Long-Term Nutritional Outcome After Gastric Bypass

Author(s)

Dalcanale, Lorenca ^{[1, 2]} ; Oliveira, Claudia P. M. S. ^[1] ; Faintuch, Joel ^[3] ; Nogueira, Monize A. ^[3] ; Rondo, Patricia ^[4] ; Lima, Vicencia M. R. ^[1] ; Mendonca, Simone ^[4] ; Pajecki, Denis ^[3] ; Mancini, Marcio ^[5] ; Carrilho, Flair J. ^[1]

Affiliation

^[1] Univ Sao Paulo, Sch Med, Clin Div, Dept Gastroenterol, Sao Paulo - Brazil

^[2] Dept Gastroenterol, BR-05405900 Sao Paulo - Brazil

^[3] Univ Sao Paulo, Sch Med, Div Surg, Dept Gastroenterol, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Sch Med, Sch Publ Hlth, Dept Nutr, Sao Paulo - Brazil

^[5] Univ Sao Paulo, Sch Med, Dept Endocrinol, Sao Paulo - Brazil

• Document type: Journal article
• Source: OBESITY SURGERY; v. 20, n. 2, p. 181-187, FEB 2010.
• Web of Science Citations: 91

Abstract

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. 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. 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 B(12) (61.8%), vitamin D(3) (60.5%), and beta-carotene (56.8%). Low preoperative measurements had already been unveiled for iron, transferrin, zinc, and vitamin B(12). 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. (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. (AU)