Department of Gastrointestinal Surgery, First Affiliated Hospital of Jinan University, Guangzhou, 510630, China.
Department of Nursing Science, School of Nursing, Jinan University, Guangzhou, 510632, China.
Obes Surg. 2018 Sep;28(9):2727-2736. doi: 10.1007/s11695-018-3225-9.
Nutritional deficiencies have been reported in bariatric surgery patients with inconsistent results. However, scarce data exist for Chinese patients. We aimed to assess nutritional deficiencies in Chinese patients undergoing Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), and to identify predictors of postoperative nutritional status.
A retrospective review of a prospectively collected database was conducted in the patients undergoing RYGB and SG in our hospital between June 2013 and January 2017. Anthropometric data and nutritional data were collected before surgery, at 6 and 12 months postoperatively.
This study enrolled 269 patients (120 RYGB, 149 SG). Nutritional deficiencies were common in Chinese bariatric candidates, with vitamin D deficiency the most serious (78.8%), followed by vitamin B1 (39.2%), vitamin B6 (28.0%), folate (26.8%), vitamin C (18.0%) albumin (13.4%), transferrin (11.6%), and phosphorus (11.5%). Despite postoperative routine multivitamin and calcium supplements, nutritional deficiencies were still obvious for RYGB and SG patients. The prevalence of hemoglobin and vitamin B12 deficiencies increased remarkably in the RYGB group; the levels of hemoglobin, globin, vitamin B12, and ferritin decreased significantly (P < 0.05). Preoperative hemoglobin, vitamin B12, and ferritin levels were independently associated with postoperative decrease, respectively. Deficiencies of vitamin D, vitamin B1, vitamin B6, vitamin C, and albumin before surgery were predictors for deficiencies 1 year after surgery, respectively.
Nutritional deficiencies are common in Chinese bariatric surgery candidates. Similar deficiencies were also seen after RYGB and SG. Routine evaluation and related corrections of preoperative nutritional abnormity could contribute to postoperative nutrient balance.
减重手术患者存在营养缺乏，但其结果不一致。然而，中国患者的数据很少。我们旨在评估中国行 Roux-en-Y 胃旁路术（RYGB）和袖状胃切除术（SG）患者的营养缺乏情况，并确定术后营养状况的预测因素。
对 2013 年 6 月至 2017 年 1 月期间在我院行 RYGB 和 SG 的患者进行前瞻性数据库的回顾性分析。收集患者术前、术后 6 个月和 12 个月的人体测量学和营养数据。
本研究纳入了 269 例患者（RYGB 组 120 例，SG 组 149 例）。中国肥胖患者中营养缺乏较为常见，其中维生素 D 缺乏最严重（78.8%），其次是维生素 B1（39.2%）、维生素 B6（28.0%）、叶酸（26.8%）、维生素 C（18.0%）、白蛋白（13.4%）、转铁蛋白（11.6%）和磷（11.5%）。尽管术后常规补充多种维生素和钙，但 RYGB 和 SG 患者仍存在明显的营养缺乏。RYGB 组血红蛋白和维生素 B12 缺乏的发生率显著增加；血红蛋白、球蛋白、维生素 B12 和铁蛋白水平显著降低（P<0.05）。术前血红蛋白、维生素 B12 和铁蛋白水平与术后下降独立相关。术前维生素 D、维生素 B1、维生素 B6、维生素 C 和白蛋白缺乏是术后 1 年缺乏的预测因素。
中国肥胖患者减重手术候选者中存在营养缺乏，RYGB 和 SG 后也存在相似的缺乏。常规评估和相关纠正术前营养异常有助于术后营养平衡。
