The Effect of Roux-en-Y Gastric Bypass on Zinc Nutritional Status

Pires, Liliane Viana; Martins, Luana Mota; Geloneze, Bruno; Tambascia, Marcos Antônio; Monte, Semíramis Jamil Hadad do; Nogueira, Nadir do Nascimento; Sousa, Gustavo Santos de; Marreiro, Dilina do Nascimento

doi:10.1007/s11695-007-9105-3

Cited by 24 publications

(20 citation statements)

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“…For instance, Madan et al (10) observed that the percentage of "abnormal" plasma zinc concentrations increased from 30% before surgery to 36% 1 y after RYGBP. Plasma and urinary zinc, but not erythrocyte zinc, were lower 6 mo after surgery (28). The percentage of plasma zinc concentrations ,75 lg/dL increased from 14% before to 37% 12-40 mo after surgery (29).…”

Section: Resultsmentioning

confidence: 84%

Zinc absorption and zinc status are reduced after Roux-en-Y gastric bypass: a randomized study using 2 supplements

Ruz¹,

Carrasco²,

Rojas³

et al. 2011

The American Journal of Clinical Nutrition

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Background: Micronutrient deficiencies are common in patients undergoing gastric bypass. The effect of this type of surgery on zinc absorption and zinc status is not well known. Objective: The objective was to evaluate the effects of Roux-en-Y gastric bypass (RYGBP) on zinc status and zinc absorption at different stages after surgery. We hypothesized that zinc status would be significantly impaired after surgery and that this impairment would be less severe in subjects receiving increased supplemental zinc. We also hypothesized that zinc absorption would be lower after surgery. Design: Anthropometric and body-composition variables and dietary and biochemical indexes of zinc status and zinc absorption were determined in 67 severe and morbidly obese women [mean (6SD) age: 36.9 6 9.8 y; BMI (in kg/m 2 ): 45.2 6 4.7] who underwent RYGBP. The subjects were randomly assigned to 1 of 2 vitamin-mineral supplementation groups. Measurements were made before and 6, 12, and 18 mo after surgery. Fifty-six subjects completed the 18-mo follow-up. Results: Mean plasma zinc, erythrocyte membrane alkaline phosphatase activity, and the size of the rapidly exchangeable zinc pool decreased after RYGBP. Percentage zinc absorption decreased significantly from 32.3% to 13.6% at 6 mo after RYGBP and to 21% at 18 mo after surgery. No effect of supplement type was observed. Conclusions: Zinc status is impaired after RYGBP, despite the finding that dietary plus supplemental zinc doubled recommended zinc intakes in healthy persons. Zinc absorption capacity is significantly reduced soon after RYGBP, with no major changes until 18 mo after surgery.

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Section: Resultsmentioning

confidence: 84%

Zinc absorption and zinc status are reduced after Roux-en-Y gastric bypass: a randomized study using 2 supplements

Ruz¹,

Carrasco²,

Rojas³

et al. 2011

The American Journal of Clinical Nutrition

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“…It is also evident that RYGB leads to not just a reduction in intake of Zn [15][16] but also its absorption [15,19]. In the study by Ruz et al [15], dietary Zn intake was 9.1, 5.4, 6.4, and 7.2 mg/d before and 6, 12, and 18 months respectively after RYGB.…”

Section: Resultsmentioning

confidence: 96%

“…In the study by Ruz et al [15], dietary Zn intake was 9.1, 5.4, 6.4, and 7.2 mg/d before and 6, 12, and 18 months respectively after RYGB. Pires et al [16] found patients were consuming lower amount of Zn than required 6 months after surgery. Mean intake in males was 8.2 mg as opposed to recommended intake of 9.4 mg and in females was 6.3 mg as opposed to 6.8 mg respectively.…”

Section: Resultsmentioning

confidence: 98%

“…Though some authors [40] have suggested that the estimates of Zn deficiency can be improved by measurement of Zn in erythrocytes and hair or by measuring activities of enzymes dependent on Zn, others [15][16] have found that Erythrocyte Zn levels may behave erratically and may actually increase [16] or remain unchanged [15] with a concomitant fall in serum and urinary Zn levels.…”

Section: Resultsmentioning

confidence: 99%

“…Up to half [9][10][11][12][13] of bariatric surgery patients are deficient in Zn preoperatively and RYGB can further exacerbate it [4,9,12] through probably both reduced intake [15][16][17][18] and reduced absorption [15,19] as Zn is predominantly absorbed in the duodenum and the proximal jejunum.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Zinc Deficiency after Gastric Bypass for Morbid Obesity: a Systematic Review

et al. 2016

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Usage guidelinesPlease refer to the usage guidelines at http://sure.sunderland.ac.uk/policies.html or alternatively contact sure@sunderland.ac.uk. 1 Abstract:Up to 50 % of patients have Zinc deficiency before bariatric surgery. Roux-en-Y Gastric Bypass (RYGB) is the commonest bariatric procedure worldwide. It can further exacerbate Zinc deficiency by reducing intake as well as absorption. British Obesity and Metabolic Surgery Society, therefore, recommends that Zinc level should be monitored routinely following gastric bypass. However, the American guidance does not recommend such monitoring for all RYGB patients and reserves it for T Z after RYGB. Routine monitoring of Zinc levels is hence unnecessary for asymptomatic patients after RYGB and should be reserved for patients with skin lesions, hair loss, pica, dysgeusia, hypogonadism or erectile dysfunction in male patients, and unexplained iron deficiency anaemia.

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