title: Evaluation of nutrient status after laparoscopic sleeve gastrectomy 1, 3, and 5 years after surgery.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy evolved as a primary bariatric procedure with little information on its nutritional effects. Our objective was to assess the longer term micronutrient and vitamin status after laparoscopic sleeve gastrectomy at a university hospital.
  
  
  METHODS
  Measurements of ferritin, iron, total iron binding capacity, hemoglobin, hematocrit, parathyroid hormone, albumin, calcium, magnesium, phosphorus, zinc, folate, and vitamins A, B1, B12, and D were obtained at baseline and 1, 3, and 5 years after surgery. Two-sample t tests with multiple adjusted comparisons and Fisher's exact test were used to determine deficiency.
  
  
  RESULTS
  A total of 82 patients (67% women), with a mean age of 46.4 years and a baseline body mass index 55.7 kg/m2 were included in the present study (35 at 1, 27 at 3, and 30 at 5 years postoperatively). The percentage of excess body mass index loss was 58.5% at year 1 in 35 patients, 63.1% at year 3 in 27 patients, and 46.1% at year 5 in 30 patients. The parathyroid hormone level decreased from 75.0 to 49.6 ng/mL in year 1 to 40.7 ng/mL in year 3. The year 5 levels increased to 99.6 ng/mL. The mean vitamin D level increased from 23.6 ng/mL to 35.0, 32.1 and 34.8 at years 1, 3, and 5 (P = .05 for baseline to year 1). The vitamin D level was less than normal in 42% of the patients at year 5. After normalization from baseline, by year 5, parathyroid hormone had increased in 58.3% of patients. At year 5, vitamin B1 was less than normal in 30.8% of patients, and hemoglobin and hematocrit were less than normal in for 28.6% and 25% of patients, respectively. Finally, 28.9% of patients reported taking supplements in year 1, 42.9% in year 3, and 63.3% in year 5. The other variables were not significantly different.
  
  
  CONCLUSIONS
  Laparoscopic sleeve gastrectomy resulted in health improvements through year 3. At year 5, the nutrient levels had reverted toward the baseline values. These observations provide focus for necessary clinical monitoring.
authors.affiliation: Department of Surgery, Weill Cornell College of Medicine, New York, New York 10065, USA.
authors.forename: Taha
authors.initials: T
authors.lastname: Saif
authors.forename: Gladys W
authors.initials: GW
authors.lastname: Strain
authors.forename: Gregory
authors.initials: G
authors.lastname: Dakin
authors.forename: Michel
authors.initials: M
authors.lastname: Gagner
authors.forename: Ricardo
authors.initials: R
authors.lastname: Costa
authors.forename: Alfons
authors.initials: A
authors.lastname: Pomp
mesh_terms: D001361:Avitaminosis / Q000209:etiology*; D015992:Body Mass Index; D015331:Cohort Studies; D019587:Dietary Supplements; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D018977:Micronutrients / Q000172:deficiency / Q000378:metabolism*; D008875:Middle Aged; D009752:Nutritional Status; D009767:Obesity, Morbid / Q000378:metabolism / Q000601:surgery; D011182:Postoperative Care; D013997:Time Factors; D014815:Vitamins / Q000378:metabolism*; D015431:Weight Loss
chemical_list: D018977:Micronutrients; D014815:Vitamins