1st Department of Surgery, Laiko Athens General Hospital, University of Athens, 17 Agiou Thoma St, GR-11527 Athens, Greece.
2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens.
Surg Obes Relat Dis. 2014 Mar-Apr;10(2):262-8. doi: 10.1016/j.soard.2013.07.014. Epub 2013 Aug 12.
Nutritional deficiencies are highly prevalent in obese patients. Bariatric surgery has been associated with adverse effects on homeostasis of significant vitamins and micronutrients, mainly after gastric bypass. The aim of the present study was to compare the extent of long-term postsurgical nutritional deficiencies between Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).
This cross-sectional, pilot study included 95 patients who underwent RYGB or SG surgery with a mean follow-up of 4 years. Demographic, anthropometric, and biochemical parameters were compared according to the type of surgery.
Both types of surgery were associated with significant nutritional deficiencies. Vitamin B12 deficiency was significantly higher in patients with RYGB compared with SG (42.1% versus 5%, P = .003). The type of surgery was associated neither with anemia nor with iron or folate deficiency (SG versus RYGB: anemia, 54.2% versus 64.3%, P = .418; folate deficiency, 20% versus 18.4%, P = .884; iron deficiency, 30% versus 36.4%, P = .635).
During a mean follow up period of 4 years postRYGB or SG, patients were identified with several micronutrient deficiencies, including vitamin D, folate, and vitamin B12. SG may have a more favorable effect on the metabolism of vitamin B12 compared with RYGB, being associated with less malabsorption. Adherence to supplemental iron and vitamin intake is of primary significance in all cases of bariatric surgery.
肥胖患者普遍存在营养缺乏的情况。减重手术与多种重要维生素和微量营养素的稳态不良有关,尤其是在胃旁路手术后。本研究旨在比较 Roux-en-Y 胃旁路术(RYGB)和袖状胃切除术(SG)术后长期营养缺乏的程度。
本横断面、初步研究纳入了 95 例接受 RYGB 或 SG 手术的患者,平均随访 4 年。根据手术类型比较了人口统计学、人体测量学和生化参数。
两种手术都与显著的营养缺乏有关。与 SG 相比,RYGB 术后维生素 B12 缺乏的发生率显著更高(42.1%比 5%,P=0.003)。手术类型与贫血或铁或叶酸缺乏无关(SG 与 RYGB:贫血发生率为 54.2%比 64.3%,P=0.418;叶酸缺乏发生率为 20%比 18.4%,P=0.884;铁缺乏发生率为 30%比 36.4%,P=0.635)。
在 RYGB 或 SG 术后平均 4 年的随访期间,患者被发现存在多种微量营养素缺乏,包括维生素 D、叶酸和维生素 B12。与 RYGB 相比,SG 对维生素 B12 的代谢可能有更有利的影响,与较少的吸收不良有关。在所有减重手术中,补充铁和维生素的依从性至关重要。