title: Incidence and prevalence of copper deficiency following roux-en-y gastric bypass surgery.
abstract: OBJECTIVE
  The frequency of copper deficiency and clinical manifestations following roux-en-y gastric bypass (RYGB) surgery is not yet clear. Objectives were to determine the prevalence and incidence of copper deficiency in patients who have undergone RYGB.
  
  
  METHODS
  We sought to determine the number of RYGB patients undergoing medical and nutritional follow-up visits at the Emory Bariatric Center who experienced copper deficiency and associated hematological and neurological complaints (n=136). Separately, in patients followed longitudinally before and during 6 and 24 months following RYGB surgery, we obtained measures of copper status (n=16). Systemic blood cell counts and measures of copper, zinc and ceruloplasmin were determined using standardized assays in reference laboratories including atomic absorption spectrometry and immunoassays.
  
  
  RESULTS
  Thirteen patients were identified to have copper deficiency suggesting a prevalence of copper deficiency of 9.6%, and the majority of these had concomitant complications including anemia, leukopenia and various neuro-muscular abnormalities. In the longitudinal study, plasma copper concentrations and ceruloplasmin activity decreased over 6 and 24 months following surgery, respectively (P<0.05), but plasma zinc concentrations did not change. A simultaneous decrease in white blood cells was observed (P<0.05). The incidence of copper deficiency in these subjects was determined to be 18.8%.
  
  
  CONCLUSIONS
  The prevalence and incidence of copper deficiency following RYGB surgery was determined to be 9.6% and 18.8%, respectively, with many patients experiencing mild-to-moderate symptoms. Given that copper deficiency can lead to serious and irreversible complications if untreated, frequent monitoring of the copper status of RYGB patients is warranted.
authors.affiliation: Department of Nutrition Science, Purdue University, West Lafayette, IN, USA. ngletsu@emory.edu
authors.forename: N
authors.initials: N
authors.lastname: Gletsu-Miller
authors.forename: M
authors.initials: M
authors.lastname: Broderius
authors.forename: J K
authors.initials: JK
authors.lastname: Frediani
authors.forename: V M
authors.initials: VM
authors.lastname: Zhao
authors.forename: D P
authors.initials: DP
authors.lastname: Griffith
authors.forename: S S
authors.initials: SS
authors.lastname: Davis
authors.forename: J F
authors.initials: JF
authors.lastname: Sweeney
authors.forename: E
authors.initials: E
authors.lastname: Lin
authors.forename: J R
authors.initials: JR
authors.lastname: Prohaska
authors.forename: T R
authors.initials: TR
authors.lastname: Ziegler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000740:Anemia / Q000453:epidemiology* / Q000209:etiology; D003300:Copper / Q000097:blood / Q000172:deficiency*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007970:Leukopenia / Q000453:epidemiology* / Q000209:etiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000453:epidemiology* / Q000209:etiology; D009767:Obesity, Morbid / Q000150:complications / Q000453:epidemiology* / Q000601:surgery; D018579:Patient Selection; D015995:Prevalence; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D003300:Copper