Temple University School of Medicine, Philadelphia, PA 19140, USA.
Curr Drug Metab. 2012 Nov;13(9):1345-55. doi: 10.2174/138920012803341339.
The prevalence of obesity continues to rise throughout the world. Increasingly, bariatric surgery is used for those with morbid obesity as a pivotal approach to achieve weight loss. Along with substantial weight loss, malabsorption of essential vitamins, minerals, and drugs also occurs. Therefore, more than ever, a better understanding of the physiology and mechanisms by which these deficiencies occur is essential. We review the normal physiology of vitamin, mineral, and drug absorption. This is followed by a description of currently performed bariatric surgeries in the United States. A detailed review of specific nutrient and mineral deficiency states is presented, based on the most significant studies published in the last two decades. Of note, screening and supplementation recommendations have been included. Drug absorption data after these procedures is presented and discussed. Studies were identified by searching the Cochrane Registry and MEDLINE using relevant search terms, as well as through review of the reference section of included manuscripts.
Bariatric surgery can be effectively used to achieve sustainable weight-loss in morbidly obese patients. It simultaneously brings forth important functional consequences on nutrient deficiencies and drug absorption that clinician's must be aware of. Further prospective, randomized research on specific procedures and deficiencies is required.
肥胖症的患病率在全球范围内持续上升。越来越多的病态肥胖患者选择接受减重手术,这已成为减轻体重的主要方法。除了显著减轻体重外,还会发生必需维生素、矿物质和药物的吸收不良。因此,比以往任何时候都更需要更好地了解这些缺陷发生的生理学和机制。我们回顾了维生素、矿物质和药物吸收的正常生理学。接下来描述了目前在美国进行的减重手术。根据过去二十年发表的最重要研究,详细介绍了特定营养素和矿物质缺乏状态。值得注意的是,包括了筛查和补充建议。介绍并讨论了这些手术后的药物吸收数据。通过使用相关搜索词在 Cochrane 注册中心和 MEDLINE 中搜索,以及查阅纳入文献的参考文献部分,确定了研究。
减重手术可有效用于实现病态肥胖患者的可持续减重。它同时对营养缺乏和药物吸收产生重要的功能性影响,临床医生必须了解这些影响。需要进一步开展针对特定手术和缺陷的前瞻性、随机研究。