Nutritional Status of Bariatric Surgery Candidates
Abstract
:1. Introduction
2. Methods
2.1. Subjects
2.2. Statistical Analysis
3. Results
3.1. Demographic
3.2. Protein Status Pre-Bariatric Surgery
Albumin and Transferrin
3.3. Vitamin Status Pre-Bariatric Surgery
3.3.1. Vitamin B1
3.3.2. Vitamin B2
3.3.3. Vitamin B6
3.3.4. Folate
3.3.5. Vitamin B12
3.3.6. Vitamin D
3.4. Anemia and Iron Status Pre Bariatric Surgery
3.4.1. Red Blood Cells (RBC)
3.4.2. Hemoglobin
3.4.3. Hematocrit
3.4.4. Mean Corpuscular Volume (MCV)
3.4.5. Ferritin
3.4.6. Iron
3.4.7. Transferrin Saturation
4. Discussion
4.1. Nutritional Deficiencies Pre Bariatric Surgery
4.2. Protein Deficiency Pre Bariatric Surgery: Albumin and Transferrin
4.3. Vitamin Deficiencies Pre Bariatric Surgery
4.3.1. B Vitamin Deficiencies Pre Bariatric Surgery
4.3.2. Vitamin D Deficiency Pre Bariatric Surgery
4.4. Anemia and Iron Deficiency Pre Bariatric Surgery
4.5. Excess Micronutrient Levels Pre Bariatric Surgery
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
- Bordalo, L.; Sales Teixeira, T.; Bressan, J.; Mourão, D. Bariatric surgery: How and why to supplement. Rev. Assoc. Méd. Bras. 2011, 57, 111–118. [Google Scholar] [CrossRef]
- Shankar, P.; Boylan, M.; Sriram, K. Micronutrient deficiencies after bariatric surgery. Nutrition 2010, 26, 1031–1037. [Google Scholar] [CrossRef] [PubMed]
- Ziegler, O.; Sirveaux, M.; Brunaud, L.; Reibel, N.; Quilliot, D. Medical follow up after bariatric surgery: Nutritional and drug issues General recommendations for the prevention and treatment of nutritional deficiencies. Diabetes Metab. 2009, 35, 544–557. [Google Scholar] [CrossRef]
- Schweiger, C.; Weiss, R.; Berry, E.; Keidar, A. Nutritional Deficiencies in Bariatric Surgery Candidates. Obes. Surg. 2010, 20, 193–197. [Google Scholar] [CrossRef] [PubMed]
- Al-Mulhim, A. Laparoscopic Sleeve Gastrectomy and Nutrient Deficiencies. Surg. Laparosc. Endosc. Percutaneous Tech. 2016, 26, 208–211. [Google Scholar] [CrossRef] [PubMed]
- Higa, K. Third IFSO Global Registry Report 2017; Dendrite Clinical Systems Limited: Henley-on-Thames, UK, 2017. [Google Scholar]
- Van Rutte, P.; Aarts, E.; Smulders, J.; Nienhuijs, S. Nutrient Deficiencies Before and After Sleeve Gastrectomy. Obes. Surg. 2014, 24, 1639–1646. [Google Scholar] [CrossRef] [PubMed]
- Ernst, B.; Thumheer, M.; Schmid, S.M. Evidence for the necessity to systematically assess micronutrient status prior to bariatric surgery. Obes. Surg. 2009, 19, 66–73. [Google Scholar] [CrossRef] [PubMed]
- Moizé, V.; Deulofeu, R.; Torres, F.; de Osaba, J.; Vidal, J. Nutritional Intake and Prevalence of Nutritional Deficiencies Prior to Surgery in a Spanish Morbidly Obese Population. Obes. Surg. 2011, 21, 1382–1388. [Google Scholar] [CrossRef] [PubMed]
- Aasheim, E.; Hofsø, D.; Hjelmesæth, J.; Birkeland, K.I.; Bøhmer, T. Vitamin status in morbidly obese patients: A cross-sectional study. Am. J. Clin. Nutr. 2008, 87, 362–369. [Google Scholar] [PubMed]
- Waki, M.; Kral, J.G.; Mazariegos, M.; Wang, J.; Pierson, R.N.; Heymsfield, S.B. Relative expansion of extracellular fluid in obese vs. nonobese women. Am. J. Physiol. 1991, 261, E199–E203. [Google Scholar] [CrossRef] [PubMed]
- Zaghloul, S.; Al-Hooti, S.; Al-Hamad, N.; Al-Zenki, S.; Alomirah, H.; Alayan, I.; Al-Attar, H.; Al-Othman, A.; Al-Shami, E.; Al-Somaie, M.; et al. Evidence for nutrition transition in Kuwait: Over-consumption of macronutrients and obesity. Public Health Nutr. 2012, 16, 596–607. [Google Scholar] [CrossRef] [PubMed]
- Coupaye, M.; Rivière, P.; Breuil, M.; Castel, B.; Bogard, C.; Dupré, T.; Flamant, M.; Msika, S.; Ledoux, S. Comparison of Nutritional Status During the first year after sleeve gastrectomy and Roux-en-Y Gastric Bypass. Obes. Surg. 2014, 24, 276–283. [Google Scholar] [CrossRef] [PubMed]
- Moizé, V.; Andreu, A.; Flores, L.; Torres, F.; Ibarzabal, A.; Delgado, S.; Lacy, A.; Rodriguez, L.; Vidal, J. Long-Term Dietary Intake and Nutritional Deficiencies following Sleeve Gastrectomy or Roux-En-Y Gastric Bypass in a Mediterranean Population. J. Acad. Nutr. Diet. 2013, 113, 400–410. [Google Scholar] [CrossRef] [PubMed]
- Saif, T.; Strain, G.; Dakin, G.; Gagner, M.; Costa, R.; Pomp, A. Evaluation of nutrient status after laparoscopic sleeve gastrectomy 1, 3, and 5 years after surgery. Surg. Obes. Relat. Dis. 2012, 8, 542–547. [Google Scholar] [CrossRef] [PubMed]
- Mahan, L.; Escott-Stump, S. Krause’s Food Nutrition Therapy, 12th ed.; Saunders/Elsevier: St. Louis, MO, USA, 2008; pp. 84–85, 414, 1229. [Google Scholar]
- Wellen, K.E.; Hotamisligil, G.S. Inflammation, stress, and diabetes. J. Clin. Investig. 2005, 115, 1111–1119. [Google Scholar] [CrossRef] [PubMed]
- Ben-Porat, T.; Elazary, R.; Yuval, J.; Wieder, A.; Khalaileh, A.; Weiss, R. Nutritional deficiencies after sleeve gastrectomy: Can they be predicted preoperatively? Surg. Obes. Relat. Dis. 2015, 11, 1029–1036. [Google Scholar] [CrossRef] [PubMed]
- Gjessing, H.; Nielsen, H.; Mellgren, G.; Gudbrandsen, O. Energy intake, nutritional status and weight reduction in patients one year after laparoscopic sleeve gastrectomy. Springerplus 2013, 2, 352. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Al-Zenki, S.; Alomirah, H.; Al Hooti, S.; Al Hamad, N.; Jackson, R.T.; Rao, A.; Al Jahmah, N.; Al Obaid, I.; Al Ghanim, J.; Al Somaie, M.; et al. Prevalence and Determinants of Anemia and Iron Deficiency in Kuwait. Int. J. Environ. Res. Public Health 2015, 12, 9036–9045. [Google Scholar] [CrossRef] [PubMed]
- Gastaldi, G.; Casirola, D.; Ferrari, G.; Rindi, G. Effect of chronic ethanol administration on thiamine transport in microvillous vesicles of rat small intestine. Alcohol Alcohol. 1989, 24, 83–89. [Google Scholar] [CrossRef] [PubMed]
- Food and Nutrition Board. Dietary Reference Intakes for Thiamin, Riboflavin, Niacin, Vitamin B b6 s, Folate, Vitamin B b12 s, Pantothenic Acid, Biotin, and Choline; National Academy Press: Washington, DC, USA, 1998; pp. 81, 182, 203–204, 211, 273. [Google Scholar]
