PP242-MON: Iron Deficiency Anemia, Dietary Pattern and Chronic Inflammation Markers in Overweight and Obese Women and Effect of Dietary Treatment

Abstract

Rationale: The emergence of severe cases of post BS nutritional complications should alert the medical community. The aim is to describe the characteristics of a cohort of inpatients, with severe nutritional complications (SNC) post BS. Methods: Observational study of 13 inpatients with SNC after BS between 2011 and 2013 in a specialized nutrition unit. Results: Nine/13patients had a single BS, 4 had at least two surgeries. Four/13 patients had a contre-indication for BS: unweaned alcoholism and severe not stabilized eating disorders. Eleven patients had not received regular monitoring or routine postoperative supplementation. Time between surgery and hospital stay was 19.5 (3 84) months, average weight loss 61 kg (40 100) [47% (32 70)] of initial weight. At admission the mean BMI was 25 (13 48), 10 patients had hypoalbuminemia 25 g/l (11 30). Six patients had vitamin B1 deficiency, 4 had memory disorders with proximal neurogenic and myogenic injury, 3 had severe functional impairment. All patients had a vitamin D deficiency and at least one micronutrient deficiency (zinc, copper, selenium). Ten patients had anemia without deficiency of vitamin B12, B9 or iron. However, anemia was always associated with a deficiency in copper and improved after parenteral supplementation. Ten patients had low plasma citrulline reflecting moderate intestinal failure with severe diarrhea and kwashiokor. All patients had parenteral vitamin and micronutrient supplementation and required enteral and/or parenteral nutritional support for an average duration of 6 (1 18) months. A total recovery was observed in 9 patients. Conclusion: Nutritional deficiencies post BS are characterized by their severity, heterogeneity and their potential irreversibility. This underlines the importance of strict compliance with the specifications and regular monitoring to prevent, detect and correct deficiencies.