Nutritional deficiencies before and 5 years after Sleeve Gastrectomy

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