van Rutte P W J, Aarts E O, Smulders J F, Nienhuijs S W
Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands,
Obes Surg. 2014 Oct;24(10):1639-46. doi: 10.1007/s11695-014-1225-y.
Obesity is associated with nutritional deficiencies. Bariatric surgery could worsen these deficiencies. Fewer nutritional deficiencies would be seen after sleeve gastrectomy compared to the Roux-en-Y gastric bypass, but sleeve gastrectomy would also cause further deterioration of the deficiencies. The aim of this study was to determine the amount of pre-operative nutrient deficiencies in sleeve gastrectomy patients and assess the evolution of the nutritional status during the first post-operative year.
Four hundred seven sleeve gastrectomy patients were assigned to a standardized follow-up program. Data of interest were weight loss, pre-operative nutrient status and evolution of nutrient deficiencies during the first post-operative year. Deficiencies were supplemented when found.
Two hundred patients completed blood withdrawal pre-operatively and in the first post-operative year. pre-operatively, 5 % of the patients were anemic, 7 % had low serum ferritin and 24 % had low folic acid. Hypovitaminosis D was present in 81 %. Vitamin A had excessive levels in 72 %. One year post-operatively, mean excess weight loss was 70 %. Anemia was found in 6 %. Low-ferritin levels were found in 8 % of the patients. Folate deficiency decreased significantly and hypovitaminosis D was still found in 36 %.
In this study, a considerable amount of patients suffered from a deficient micronutrient status pre-operatively. One year after surgery, micronutrient deficiencies persisted or were found de novo in a considerable amount of patients, despite significant weight loss and supplementation. Significant reductions were seen only for folate and vitamin D.
肥胖与营养缺乏有关。减肥手术可能会使这些缺乏情况恶化。与Roux-en-Y胃旁路手术相比，袖状胃切除术术后出现的营养缺乏情况较少，但袖状胃切除术也会导致营养缺乏情况进一步恶化。本研究的目的是确定接受袖状胃切除术患者术前营养缺乏的程度，并评估术后第一年营养状况的变化。
407例接受袖状胃切除术的患者被纳入标准化随访计划。关注的数据包括体重减轻、术前营养状况以及术后第一年营养缺乏情况的变化。发现缺乏情况时进行补充。
200例患者在术前及术后第一年完成了血液检查。术前，5%的患者贫血，7%的患者血清铁蛋白水平低，24%的患者叶酸水平低。81%的患者存在维生素D缺乏。72%的患者维生素A水平过高。术后一年，平均超重减轻了70%。6%的患者出现贫血。8%的患者铁蛋白水平低。叶酸缺乏显著减少，但仍有36%的患者存在维生素D缺乏。
在本研究中，相当数量的患者术前存在微量营养素缺乏状况。术后一年，尽管体重显著减轻且进行了补充，但相当数量的患者仍存在微量营养素缺乏或出现新的缺乏情况。仅叶酸和维生素D出现了显著降低。
