Department of Internal Medicine, Laval University, Quebec, Canada.
Department of Surgery, Quebec Heart and Lung Institute, Laval University, Quebec, Canada.
Surg Obes Relat Dis. 2017 Oct;13(10):1664-1673. doi: 10.1016/j.soard.2017.07.019. Epub 2017 Jul 18.
Sleeve gastrectomy (SG) has become a predominant bariatric procedure throughout the world. However, the long-term nutritional impact of this procedure is unknown.
To describe the nutritional deficiencies before and after SG and to analyze the influence of baseline weight on nutritional status.
University-affiliated tertiary care center.
All patients who underwent SG as a standalone procedure between 2008 and 2012 were included in this study. Patients were given multivitamin supplementation. Data were obtained from our prospectively maintained electronic database and are reported as mean ± standard deviation and percentage. Bivariate analyses were conducted to evaluate the influence of selected variables on outcomes.
The mean age of the 537 patients was 48.0 ± 11.3 years, with an initial body mass index of 48.1 ± 8.7 kg/m. Excess weight loss and total weight loss were 56.2% and 28.0% at 1 year and 43.0% and 21.1% at 5 years, respectively (P<.0001). Percentage of follow-up was 74% at 5 years (n = 79). The mean follow-up time was 34.3 ± 17.2 months. Hypoalbuminemia was present in 1.1% preoperatively and 4.2% at 5 years (P = .0043), low ferritin levels in 8.6% and 37.8% (P<.0001), low vitamin B12 in 30.3% and 16.4% (P<.0001), low vitamin D 63.2% and 24.3% (P<.0001), and hyperparathyroidism in 23.4% and 20.8% (P<.0001). There was no significant difference in the prevalence of anemia over time (P = 0.4301). The prevalence of vitamin A insufficiency peaked from 7.9% preoperatively to 28.7% at 3 months (P<.0001) and returned to baseline thereafter. Baseline weight was negatively correlated with vitamin B12 and vitamin D.
Nutritional deficiencies are common in patients with morbid obesity before and after surgery. Preoperative supplementation and long-term nutritional follow-up are required to prevent nutritional deficiencies.
袖状胃切除术（SG）已成为全球主要的减重手术。然而，该手术的长期营养影响尚不清楚。
描述 SG 前后的营养不足情况，并分析基线体重对营养状况的影响。
大学附属三级保健中心。
纳入 2008 年至 2012 年间单独行 SG 的所有患者。患者给予多种维生素补充。数据来自我们前瞻性维护的电子数据库，并以平均值±标准差和百分比报告。进行了单变量分析以评估选定变量对结果的影响。
537 例患者的平均年龄为 48.0±11.3 岁，初始体重指数为 48.1±8.7kg/m²。术后 1 年和 5 年时的超体重减轻率和总体重减轻率分别为 56.2%和 28.0%（P<.0001）。5 年时的随访率为 74%（n=79）。平均随访时间为 34.3±17.2 个月。术前低白蛋白血症发生率为 1.1%，5 年时为 4.2%（P=0.0043），低铁蛋白水平发生率分别为 8.6%和 37.8%（P<.0001），低维生素 B12 发生率分别为 30.3%和 16.4%（P<.0001），低维生素 D 发生率分别为 63.2%和 24.3%（P<.0001），高甲状旁腺素血症发生率分别为 23.4%和 20.8%（P<.0001）。随时间推移，贫血的发生率无显著差异（P=0.4301）。术前维生素 A 不足的发生率从 7.9%上升至术后 3 个月的 28.7%（P<.0001），此后恢复到基线水平。基线体重与维生素 B12 和维生素 D 呈负相关。
病态肥胖患者术前和术后均存在营养不足。需要术前补充和长期营养随访，以预防营养不足。
