Unit of Obesity Surgery and Unit of Clinical Nutrition and Dietetics, Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, IRyCIS, Carretera de Colmenar Km. 9.1, 28034, Madrid, Spain.
Obes Surg. 2011 Jun;21(6):744-50. doi: 10.1007/s11695-011-0389-y.
There are limited data on the prevalence of copper and zinc deficiency in the long term after bariatric surgery.
We analysed copper and zinc serum levels in a cohort of 141 patients, 52 who underwent Roux-en-Y gastric bypass (RYGB) and 89 biliopancreatic diversion (BPD), with a follow-up of 5 years.
Mean copper level was significantly lower in the BPD group (P < 0.0001 vs. RYGB). Forty-five (50.6%) BPD patients had, at least once, a low copper level, and half of them, 27 (30.3%) patients, had repeatedly low levels. In this group, serum copper level correlated positively with total leukocyte and granulocyte count (r = 0.14, P = 0.002, and r = 0.17, P < 0.001, respectively). However, no patient had clinical evidence of haematological or neurological disorders. Only two RYGB patients (3.8%) had copper deficiency. Mean zinc level was also significantly lower in the BPD group (P < 0.0001). All but one BPD patient had hypozincaemia at least once, and the percentage of patients with hypozincaemia ranged from 44.9% to 74.2%. In RYGB patients, zinc deficiency peaked at 48 and 60 months (15.4% and 21.2%, respectively). The zinc level was determined by the alimentary limb length in this group, but the common channel length had no influence on copper and zinc levels in the BPD group.
Hypocupremia, and especially hypozincaemia, are frequent findings in BPD patients, but rarely found in patients who underwent RYGB, particularly short RYGB. Our data also suggest that a long-standing and severe hypocupremia is required to develop neurological and haematological disorders after bariatric surgery.
在减重手术后长期，铜和锌缺乏的患病率数据有限。
我们分析了 141 例患者（52 例行 Roux-en-Y 胃旁路术（RYGB），89 例行胆胰分流术（BPD））的铜和锌血清水平，随访时间为 5 年。
BPD 组的平均铜水平显著较低（P<0.0001 比 RYGB）。45（50.6%）名 BPD 患者至少有一次低铜水平，其中一半（30.3%）患者有反复低水平。在该组中，血清铜水平与总白细胞和粒细胞计数呈正相关（r=0.14，P=0.002 和 r=0.17，P<0.001）。然而，没有患者出现血液学或神经系统疾病的临床证据。只有两名 RYGB 患者（3.8%）存在铜缺乏。BPD 组的平均锌水平也显著较低（P<0.0001）。除一名患者外，所有 BPD 患者至少有一次缺锌，缺锌患者的比例为 44.9%至 74.2%。在 RYGB 患者中，锌缺乏在 48 和 60 个月时达到峰值（分别为 15.4%和 21.2%）。在该组中，锌水平由喂养支的长度决定，但共同通道的长度对 BPD 组的铜和锌水平没有影响。
低铜血症，特别是低锌血症，在 BPD 患者中很常见，但在接受 RYGB 的患者中很少见，尤其是短 RYGB。我们的数据还表明，减重手术后发生神经和血液系统疾病需要长期严重的低铜血症。
