Department of Medicine A, University Medicine Greifswald, Greifswald, Germany.
Institute of Evidence-based Dietetics (NIED), University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany.
PLoS One. 2023 Mar 3;18(3):e0282683. doi: 10.1371/journal.pone.0282683. eCollection 2023.
Patients with bariatric surgery often show poor long-term compliance to recommendations for prevention of nutrient deficiency but it is unclear which factors contribute. We investigated the associations of age, sex, and socioeconomic status (SES) with adherence to guideline recommendations on protein intake and micronutrient supplementation.
In a monocentric cross-sectional study we prospectively recruited patients with sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) and a minimum postoperative period of 6 months. Clinical and demographic data were obtained from the patients' medical files and by questionnaire. Patients reported on supplement usage, recorded their dietary intake for seven days and underwent physical examinations including blood testing.
We included 35 patients (SG: n = 25, RYGB: n = 10) with a mean (+SD) postoperative period of 20.2 (±10.4) months. Distributions of age, sex and SES were comparable between the SG and RYGB groups. Non-adherence to recommended protein intake was associated with age ≥ 50 years (p = 0.041) but not sex or SES. Protein intake inversely correlated with markers of obesity. There were no significant associations of age or sex with micronutrient supplementation. Only for vitamins A (p = 0.049) and B1 (p = 0.047) higher SES was associated with greater compliance. The only manifest deficiency associated with non-adherence to micronutrient supplementation was that for folic acid (p = 0.044).
In patients after bariatric surgery, those of older age and of lower SES might have a greater risk of unfavorable outcome and may require greater attention to micronutrient and protein supplementation.
接受减重手术的患者通常对预防营养缺乏的建议的长期依从性较差，但不清楚哪些因素与之相关。我们研究了年龄、性别和社会经济地位（SES）与遵循蛋白质摄入和微量营养素补充指南建议的相关性。
在一项单中心横断面研究中，我们前瞻性招募了接受袖状胃切除术（SG）或 Roux-en-Y 胃旁路术（RYGB）且术后时间至少 6 个月的患者。临床和人口统计学数据从患者的病历和问卷调查中获得。患者报告了补充剂的使用情况，记录了他们的七天饮食摄入量，并接受了体检，包括血液检查。
我们纳入了 35 名患者（SG：n = 25，RYGB：n = 10），平均（+SD）术后时间为 20.2（±10.4）个月。SG 和 RYGB 组之间的年龄、性别和 SES 分布相似。未达到推荐蛋白质摄入量与年龄≥50 岁相关（p = 0.041），但与性别或 SES 无关。蛋白质摄入量与肥胖标志物呈负相关。年龄或性别与微量营养素补充之间没有显著相关性。只有 SES 较高与维生素 A（p = 0.049）和 B1（p = 0.047）的补充更一致。与不遵守微量营养素补充相关的唯一明显缺乏是叶酸（p = 0.044）。
在接受减重手术后的患者中，年龄较大和 SES 较低的患者可能面临更不利的结果风险，可能需要更关注微量营养素和蛋白质补充。
