J Acad Nutr Diet. 2020 May;120(5):874-884. doi: 10.1016/j.jand.2019.10.017. Epub 2019 Dec 28.
Nutritional deficiencies are a well-recognized long-term complication following bariatric surgery. The presence of preoperative deficiencies has been shown to be predictive of postoperative deficiencies.
The aim of the study was to investigate the prevalence of micronutrient deficiency in a large sample of patients with severe obesity preoperatively, and to determine whether such deficiencies may be related to patient's sex, body mass index, or ethnic subgroup.
A cross-sectional study of data collected at the time of the preoperative evaluation.
PARTICIPANTS/SETTING: Data were collected during the preoperative evaluation of 872 bariatric surgery candidates in a university hospital in Israel between 2011 and 2018. The patients were 72.9% women, with a mean age of 37.9±12.1 years and mean body mass index of 42.4±4.7 MAIN OUTCOME MEASURES: Nutritional deficiencies according to blood assays. Data on anthropometrics, comorbidities, and demographic characteristics was also collected.
Baseline differences between patient subgroups were analyzed using independent-samples t test, analysis of variance, or χ test.
Deficiencies of vitamin D, iron, folate, vitamin B-12, elevated parathyroid hormone and low transferrin saturation were present in 75.2%, 42.6%, 28.5%, 8.5%, 35.5%, and 70% of patients, respectively. Nutritional deficiencies were significantly more common among women compared with men for iron (45.9% vs 33.5%; P=0.002), low transferrin saturation (77.7% vs 44.6%; P<0.001), vitamin D (77.5% vs 69.2%; P=0.019) and elevated parathyroid hormone level (39.5% vs 22.9%; P=0.002). Iron, transferrin saturation, and vitamin D deficiencies were more prevalent in Arab patients compared with Jewish patients: 59.6% vs 36%; P<0.001, 80.2% vs 62.8%; P=0.003, and 85.1% vs 71.6%; P<0.001, respectively. Vitamin D and iron deficiency were more common among higher body mass index subgroups (P=0.004 and P=0.040, respectively).
The results indicate a high prevalence of nutritional deficiencies, mainly of iron and vitamin D in bariatric surgery candidates. Patients at higher risk for nutritional deficiencies include those with higher body mass index, women, and Arabs.
营养缺乏是减重手术后长期存在的问题。术前存在营养缺乏被认为是术后缺乏的预测因素。
本研究旨在调查大量严重肥胖患者术前微量营养素缺乏的患病率，并确定这种缺乏是否与患者的性别、体重指数或种族亚组有关。
这是一项在以色列一所大学医院进行的术前评估时收集数据的横断面研究。
参与者/设置：2011 年至 2018 年期间，共有 872 名减重手术候选者的数据被收集。患者中 72.9%为女性，平均年龄为 37.9±12.1 岁，平均体重指数为 42.4±4.7。
根据血液检测确定营养缺乏情况。还收集了与人体测量学、合并症和人口统计学特征有关的数据。
采用独立样本 t 检验、方差分析或卡方检验分析患者亚组之间的基线差异。
维生素 D、铁、叶酸、维生素 B-12、甲状旁腺激素升高和转铁蛋白饱和度降低的缺乏率分别为 75.2%、42.6%、28.5%、8.5%、35.5%和 70%。与男性相比，女性的铁（45.9%比 33.5%；P=0.002）、低转铁蛋白饱和度（77.7%比 44.6%；P<0.001）、维生素 D（77.5%比 69.2%；P=0.019）和甲状旁腺激素水平升高（39.5%比 22.9%；P=0.002）的营养缺乏更为常见。与犹太患者相比，阿拉伯患者的铁、转铁蛋白饱和度和维生素 D 缺乏更为常见：59.6%比 36%；P<0.001，80.2%比 62.8%；P=0.003，85.1%比 71.6%；P<0.001。较高体重指数亚组的维生素 D 和铁缺乏更为常见（P=0.004 和 P=0.040）。
结果表明，在减重手术候选者中，营养缺乏的发生率很高，主要是铁和维生素 D 缺乏。营养缺乏风险较高的患者包括体重指数较高的患者、女性和阿拉伯人。
