Impact of bariatric surgery on vitamin metabolisms in obese patients


Cite item

Full Text

Abstract

Aim. To investigate the impact of bariatric surgery (BS) on the level of vitamins in obese patients. Subjects and methods. One hundred obese patients (78 women and 22 men) aged 19 to 61 years were examined. Controlled gastric banding (CGB) was carried out in 20 patients (mean body mass index (BMI), 41.3±8.2 kg/m2); gastric sleeve resection (GSR) in 40 patients, and gastric shunting (GS) in 40 (the mean BMI in these groups were 41.1±17.8 and 45.9±6.2 kg/m2, respectively). A control group consisted of 10 apparently healthy individuals (BMI, 24.9±3.2 kg/m2). An enzyme immunoassay was used to determine the serum concentrations of vitamins В1, В2, В5, В6, В9, В12, С, and D, niacin, biotin, and retinol-binding protein (RBP) before and 1 year after surgery. Results. All the three groups showed a considerable decrease in the levels of vitamins C, В5, В6, and D, and RBP both prior to and following BS. More than 50% of the patients who had undergone GSR had also a lower baseline niacin level. A year after CGB, GSR, and GS, the number of patents with deficiency of these vitamins remained the same or increased. The majority of patients with the same level of vitamin B2, niacin, and folic acid (FA) were observed to have its decrease a year postsurgery. The concentration of the other test vitamins was also reduced a year after all operations; however, it remained within the normal range. GS had no substantial impact on the concentrations of FA, vitamins B2, B12, B1, and biotin. The lower serum vitamin levels were not accompanied by clinical symptoms in most patients following BS. Conclusion. In 80% of the patients with obesity, the levels of vitamins C, B6, and D were decreased to a variable degree. After BS, there was a rise in the number of patients with low serum vitamin C, D, B6, B5, niacin, FA, and RBP concentrations, at the same time the number of patients with FA deficiency increased by more than twice. BS did not significantly affect the metabolism of vitamins В1, В2, В12, and biotin.

References

  1. Fried M., Yumuk V., Oppert J.-M. et al. Interdisciplinary European Guidelineson Metabolic and Bariatric Surgery. Obes Facts 2013; 6: 449-468.
  2. Бодунова Н.А., Сабельникова Е.А., Парфенов А.И. Влияние бариатрических операций на всасывание пищевых веществ у больных ожирением. Тер арх 2013; 10: 98-104.
  3. Kramer L.D., Locke E. Wernicke'sencephalopathy: complication of gastric plication. J Clin Gastroenterol 1987; 9: 549-552.
  4. Sola E., Morillas C., Garzon S. et al. Rapid onset of Wernicke's encephalopathy following gastric restrictive surgery. Obes Surg 2003; 13: 661-662.
  5. Gollobin C., Marcus W.Y. Bariatric beriberi. Obes Surg 2002; 12: 309-311.
  6. John S., Hoegeri C. Nutritional deficiencies after gastric bypass surgery. J Am Osteopath Assoc 2009; 109 (11): 601-604.
  7. Khandalavala B.N., Hibma P.P., Fang X. Prevalence and persistence of vitamin D deficiency in biliopancreatic diversion patients: a retrospective study. Obes Surg 2010; 20 (7): 881-884.
  8. Ziegler O., Sirveaux M.A., Brunaud L. et al. Medical follow up after bariatric surgery: nutritional and drug issues. General recommendations for the prevention and treatment of nutritional deficiencies. Diabetes Metab 2009; 35 (6 Pt 2): 554-557.
  9. Bhan A., Rao A.D., Rao D.S. Osteomalacia as a result of vitamin D deficiency. Endocrinol Metab Clin North Am 2010; 39 (2): 321-331.
  10. Strohmayer E., Via M.A., Yanagisawa R. Metabolic management following bariatric surgery. Mt Sinai J Med 2010; 77 (5): 431-445.
  11. Xanthakos S.A. Nutritional deficiencies in obesity and after bariatric surgery. Pediatric Clin North Am 2009; 56 (5): 1105-1121.
  12. Al-Shoha A., Quin S., Palniktar S. et al. Osteomalacia with bone marrow fibrosis due to severe vitamin D deficiency after a gastrointestinal bypass operation for severe obesity. Endocr Pract 2009; 15 (6): 528-533.
  13. Kaidar-Person O., Rosenthal R.J. Malnutrition in morbidly obese patients: fact or fiction? Minerva Chir 2009; 64 (3): 297-302.
  14. Ребров В.Г., Громова О.А. Витамины, макро- и микроэлементы. 2008; 153-172.
  15. Gasteyger C., Suter M., Calmes J.M. et al. Changes in body composition, metabolic profile, and nutritional status 24 months after gastric banding. Obes Surg 2006; 16: 243-250.
  16. MacLean L.D., Rhode B.M., Shizgal H.M. Nutrition following gastric operations for morbid obesity. Ann Surg 1983; 198 (3): 347-355.
  17. Rhode B.M., Arseneau P., Cooper B.A. et al. Vitamin B-12 deficiency after gastric surgery for obesity. Am J Clin Nutr 1996; 63 (1): 103-109.
  18. Brolin R.E., Gorman J.H., Gorman R.C. et al. Are vitamin B-12 and folate deficiency clinically important after Roux-en-Y gastric by-pass? J Gastrointest Surg 1998; 2: 436-442.
  19. Halverson J.D. Micronutrient deficiencies after gastric bypass for morbid obesity. Am Surg 1986; 52 (11): 594-598.
  20. Seehra H., MacDermott N., Lascelles R.G., Taylor T.V. Wernicke's encephalopathy after vertical banded gastroplasty for morbid obesity. BMJ 1996; 312: 434.
  21. Munoz-Farjas E., Jerico I., Pascual-Millan L.F. et al. Neuropathic beriberi as a complication of surgery of morbid obesity. Rev Neurol 1996; 24: 456-458.
  22. Lakhani S.V., Shah H.N., Alexander K. et al. Small intestinal bacterial overgrowth and thiamin deficiency after Roux-en-Y gastric bypass surgent in obese patients. Nutr Res 2008; 28: 293-298.
  23. Chang C.G., Adams-Huet B., Provost D.A. Acute post-gastric reduction surgery (APGARS) neuropathy. Obes Surg 2004; 14: 182-189.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2015 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Novij Zykovskij proezd, 3, 40, Moscow, 125167

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

 © 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies