Is the Current Micronutrient Supplementation Adequate in Preventing Deficiencies in Indian Patients? Short- and Mid-Term
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Is the Current Micronutrient Supplementation Adequate in Preventing Deficiencies in Indian Patients? Short- and Mid-Term Comparison of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Shivanshu Misra 1 & Shankar Balasubramanian 1 & Usha Isaac 1 & Menaka Srinivasan 1 & Christinajoice Saminathan 1 & S Saravana Kumar 1 & P Praveen Raj 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Bariatric procedures reduce the capacity of the gut and alter the gastrointestinal transit time predisposing to micronutritional deficiencies. This study analyzed and compared the micro-nutritional parameters following laparoscopic sleeve gastrectomy (LSG) and Roux-en-Y gastric bypass (RYGB) in the Indian population. Materials and Methods This is a retrospective study of patients who underwent LSG or RYGB for morbid obesity at a tertiary care center between January 2015 and December 2016. The micronutrient parameters, namely, serum ferritin, vitamin B12, ionized calcium, vitamin D3, and parathormone (PTH) in the preoperative settings and subsequently at 1, 2, and 3 years were analyzed. Results A total of 390 patients were studied, of which 258 (66.15%) underwent LSG while 132 (33.85%) underwent RYGB. Baseline micronutrient parameters were comparable in the two groups. Anemia (58.1% vs. 59.1%), deficiencies of ferritin (31.7% vs. 34.3%), vitamin B12 (18.8% vs. 36.4%), ionized calcium (65.1% vs. 72.7%), vitamin D3 (95.3% vs. 90.9%), and secondary hyperparathyroidism (45.5% vs. 58.1%) were seen following LSG and RYGB at the end of 3 years, respectively. There was no significant difference found between LSG and RYGB in terms of micronutrient deficiencies studied, including rising in PTH at 1, 2, and 3 years. Vitamin D3 levels were significantly lower at 2 and 3 years following RYGB (p = 0.035 and p = 0.032, respectively). Conclusion LSG and RYGB have comparable micronutrient deficiencies in the short- and mid-term except for vitamin D3, which is higher following RYGB. Long-term studies are needed to define optimum micronutrient supplement dosages for the Indian population. Keywords Bariatric surgery . Weight loss . Micronutrition . Sleeve gastrectomy . LSG . RYGB . Midterm
* P Praveen Raj [email protected] Shivanshu Misra [email protected] Shankar Balasubramanian [email protected] Usha Isaac [email protected] Menaka Srinivasan [email protected] Christinajoice Saminathan [email protected] S Saravana Kumar [email protected] 1
Department of bariatric and metabolic surgery, GEM hospital & research center, Coimbatore, Tamil Nadu 641045, India
Introduction Obesity is a global pandemic carrying a significant amount of socioeconomic burden [1]. The WHO has considered obesity as one of the significant global health concerns in its 2013 World Health Assembly. The National Family Health Survey 4 reported that 20.6% of Indian women and 18.9% of Indian men were overweight or obese in 2015–2016. The high prevalence of obesity in India could be attr
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