title: Long-term nutritional outcome after gastric bypass.
abstract: 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.
authors.affiliation: Department of Gastroenterology, Clinical Division, University of São Paulo School of Medicine, São Paulo, Brazil. adal19@hotmail.com
authors.forename: Lorença
authors.initials: L
authors.lastname: Dalcanale
authors.forename: Claudia P M S
authors.initials: CP
authors.lastname: Oliveira
authors.forename: Joel
authors.initials: J
authors.lastname: Faintuch
authors.forename: Monize A
authors.initials: MA
authors.lastname: Nogueira
authors.forename: Patrícia
authors.initials: P
authors.lastname: Rondó
authors.forename: Vicência M R
authors.initials: VM
authors.lastname: Lima
authors.forename: Simone
authors.initials: S
authors.lastname: Mendonça
authors.forename: Denis
authors.initials: D
authors.lastname: Pajecki
authors.forename: Marcio
authors.initials: M
authors.lastname: Mancini
authors.forename: Flair J
authors.initials: FJ
authors.lastname: Carrilho
mesh_terms: 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
chemical_list: D008903:Minerals; D014815:Vitamins
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