Abstract
Malabsorptive bariatric surgery requires life-long micronutrient supplementation. Based on the recommendations, we assessed the number of adjustments of micronutrient supplementation and the prevalence of vitamin and mineral deficiencies at a minimum follow-up of 5years after biliopancreatic diversion with duodenal switch (BPD-DS). Between October 2010 and December 2013, a total of 51 patients at a minimum follow-up of 5years after BPD-DS were invited for a clinical check-up with a nutritional blood screening test for vitamins and minerals. Forty-three of fifty-one patients (84.3%) completed the blood sampling with a median follow-up of 71.2 (range 60-102) months after BPD-DS. At that time, all patients were supplemented with at least one multivitamin. However, 35 patients (81.4%) showed either a vitamin or a mineral deficiency or a combination of it. Nineteen patients (44.1%) were anemic, and 17 patients (39.5%) had an iron deficiency. High deficiency rates for fat-soluble vitamins were also present in 23.2% for vitamin A, in 76.7% for vitamin D, in 7.0% for vitamin E, and in 11.6% for vitamin K. The results of our study show that the prevalence of vitamin and mineral deficiencies after BPD-DS is 81.4% at a minimum follow-up of 5years. The initial prescription of micronutrient supplementation and further adjustments during the first follow-up were insufficient to avoid long-term micronutrient deficiencies. Life-long monitoring of micronutrients at a specialized bariatric center and possibly a better micronutrient supplementation, is crucial to avoid a deficient micronutrient status at every stage after malabsorptive bariatric surgery.
Published Version
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