Investigating the Prevalence of Copper and Zinc Abnormalities in Patients Pre and Post bariatric Surgery—an Australian Experience

Abstract

IntroductionBariatric surgery predisposes patients to nutritional deficiencies. There are limited studies on zinc and copper abnormalities in this cohort.PurposeThe aim of this study was to identify the prevalence of these abnormalities in a cohort of Australian bariatric patients. Inflammatory markers, adherence to multivitamin supplementation (MVS) and the presence of gastrointestinal (GI) symptoms were also investigated.Material and MethodsData was collected on all patients who attended a single clinic in Sydney, Australia, from August 2020 to August 2021.ResultsThe study cohort consisted of 231 patients (76.2% female; mean pre-operative body mass index of 43.4 ± 7.1 kg/m2), most of whom underwent sleeve gastrectomy (78.8%). Data were collected preoperatively and then at ≤ 6 months, 1 and > 2 years postoperatively. Prior to surgery, low levels of zinc (2.1%) and copper (0.7%) were rare, but elevated copper levels were common (16.7%) and potentially related to an elevated C-reactive protein (CRP) (47.7%). Following surgery at > 2 years, the mean total weight loss (TWL) was 33.5 ± 12.4. CRP levels improved over time. Post operatively, low zinc (2.7–3.6%) and copper (1.5%) levels were rare. Patients with low levels in zinc and copper were a higher-risk group and generally exhibited GI symptoms, despite taking MVS.ConclusionIn the initial post-operative stages and with good adherence to MVS containing copper and zinc, abnormalities may not be a concern. Patients with GI symptoms appear to be at higher risk of abnormalities; increasing awareness, thorough screening, and more comprehensive supplementation are recommended.Graphical