Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15067, Peru.
Facultad de Ciencias de la salud, Escuela Profesional de Medicina Humana, Universidad Nacional de Piura, Piura 20002, Peru.
Nutrients. 2021 Dec 25;14(1):82. doi: 10.3390/nu14010082.
Previous studies have described multiple nutritional deficiencies after bariatric surgery (BS). However, few studies have evaluated these deficiencies prior to BS, specifically in Latin America. This study aimed to determine the factors associated with nutritional deficiency biomarkers in candidates for BS in Peru. We included adults of both sexes, aged 18 to 59 years, admitted to a Peruvian clinic with a body mass index (BMI) ≥30 kg/m; they were candidates for BS from 2017 to 2020. We considered the serum levels of hemoglobin and albumin (in tertiles) as the nutritional deficiency biomarkers. In order to assess the associated factors, we calculated crude (cPR) and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95%CI). We analyzed 255 patients: 63.1% were males, with a mean age of 37.1 ± 10.3 years and mean hemoglobin and albumin values of 14.0 ± 1.5 g/dL and 4.6 ± 0.4 g/dL, respectively. We found that males (aPR = 1.86; 95%CI: 1.26-2.73; = 0.002), participants between 30 and 49 (aPR = 2.02; 95%CI: 1.24-3.28; = 0.004) or 50 years or more (aPR = 2.42; 95%CI: 1.35-4.35; = 0.003), participants with a BMI ≥40 kg/m (aPR = 1.68; 95%CI: 1.09-2.60; = 0.018), participants with impaired high-density lipoprotein levels (aPR = 1.43; 95%CI: 1.01-2.05; = 0.049) and individuals in the high tertile of C-reactive protein (aPR = 6.94; 95%CI: 3.37-14.32; < 0.003) had a higher probability of being in the lower tertile of albumin. In addition, we found that the male sex (aPR = 6.94; 95%CI: 3.37-14.32; < 0.001) and elevated cholesterol levels (aPR = 0.71; 95%CI: 0.52-0.97; = 0.034) were associated with the lowest hemoglobin tertile. In our setting, nutritional deficiency biomarkers were associated with sociodemographic, anthropometric and laboratory markers. The pre-bariatric surgery correction of nutritional deficiencies is essential, and can prevent major complications after surgery.
先前的研究描述了减重手术后（BS）存在多种营养缺乏。然而，很少有研究评估过拉丁美洲的 BS 前这些缺陷。本研究旨在确定与秘鲁 BS 候选人的营养缺乏生物标志物相关的因素。我们纳入了年龄在 18 至 59 岁之间的、来自秘鲁诊所的、身体质量指数（BMI）≥30 kg/m2的男性和女性成年人，他们是 2017 年至 2020 年间 BS 的候选人。我们考虑了血红蛋白和白蛋白的血清水平（分为三分位数）作为营养缺乏生物标志物。为了评估相关因素，我们计算了粗（cPR）和调整后的患病率比（aPR）及其相应的 95%置信区间（95%CI）。我们分析了 255 名患者：63.1%是男性，平均年龄为 37.1±10.3 岁，平均血红蛋白和白蛋白值分别为 14.0±1.5 g/dL 和 4.6±0.4 g/dL。我们发现男性（aPR=1.86；95%CI：1.26-2.73； = 0.002）、30-49 岁（aPR=2.02；95%CI：1.24-3.28； = 0.004）或 50 岁及以上（aPR=2.42；95%CI：1.35-4.35； = 0.003）、BMI≥40 kg/m2（aPR=1.68；95%CI：1.09-2.60； = 0.018）、高密度脂蛋白水平受损（aPR=1.43；95%CI：1.01-2.05； = 0.049）和 C 反应蛋白（CRP）三分位数较高（aPR=6.94；95%CI：3.37-14.32； < 0.003）的个体白蛋白较低的三分位数的可能性更高。此外，我们发现男性（aPR=6.94；95%CI：3.37-14.32； < 0.001）和胆固醇水平升高（aPR=0.71；95%CI：0.52-0.97； = 0.034）与最低血红蛋白三分位数相关。在我们的研究中，营养缺乏生物标志物与社会人口统计学、人体测量学和实验室标志物相关。BS 前纠正营养缺乏至关重要，可以预防手术后的主要并发症。
