Nutritional deficiency after gastric sleeve

Nutritional deficiencies before and after Sleeve Gastrectomy

Nutritional deficiencies after Sleeve Gastrectomy

Nutritional deficiency after gastric sleeve

Nutritional deficiencies are common in obese patients before and 5 years after a Sleeve Gastrectomy.

The Sleeve Gastrectomy (SG) has become a predominant bariatric procedure to treat obesity throughout the world. However, the long-term nutritional impact of this procedure is unknown. In a retrospective cohort study, the nutritional deficiencies in 537 patients before and after SG were monitored over a 5-year follow-up.

Nutritional deficiencies

Although patients were given multivitamin supplementation, nutritional deficiencies were common. Low ferritin levels were observed prior to SG, and the prevalence of ferritin deficiency increased after 5 years. A slight increase in albumin deficiency was also observed, whereas preoperative deficiencies in vitamin B12 and D decreased after 5 years. There was no significant difference in the prevalence of anemia over time.

Prevalence of deficiency Preoperative (%) 5 years after SG (%)
Albumin 1,1 4,2
Ferritin 8,6 37,8
Vitamin B12 30,3 16,4
Vitamin D 63,2 24,3
Anemia 19,6 11,8

Weight loss

Excess weight loss was maximal at 18 months after surgery. However, this weight loss was followed with weight regain up to 5 years. Baseline weight was negatively correlated with albumin, vitamin B12 and vitamin D: patients with a higher preoperative weight had lower albumin, vitamin B12 and vitamin D levels before and after surgery. In contrast, patients with a lower preoperative weight had higher preoperative and postoperative hemoglobin, a positive baseline weight correlation.

Long-term nutritional follow-up

Nutritional deficiencies are common in patients with morbid obesity before and after surgery. Preoperative supplementation and long-term nutritional follow-up are required to prevent and correct nutritional deficiencies.

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M. Caron, F.S. Hould, O. Lescelleur, S. Marceau, S. Lebel, F. Julien, S. Simard, Laurent Biertho (2017) Long-term nutritional impact of sleeve gastrectomy. Surgery for Obesity and Related Diseases 13 (2017) 1664–1675

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