- Zhang, F.; Al Hooti, S.; Al Zenki, S.; Alomirah, H.; Jamil, K.; Rao, A.; Al Jahmah, N.; Saltzman, E.; Ausman, L.M. Vitamin D deficiency is associated with high prevalence of diabetes in Kuwaiti adults: Results from a national survey. BMC Public Health 2016, 16, 100. [Google Scholar] [CrossRef] [PubMed]
- Molla, A.; Al Badawi, M.; Hammoud, M.; Molla, A.; Shukkur, M.; Thalib, L.; Eliwa, M. Vitamin D status of mothers and their neonates in Kuwait. Pediatr. Int. 2005, 47, 649–652. [Google Scholar] [CrossRef] [PubMed]
- El-Hajj Fuleihan, G. Vitamin D Deficiency in the Middle East and its Health Consequences for Children and Adults. Clin. Rev. Bone Miner. Metab. 2009, 7, 77–93. [Google Scholar] [CrossRef]
- Ardawi, M.; Sibiany, A.; Bakhsh, T.; Qari, M.; Maimani, A. High prevalence of vitamin D deficiency among healthy Saudi Arabian men: Relationship to bone mineral density, parathyroid hormone, bone turnover markers, and lifestyle factors. Osteoporos. Int. 2012, 23, 675–686. [Google Scholar] [CrossRef] [PubMed]
- Vanlint, S. Vitamin D and Obesity. Nutrients 2013, 5, 949–956. [Google Scholar] [CrossRef] [PubMed]
- Tsiaras, W.; Weinstock, M. Factors Influencing Vitamin D Status. Acta Derm. Venereol. 2011, 91, 115–124. [Google Scholar] [CrossRef] [PubMed]
- Holick, M.F. Vitamin D deficiency. N. Engl. J. Med. 2007, 357, 266–281. [Google Scholar] [CrossRef] [PubMed]
- Bell, N.; Epstein, S.; Greene, A.; Shary, J.; Oexmann, M.; Shaw, S. Evidence for alteration of the vitamin D-endocrine system in obese subjects. J. Clin. Investig. 1985, 76, 370–373. [Google Scholar] [CrossRef] [PubMed]
- Toh, S.; Zarshenas, N.; Jorgensen, J. Prevalence of nutrient deficiencies in bariatric patients. Nutrition 2009, 25, 1150–1156. [Google Scholar] [CrossRef] [PubMed]
- Damms-Machado, A.; Friedrich, A.; Kramer, K.; Stingel, K.; Meile, T.; Küper, M.; Königsrainer, A.; Bischoff, S.C. Pre- and Postoperative Nutritional Deficiencies in Obese Patients Undergoing Laparoscopic Sleeve Gastrectomy. Obes. Surg. 2012, 22, 881–889. [Google Scholar] [CrossRef] [PubMed]
- Christensen, S. Vitamin B6 Overdose Amount. Available online: https://www.livestrong.com/article/438301-what-is-vitamin-b6-used-for/ (accessed on 23 November 2017).
Nutritional Parameter | Number of Patients | Mean By Gender | Reference Range | |||
---|---|---|---|---|---|---|
Sample Mean ± SD | Male Mean ± SD (n) | Female Mean ± SD (n) | p | |||
Albumin | 1065 | 38.4 ± 3.0 | 39.5 ± 3.0 (288) | 38.0 ± 3.0 (777) | 0.000 * | 35–48 g/L |
Transferrin | 97 | 2.8 ± 0.5 | 2.7 ± 0.6 (27) | 2.9 ± 0.5 (70) | 0.120 | 2.15–3.8 g/L |
Vitamin B1 | 637 | 65.0 ± 28.0 | 72.3 ± 35.6 (187) | 62.0 ± 23.5 (450) | 0.000 * | 20–100 ng/mL |
Vitamin B2 | 420 | 245.5 ± 80.6 | 258.0 ± 103.4 (120) | 341.5 ± 68.7 (300) | 0.058 | 75–300 ng/mL |
Vitamin B6 | 630 | 28.4 ± 27.2 | 33.9 ± 40.9 (183) | 26.1 ± 18.7 (447) | 0.001 * | 7–30 ng/mL |
