Schiavo Luigi, Pilone Vincenzo, Rossetti Gianluca, Romano Mafalda, Pieretti Gorizio, Schneck Anne-Sophie, Iannelli Antonio
1Center of Excellence of Bariatric Surgery of the Italian Society of Obesity Surgery and Metabolic Disease (SICOB), Unit of General and Emergency Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Mercato San Severino, Salerno, Italy.
2Department of Medicine, Surgery, and Dentistry, "Scuola Medica Salernitana", University of Salerno, Italy.
Int J Vitam Nutr Res. 2019 Jul;89(1-2):22-28. doi: 10.1024/0300-9831/a000532. Epub 2019 Jan 29.
Micronutrient deficiencies (MD) shortly after sleeve gastrectomy (SG) are frequent and patients with obesity often show MD preoperatively. Our aim was to assess whether the correction of MD before SG could play a role in preventing early postoperative MD. Eighty patients (58 females, 22 males) who underwent SG were evaluated retrospectively. Patients were divided according to whether they had received preoperative MD correction (Group A, n = 42; 30 females, 12 males) or not (Group B, n = 38; 28 females, 10 males). Micronutrient status was assessed preoperatively, at 3 and 12-months after SG in both groups. After SG, Group A and Group B patients received the same multivitamin supplement and followed the same diet. Nutrient intake of all patients was evaluated by food frequency questionnaires. Before SG, patients of Group A had no MD, whereas patients of Group B were mostly deficient in vitamin B12 (10.5%, 3 women, 1 man), folate (15.8%, 5 women, 1 man), 25-vitamin D (39.5%, 10 women, 5 men), iron (26.3%, 8 women, 2 men), and zinc (7.9%, 2 women, 1 men). At 3- and 12-month follow-up, no patient in group A had developed new MD, whereas all patients of Group B continued to be deficient in one or more micronutrient, despite systematic postoperative supplementation. No statistical differences (p<0.05) in estimated nutrient intake were observed in either group. Based on our findings, we are able to support the hypothesis that pre-SG correction of MD may be useful in preventing early post-SG MD.
袖状胃切除术后短期内微量营养素缺乏(MD)很常见,肥胖患者术前常存在微量营养素缺乏。我们的目的是评估袖状胃切除术(SG)前纠正微量营养素缺乏是否对预防术后早期微量营养素缺乏有作用。对80例行袖状胃切除术的患者(58例女性,22例男性)进行回顾性评估。根据患者术前是否接受微量营养素缺乏纠正分为两组(A组,n = 42;30例女性,12例男性)和未接受纠正组(B组,n = 38;28例女性,10例男性)。两组均在术前、袖状胃切除术后3个月和12个月评估微量营养素状况。袖状胃切除术后,A组和B组患者接受相同的多种维生素补充剂并遵循相同的饮食。通过食物频率问卷评估所有患者的营养摄入。术前,A组患者无微量营养素缺乏,而B组患者大多缺乏维生素B12(10.5%,3名女性,1名男性)、叶酸(15.8%,5名女性,1名男性)、25-维生素D(39.5%,10名女性,5名男性)、铁(26.3%,8名女性,2名男性)和锌(7.9%,2名女性,1名男性)。在3个月和12个月的随访中,A组无患者出现新的微量营养素缺乏,而B组所有患者尽管术后进行了系统补充,但仍有一种或多种微量营养素缺乏。两组在估计营养摄入方面均未观察到统计学差异(p<0.05)。根据我们的研究结果,我们支持术前纠正微量营养素缺乏可能有助于预防袖状胃切除术后早期微量营养素缺乏这一假设。