Skip to main content
Erschienen in: Obesity Surgery 2/2010

01.02.2010 | Clinical Research

Long-Term Nutritional Outcome After Gastric Bypass

verfasst von: Lorença Dalcanale, Claudia P. M. S. Oliveira, Joel Faintuch, Monize A. Nogueira, Patrícia Rondó, Vicência M. R. Lima, Simone Mendonça, Denis Pajecki, Marcio Mancini, Flair J. Carrilho

Erschienen in: Obesity Surgery | Ausgabe 2/2010

Einloggen, um Zugang zu erhalten

Abstract

Background

Weight loss and nutritional status 5 or more years after Roux-en-Y gastric bypass was prospectively documented. The hypothesis was that even after clinical adaptation, imbalances might still occur.

Methods

Seventy-five consecutive patients (age 49.3 ± 10.6 years, 89.3% females) were recruited 83.4 ± 14.3 months after the intervention. Weight loss and nutritional abnormalities were registered.

Results

Body mass index (BMI) was 56.5 ± 10.0 preoperatively, 29.4 ± 6. 2 by 24 months and 34.4 ± 14.6 when last seen. Major current deficit occurred for magnesium (32.1% of the patients), hemoglobin (50.8%), iron (29.8%), ferritin (36.0%), zinc (40.5%), vitamin B12 (61.8%), vitamin D3 (60.5%), and β-carotene (56.8%). Low preoperative measurements had already been unveiled for iron, transferrin, zinc, and vitamin B12. Total drug consumption tended to decrease after operation, and present findings correlated with excess weight loss (EWL). Also presence of diabetes and BMI value were predictors of long-term EWL, along with biochemical profile by 2 years. Multivitamin supplementation and gastrointestinal complaints partially correlated with nutritional results.

Conclusions

(1) Good initial weight loss with moderate late regain, anemia, and multiple nutrient deficits was the common pattern. (2) Massive weight loss, frequent vomiting, dumping syndrome, and women in reproductive age were risk factors for hemoglobin or vitamin deficits, whereas superobesity, diabetes, and use of multiple drugs were associated with EWL result. (3) Most laboratory tests became stable by 2 years and along with BMI correlated with late EWL. (4) Two-year nutritional investigation is especially recommended because of its long-term predictive value.
Literatur
1.
Zurück zum Zitat Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obesity subjects. N Engl J Med. 2007;357:741–52.CrossRefPubMed Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obesity subjects. N Engl J Med. 2007;357:741–52.CrossRefPubMed
2.
Zurück zum Zitat Faintuch J, Matsuda M, Cruz ME, et al. Severe protein–calorie malnutrition after bariatric procedures. Obes Surg. 2004;14:175–81.CrossRefPubMed Faintuch J, Matsuda M, Cruz ME, et al. Severe protein–calorie malnutrition after bariatric procedures. Obes Surg. 2004;14:175–81.CrossRefPubMed
3.
Zurück zum Zitat Chaves LC, Faintuch J, Kahwage S, et al. A cluster of polyneuropathy and Wernicke–Korsakoff syndrome in a bariatric unit. Obes Surg. 2002;12:328–34.CrossRefPubMed Chaves LC, Faintuch J, Kahwage S, et al. A cluster of polyneuropathy and Wernicke–Korsakoff syndrome in a bariatric unit. Obes Surg. 2002;12:328–34.CrossRefPubMed
4.
Zurück zum Zitat Ishida RK, Faintuch J, Paula AM, et al. Microbial flora of the stomach after gastric bypass for morbid obesity. Obes Surg. 2007;17:752–8.CrossRefPubMed Ishida RK, Faintuch J, Paula AM, et al. Microbial flora of the stomach after gastric bypass for morbid obesity. Obes Surg. 2007;17:752–8.CrossRefPubMed
5.
Zurück zum Zitat Kaidar-Person O, Person B, Szomstein S, et al. Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? Part A: vitamins. Obes Surg. 2008;18:870–6.CrossRefPubMed Kaidar-Person O, Person B, Szomstein S, et al. Nutritional deficiencies in morbidly obese patients: a new form of malnutrition? Part A: vitamins. Obes Surg. 2008;18:870–6.CrossRefPubMed
6.
Zurück zum Zitat Kaidar-Person O, Person B, Szomstein S, et al. Nutritional deficiencies in morbidly obese patients: a new form of malnutrition ? Part B: minerals. Obes Surg. 2008;18:1028–34.CrossRefPubMed Kaidar-Person O, Person B, Szomstein S, et al. Nutritional deficiencies in morbidly obese patients: a new form of malnutrition ? Part B: minerals. Obes Surg. 2008;18:1028–34.CrossRefPubMed
7.
Zurück zum Zitat Kushner FR. Micronutrient deficiencies and bariatric surgery. Curr Opin Endocrinol Diabetes Obes. 2006;13:405–11.CrossRef Kushner FR. Micronutrient deficiencies and bariatric surgery. Curr Opin Endocrinol Diabetes Obes. 2006;13:405–11.CrossRef
8.
Zurück zum Zitat Allied Health Sciences Section Ad Hoc Nutrition Committee, Aills L, Blankenship J, et al. ASMBS Allied Health Nutritional Guidelines for the surgical weight loss patient. Surg Obes Relat Dis. 2008;4(5 Suppl):S73–108.CrossRefPubMed Allied Health Sciences Section Ad Hoc Nutrition Committee, Aills L, Blankenship J, et al. ASMBS Allied Health Nutritional Guidelines for the surgical weight loss patient. Surg Obes Relat Dis. 2008;4(5 Suppl):S73–108.CrossRefPubMed
9.
Zurück zum Zitat Ritz P, Becouarn G, Douay O, et al. Gastric bypass is not associated with protein malnutrition in morbidly obese patients. Obes Surg. 2008;19:840–844.CrossRefPubMed Ritz P, Becouarn G, Douay O, et al. Gastric bypass is not associated with protein malnutrition in morbidly obese patients. Obes Surg. 2008;19:840–844.CrossRefPubMed
10.
Zurück zum Zitat World Health Organization. Obesity. Preventing and managing the global epidemic. Report of a WHO consultation on obesity. WHO/NUT/NCD/981. Geneva: WHO; 1998. World Health Organization. Obesity. Preventing and managing the global epidemic. Report of a WHO consultation on obesity. WHO/NUT/NCD/981. Geneva: WHO; 1998.
11.
Zurück zum Zitat Pajecki D, Dalcanalle L, de Oliveira CP Souza, et al. Follow-up of Roux-en-Y gastric bypass patients at 5 or more years postoperatively. Obes Surg. 2007;17:601–7.CrossRefPubMed Pajecki D, Dalcanalle L, de Oliveira CP Souza, et al. Follow-up of Roux-en-Y gastric bypass patients at 5 or more years postoperatively. Obes Surg. 2007;17:601–7.CrossRefPubMed
12.
Zurück zum Zitat Pories WJ, Swanson MS, MacDonald KG, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995;222:339–50.CrossRefPubMed Pories WJ, Swanson MS, MacDonald KG, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995;222:339–50.CrossRefPubMed
13.
Zurück zum Zitat Christou NV, Sampalis JS, Liberman M, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004;240:416–23.CrossRefPubMed Christou NV, Sampalis JS, Liberman M, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004;240:416–23.CrossRefPubMed
14.
Zurück zum Zitat Higa KD, Boone KB, Ho T, et al. Laparoscopic Roux-en-Y gastric bypass for morbid obesity: technique and preliminary results of our first 400 patients. Arch Surg. 2000;135:1029–33.CrossRefPubMed Higa KD, Boone KB, Ho T, et al. Laparoscopic Roux-en-Y gastric bypass for morbid obesity: technique and preliminary results of our first 400 patients. Arch Surg. 2000;135:1029–33.CrossRefPubMed
15.
Zurück zum Zitat Brolin RE, Leung M. Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity. Obes Surg. 1999;9:150–4.CrossRefPubMed Brolin RE, Leung M. Survey of vitamin and mineral supplementation after gastric bypass and biliopancreatic diversion for morbid obesity. Obes Surg. 1999;9:150–4.CrossRefPubMed
16.
17.
Zurück zum Zitat Granado-Lorencio F, Herrero-Barbudo C, Olmedilla-Alonso B, et al. Hypocarotenemia after bariatric surgery: a preliminary study. Obes Surg. 2008;19:879–82.CrossRefPubMed Granado-Lorencio F, Herrero-Barbudo C, Olmedilla-Alonso B, et al. Hypocarotenemia after bariatric surgery: a preliminary study. Obes Surg. 2008;19:879–82.CrossRefPubMed
18.
Zurück zum Zitat Brolin RE, Gorman JH, Gorman RC, et al. Are vitamin B12 and folate deficiency clinically important after Roux-en-Y gastric bypass? J Gastrointest Surg. 1998;2:436–42.CrossRefPubMed Brolin RE, Gorman JH, Gorman RC, et al. Are vitamin B12 and folate deficiency clinically important after Roux-en-Y gastric bypass? J Gastrointest Surg. 1998;2:436–42.CrossRefPubMed
19.
Zurück zum Zitat Folope V, Coeffier M, Dechelotte P. Nutritional deficiencies associated with bariatric surgery. Gastroenterol Clin Biol. 2007;31:369–77.PubMedCrossRef Folope V, Coeffier M, Dechelotte P. Nutritional deficiencies associated with bariatric surgery. Gastroenterol Clin Biol. 2007;31:369–77.PubMedCrossRef
20.
Zurück zum Zitat Goldner WS, Stoner JA, Lyden E, et al. Finding the optimal dose of vitamin D following Roux-en-Y gastric bypass: a prospective, randomized pilot clinical trial. Obes Surg. 2009;19:173–9.CrossRefPubMed Goldner WS, Stoner JA, Lyden E, et al. Finding the optimal dose of vitamin D following Roux-en-Y gastric bypass: a prospective, randomized pilot clinical trial. Obes Surg. 2009;19:173–9.CrossRefPubMed
Metadaten
Titel
Long-Term Nutritional Outcome After Gastric Bypass
verfasst von
Lorença Dalcanale
Claudia P. M. S. Oliveira
Joel Faintuch
Monize A. Nogueira
Patrícia Rondó
Vicência M. R. Lima
Simone Mendonça
Denis Pajecki
Marcio Mancini
Flair J. Carrilho
Publikationsdatum
01.02.2010
Verlag
Springer-Verlag
Erschienen in
Obesity Surgery / Ausgabe 2/2010
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-009-9916-5

Weitere Artikel der Ausgabe 2/2010

Obesity Surgery 2/2010 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.