Evaluation of Micronutrient Status Post Laparoscopic Sleeve Gastrectomy: an Australian Perspective
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Evaluation of Micronutrient Status Post Laparoscopic Sleeve Gastrectomy: an Australian Perspective Lillian Dong 1 & Hyerim Suh 1,2 & William Karantanis 1 & Sisi Jia 3 & Yive Yang 4 & Ken W. K. Loi 5 Received: 6 May 2020 / Revised: 24 October 2020 / Accepted: 26 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Laparoscopic sleeve gastrectomy (LSG) is a type of bariatric technique that has comparable outcomes to Roux-en-Y gastric bypass, the current gold standard. However, it can be associated with nutritional deficiencies postoperatively. The aim of this study was to evaluate micronutrient status post LSG. Methods This is a retrospective study of 565 patients who underwent an LSG from January 2015 to September 2018. Patients lost to follow-up at 3, 6 and 12 months were 6.3%, 18.6% and 32.4%, respectively. Follow-up of the patients included regular dietetic input and micronutrient supplementation. Data that was collected included both anthropometry and nutritional markers. Results The mean preoperative weight and body mass index (BMI) were 118.13 ± 25.36 kg and 42.40 ± 7.66 kg/m2, respectively. Statistically, significant reductions in anthropometric parameters including weight, BMI (30.50 kg/m2), total weight loss (28.03%), excess weight loss (72.03%) and BMI loss (12.32 kg/m2) were observed at all timepoints up to 12 months follow-up. At 12 months, there were significant increases in 25-OH vitamin D with the incidence of deficiency decreasing from 45.7 to 15.0% compared to baseline. The incidence of hyperparathyroidism also decreased from 32.2 to 18.9% compared to baseline, and incidence of folate deficiency increased from 7.7 to 19.2%. Other nutritional parameters including calcium, iron, ferritin, vitamin B12, holotranscobalamin (active B12) and haemoglobin did not significantly change. Conclusions Modest effects on micronutrient status were observed in the 12-month postoperative period. Of clinically significant, de novo folate deficiencies increased, and vitamin D deficiency and hyperparathyroidism decreased. Thus, optimizing postoperative micronutrient status is imperative following LSG. Keywords Australia . Bariatric surgery . Laparoscopic sleeve gastrectomy . Malnutrition . Nutritional outcomes . Anthropometry . Weight loss . Parathyroid hormone . Vitamin D . Vitamin B12 . Iron . Ferritin . Haemoglobin . Folate
Introduction Obesity is a rising epidemic within the Australian setting with approximately two-thirds of the population reported to be overweight or obese. Obesity is associated with an increased
risk of type II diabetes, cardiovascular disease, musculoskeletal conditions and some cancers [1]. With a high demand for obesity-reducing treatments, non-surgical methods such as lifestyle modifications and/or pharmacotherapy have proven only moderately effective at best. Bariatric surgery is an
* Ken W. K. Loi [email protected] Lillian Dong [email protected] Hyerim Suh [email protected] William Karantanis wkarantanis@gm
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