Authors: Muriel Coupaye Karin Puchaux Catherine Bogard Simon Msika Pauline Jouet Christine Clerici Etienne Larger Séverine Ledoux
Publish Date: 2008/06/10
Volume: 19, Issue: 1, Pages: 56-65
Abstract
Gastric bypass GBP is more efficient than adjustable gastric banding AGB on weight loss and comorbidities but potentially induces more nutritional deficits However no study has compared the prevalence of nutritional deficiencies after these two bariatric proceduresWe have performed a 1year prospective study of nutritional parameters in 70 consecutive severe obese patients who had undergone bariatric surgery 21 AGB and 49 GBP After GBP multivitamin supplements were systematically prescribed and vitamin B12 supplementation was introduced if a deficiency was observedPatients lost more weight after GBP than after AGB 40 ± 13 vs 16 ± 8 kg p 0001 Vitamins B1 and C and iron deficiencies were frequent before surgery but were not worsened by GBP AGB only induced a slight decrease of vitamin B1 at 1 year whereas GBP induced significant decreases of vitamins B12 and E serum prealbumin and creatinine concentrations with only minor clinical consequences Anemia was observed in 10 of the patients after bariatric surgery Hemoglobin concentration was not correlated to vitamin B12 or folate concentrations but was related to iron status Risk of iron deficiency anemia was better assessed by transferrin saturation than by serum ferritin concentration in this obese populationSevere nutritional deficits can be avoided after bariatric surgery if patients are systematically supplemented with multivitamin and carefully monitored However specific care is required to avoid iron and vitamin B12 deficiencies anemia and protein malnutritionContribution of each author SL and MC contributed to the conception and design of the study MC SL PJ and KP contributed to data collection CB contributed to the interpretation of biochemical assays SM contributed to patient recruitment and performed surgery CC contributed to patient recruitment SL and EL contributed to data interpretation and wrote the manuscript The authors thank Philippe Boudou Unité de Biochimie Hormonale Hôpital Saint Louis APHP 75010 Paris Fathi Moussa Service de Biochimie Hôpital Trousseau APHP 75012 Paris and Thierry Dupré Service de Biochimie Hôpital Bichat APHP 75018 Paris for biochemical assays They thank Pauline Chenebault and MarieChristine Breuil for their help in quantification of caloric intake
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