Long-term nutritional outcome after gastric bypass.
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 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.


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.
Dalcanale
Lorença
L
Department of Gastroenterology, Clinical Division, University of São Paulo School of Medicine, São Paulo, Brazil. adal19@hotmail.com
Oliveira
Claudia P M S
CP
Faintuch
Joel
J
Nogueira
Monize A
MA
Rondó
Patrícia
P
Lima
Vicência M R
VM
Mendonça
Simone
S
Pajecki
Denis
D
Mancini
Marcio
M
Carrilho
Flair J
FJ
D000740:Anemia / Q000453:epidemiology / Q000209:etiology; D015992:Body Mass Index; D003677:Deficiency Diseases / Q000453:epidemiology* / Q000209:etiology; D019587:Dietary Supplements; D004377:Dumping Syndrome / Q000150:complications / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D008903:Minerals / Q000008:administration & dosage / Q000097:blood; D015596:Nutrition Assessment; D009748:Nutrition Disorders / Q000453:epidemiology* / Q000209:etiology; D009751:Nutritional Requirements; D009752:Nutritional Status; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016896:Treatment Outcome; D014815:Vitamins / Q000008:administration & dosage / Q000097:blood; D015431:Weight Loss / Q000502:physiology
D008903:Minerals; D014815:Vitamins
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