Hypocarotenemia after bariatric surgery: a preliminary study.
BACKGROUND
Dietary carotenoids have attracted a great deal of attention due to their potential clinical relevance in conditions such as age-related maculopathy, osteoporosis, cardiovascular disease, and cancer. Surgical procedures have become the primary treatment of severe obesity, although nutrient deficiencies are common and long-term metabolic sequelae remain unknown. Thus, our aim was to assess the carotenoid status in serum of subjects after obesity surgery.


METHODS
We evaluated the status of lutein, zeaxanthin, alpha- and beta-cryptoxanthin, lycopene, alpha- and beta-carotene, and fat-soluble vitamins by a quality-controlled high-performance liquid chromatography method in serum of 53 patients. Subjects were consecutively included as they were monitored for nutritional status after Roux-en-Y gastric bypass (RYGBP) or biliopancreatic diversion (BPD). Average follow-up time was 18 and 14 months for each protocol, respectively.


RESULTS
After obesity surgery, a consistent and continuous decline in all carotenoids to almost undetectable levels occurs, especially in those who underwent BPD diversion who, on average, displayed serum levels about one half to one third of those found in RYGBP patients.


CONCLUSIONS
The hypocarotenemia observed after bariatric surgery may compromise the availability of carotenoids to tissues and the vitamin A status, reducing the fat-soluble antioxidant capacity and constituting an additional risk factor for several clinical conditions. Given the emerging role of carotenoids in disease prevention, dietary advice on carotenoid-rich and fortified foods or the use of supplements in these patients should be considered.
Granado-Lorencio
F
F
Unidad de Vitaminas, Servicio de Bioquímica Clínica, Hospital Universitario Puerta de Hierro, 28035, Madrid, Spain. fgranado.hpth@salud.madrid.org
Herrero-Barbudo
C
C
Olmedilla-Alonso
B
B
Blanco-Navarro
I
I
Pérez-Sacristán
B
B
D000328:Adult; D000975:Antioxidants; D015904:Biliopancreatic Diversion / Q000009:adverse effects*; D002338:Carotenoids / Q000097:blood*; D065366:Cryptoxanthins; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D014975:Lutein / Q000097:blood; D000077276:Lycopene; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D014801:Vitamin A / Q000378:metabolism*; D014815:Vitamins / Q000378:metabolism*; D024341:Xanthophylls / Q000097:blood; D065146:Zeaxanthins; D019207:beta Carotene / Q000097:blood
D000975:Antioxidants; D065366:Cryptoxanthins; D014815:Vitamins; D024341:Xanthophylls; D065146:Zeaxanthins; D019207:beta Carotene; D014801:Vitamin A; D002338:Carotenoids; D000077276:Lycopene; D014975:Lutein