.9% of the overall sample (both techniques). Gastric banding was performed more (68.9%), but greater nutrient deficiencies were found following gastric bypass. Iron was the most prevalent deficiency (21.3%), followed by vitamin B12 (16.9%) and folic acid (4.5%). Mild to moderate alcohol intake, adherence to the diet and the use of multivitamins reduced the frequency, but did not avoid micronutrient deficiency. Conclusion: Vitamin B12, iron and folic acid deficiencies were found in the first and second year following the two bariatric techniques analyzed and were more frequent among individuals submitted to gastric bypass.

Is There Any Change in Phenotypic Characteristics Comparing 5 to 10 Years of Follow-Up in Obese Patients Undergoing Roux-en-Y Gastric Bypass?

“…However, in the period of five to 10 years the prevalence of patients with folic acid deficiency increased to 3.7%. This can be attributed to segment loss, lack of nutritional monitoring, and resistance to changes in eating habits after surgery 32 .…”

Efeito da redução de peso em pacientes submetidos à técnica do Bypass Gástrico em Y-de-Roux

“…No estudo realizado por Silva et al [25], a maior parte da população estudada apresentava HAS (76%), DM (36%) e dislipidemia (27%) no pré-operatório. Esses dados diferiram, principalmente os achados para HAS, dos encontrados na pesquisa realizada por Buckwald et al [5], que demonstrou um alto índice de diabetes Mellitus tipo 2 em 15,3%, HAS em 35,4% e dislipidemia em 35,6% da amostra estudada.…”

Postoperative Changes in Intestinal Microbiota and Use of Probiotics in Roux-en-Y Gastric Bypass and Sleeve Vertical Gastrectomy: An Integrative Review

“…It is estimated that in the gastrointestinal tract there are approximately 10 14 micro-organisms, composed by more than a thousand distinct kinds of species and more than three million genes, compared to approximately 30.000 in human genome, showing a co-evolutionary pathway 17 . This microbiota has been shown to interact with the host in a symbiotic way, modulating inflammation and the immune system; acting in the biotransformation of xenobiotics and in the absorption of micronutrients; synthetizing vitamins, enzymes and proteins used by the host; fermenting energetic substrates; providing resistance to pathogens; and changing amount of available energy in the diet 15 , 17 , 22 , 23…”