Folate | 306 | 23.0 ± 9.0 | 21.8 ± 8.9 (84) | 23.4 ± 9.1 (222) | 0.153 | 7–45 nmol/L |
Vitamin B12 | 563 | 178.6 ± 91.4 | 182.8 ± 92.0 (165) | 176.6 ± 91.2 (398) | 0.464 | <107 pmol/L Deficient; 107–133 pmol/L Indeterminate; 133–675 pmol/L Normal |
25 (OH) Vitamin D | 610 | 37.0 ± 31.0 | 30.0 ± 21.6 (167) | 39.6 ± 33.6 (443) | 0.001 * | <50 nmol/L Deficient; 50–75 nmol/L Insufficient; >75 nmol/L Sufficient; >250 nmol/L Critical High |
RBC | 1079 | 4.9 ± 0.5 | 5.2 ± 0.6 (292) | 4.8 ± 0.5 (787) | 0.000 * | Male: 4.5–5.5 (1012/L); Female: 3.8–4.8 (1012/L) |
Hemoglobin | 1079 | 133.4 ± 15.3 | 145.4 ± 15.2 (292) | 129.0 ± 12.7 (787) | 0.000 * | Male: 130–170 g/L; Female: 120–150 g/L |
Hematocrit | 1079 | 0.40 ± 0.04 | 0.43 ± 0.04 (292) | 0.39 ± 0.03 (787) | 0.000 * | Male: 0.4–0.5 L/L; Female: 0.36–0.46 L/L |
MCV | 1079 | 82.1 ± 6.8 | 83.6 ± 6.4 (292) | 81.5 ± 6.9 (787) | 0.000 * | <83 fL Microcytic; 83–101 fL Normocytic; >101 fL Macrocytic |
Ferritin | 78 | 46.0 ± 65.1 | 123.2 ± 108.5 (14) | 29.4 ± 34.8 (64) | 0.000 * | Male: 23.9–336.2 ng/mL; Female: 11–306.8 ng/mL |
Iron | 102 | 11.9 ± 6.5 | 12.0 ± 4.7 (22) | 11.9 ± 6.9 (80) | 0.939 | 11–28 µmol/L |
Transferrin Saturation | 97 | 18.2 ± 11.3 | 23.3 ± 15.8 (27) | 16.3 ± 8.6 (70) | 0.006 * | 20−40% |
Demographics | Mean ± SD |
---|---|
Age (years) | 35 ± 11.2 |
Height (cm) | 163.8 ± 9.0 |
Weight (kg) | 123.8 ± 24.3 |
Body mass index (BMI) (kg/m2) | 46.1 ± 8.0 |
EW (kg) | 56.5 ± 21.7 |
Nutritional Parameter | Number of Patients | % Deficient/Low | % Excess |
---|---|---|---|
Albumin | 1065 | 10.1 | 0 |
Transferrin | 97 | 9.0 | 3.0 |
Vitamin B1 | 637 | 0.3 | 7.0 |
Vitamin B2 | 420 | 0.7 | 16.7 |
Vitamin B6 | 630 | 0 | 24.1 |
Folate | 306 | 0 | 3.3 |
Vitamin B12 | 563 | 16.4 | 0.4 |
25 (OH) Vitamin D | 610 | 75.6 | 0.2 |
RBC | 1079 | 3.1 | 0 |
Hemoglobin | |||
Both Genders | 1079 | 19.6 | 0 |
Male | 292 | 14.4 | |
Female | 787 | 21.6 | |
Hematocrit | |||
Both Genders | 1079 | 18.4 | 0 |
Male | 292 | 17.8 | |
Female | 787 | 18.6 | |
MCV | 1079 | 47.9 | 0 |
Ferritin | |||
Both Genders | 78 | 28.2 | 0 |
Male | 14 | 21.4 | |
Female | 64 | 29.7 | |
Iron | 102 | 50.5 | 1.0 |
Transferrin Saturation | 97 | 59.0 | 2.0 |
© 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
Share and Cite
Al-Mutawa, A.; Anderson, A.K.; Alsabah, S.; Al-Mutawa, M. Nutritional Status of Bariatric Surgery Candidates. Nutrients 2018, 10, 67. https://doi.org/10.3390/nu10010067
Al-Mutawa A, Anderson AK, Alsabah S, Al-Mutawa M. Nutritional Status of Bariatric Surgery Candidates. Nutrients. 2018; 10(1):67. https://doi.org/10.3390/nu10010067
Chicago/Turabian StyleAl-Mutawa, Aliaa, Alfred Kojo Anderson, Salman Alsabah, and Mohammad Al-Mutawa. 2018. "Nutritional Status of Bariatric Surgery Candidates" Nutrients 10, no. 1: 67. https://doi.org/10.3390/nu10010067
APA StyleAl-Mutawa, A., Anderson, A. K., Alsabah, S., & Al-Mutawa, M. (2018). Nutritional Status of Bariatric Surgery Candidates. Nutrients, 10(1), 67. https://doi.org/10.3390/nu10010067