Department of Biomedical Science, University of Wollongong, Wollongong, Australia.
Nutrition. 2009 Nov-Dec;25(11-12):1150-6. doi: 10.1016/j.nut.2009.03.012. Epub 2009 May 31.
The aims of this study were to determine the prevalence of nutrient deficiencies in patients who present for bariatric surgery, assess nutritional status after surgery, and compare these with preoperative levels.
A retrospective study was conducted to identify preoperative and 1-year postoperative nutrition deficiencies in patients undergoing bariatric surgery. The screening included serum ferritin, vitamin D, vitamin B(12), homocysteine, folate, red blood cell folate, and hemoglobin. Results were available for 232 patients preoperatively and 149 patients postoperatively. Two-tailed chi(2) tests and paired-sample t tests were used.
Preoperatively, vitamin D deficiency was noted at 57%. The prevalence of abnormalities 1 year after roux-en-Y gastric bypass was higher compared with preoperative levels (P < .05). After surgery, anemia was detected in 17%, elevated homocysteine levels (women only) in 29%, low ferritin in 15%, low vitamin B(12) in 11%, and low RBC folate in 12%. Mean hemoglobin, ferritin, and RBC folate levels deteriorated significantly but remained well within normal ranges. The prevalence of vitamin D deficiencies decreased, but not significantly. In sleeve gastrectomy patients, mean ferritin levels decreased (P < .05), without any patient developing a deficiency.
Vitamin D deficiency is common among morbidly obese patients seeking bariatric surgery. Because the prevalence of micronutrient deficiencies persists or worsens postoperatively, routine nutrition screening, recommendation of appropriate supplements, and monitoring adherence are imperative in this population.
本研究旨在确定接受减重手术患者的营养缺乏症患病率，评估术后营养状况，并与术前水平进行比较。
对接受减重手术的患者进行回顾性研究，以确定术前和术后 1 年的营养缺乏症。筛选包括血清铁蛋白、维生素 D、维生素 B(12)、同型半胱氨酸、叶酸、红细胞叶酸和血红蛋白。术前有 232 例患者和术后有 149 例患者的结果可用。使用双尾 χ(2)检验和配对样本 t 检验。
术前维生素 D 缺乏症发生率为 57%。与术前水平相比，Roux-en-Y 胃旁路术后 1 年异常的发生率更高（P <.05）。术后 17%的患者出现贫血，29%的女性出现高同型半胱氨酸水平，15%的患者出现低铁蛋白，11%的患者出现低维生素 B(12)，12%的患者出现低红细胞叶酸。平均血红蛋白、铁蛋白和红细胞叶酸水平显著恶化，但仍在正常范围内。维生素 D 缺乏症的患病率虽有所下降，但无统计学意义。在胃袖状切除术患者中，铁蛋白平均水平下降（P <.05），但无患者出现缺乏症。
寻求减重手术的病态肥胖患者中普遍存在维生素 D 缺乏症。由于术后微量营养素缺乏症的患病率持续存在或恶化，因此在该人群中，常规营养筛查、推荐适当的补充剂以及监测依从性至关重要。
