Amaya García M J, Vilchez López F J, Campos Martín C, Sánchez Vera P, Pereira Cunill J L
Unidad de Endocrinología y Nutrición, Hospital San Pedro de Alcántara, San Pedro de Alcántara, Cáceres, España.
Nutr Hosp. 2012 Mar-Apr;27(2):349-61. doi: 10.1590/S0212-16112012000200004.
The morbid obesity is a chronic disease with increasing prevalence and that associates an important morbility and mortality. The bariatric surgery is the most effective treatment to secure a weight reduction maintained in the time and a diminution in the rates of complications associated to the obesity. The overweight and the obesity are risk factors for the deficit of several micronutrients like vitamins B1, B6, C, folic acid and D, minerals like the iron and trace elements like zinc, generally by dietetic deficit. In spite of it, at the moment a consensus don't exist about the monitoring of micronutrients in the preoperative one, although it seems reasonable in view of his considerable prevalence. The bariatric surgery can bring about deficit of micronutrients or to intensify previous deficiencies, as much by limitation of the ingestion like by the maldigestión and malabsorption in the malabsortives techniques, being the parallel risk to the ponderal loss. It is precise to monitor of by life the different micronutrients, mainly after the malabsortives surgical techniques. The use of a polivitamínic complex of systematic form is recommended and in the cases in which he is insufficient, it will be precise to use specific suplementación.
病态肥胖是一种患病率不断上升的慢性疾病,它与较高的发病率和死亡率相关。减肥手术是确保长期体重减轻以及降低与肥胖相关并发症发生率的最有效治疗方法。超重和肥胖是多种微量营养素缺乏的危险因素,如维生素B1、B6、C、叶酸和D,矿物质如铁,以及微量元素如锌,通常是由于饮食缺乏所致。尽管如此,目前对于术前微量营养素监测尚无共识,尽管鉴于其相当高的患病率,进行监测似乎是合理的。减肥手术可能导致微量营养素缺乏或加剧先前存在的缺乏情况,这既可能是由于摄入受限,也可能是由于吸收不良技术导致的消化和吸收不良,这与体重减轻风险并存。有必要对不同的微量营养素进行终身监测,尤其是在采用吸收不良手术技术之后。建议常规使用复合维生素,如果不足,则需要进行特定的补充。