Micronutrient deficiencies one year after sleeve gastrectomy

Abstract

Obesity is one of the largest problems in public health worldwide today. For patients with severe obesity and associated comorbidities, surgical treatment is recommended. To analyze the frequency of micronutrient deficiencies and food intake at least 12 months after sleeve gastrectomy (SG). This is a cross sectional study carried out between October and December 2009 with measure of serum levels of vitamin B12, vitamin D, folate, calcium, ferritin, zinc, parathyroid hormone and bone mineral density on patients underwent SG at least 12 months before the study. A food intake questionnaire was also performed. For the statistical analysis, the Pearson or Spearman tests was used. Forty patients were evaluated with a mean age of 40 ± 10 years and mean time post surgery of 26 ± 6 months. Mean plasma level of 25 OH-vitamin D was 20.9 ± 10.5 ng/ml. Forty-three percent had low levels of vitamin D (< 20 ng/ml), and 68% showed low levels of calcium (< 1,1 mmol/L) without secondary hyperparathyroidism. Anemia was present in 28% and iron deficiency occurred in 38% of these patients. Deficit of folic acid and vitamin B12 were observed in 13% of the patients. Average daily food intake was 1,256 kcal, 54% of total calories as carbohydrates, 26% as fat and 21% as protein. Iron, calcium and vitamin D are the most prevalent micronutrient deficiencies after SG. Long-term vitamin and mineral supplementation should be considered on every patient. Additional long-term studies are needed to establish specific supplementation recommendations after SG.