Assessment of selenium in Roux-en-Y gastric bypass and gastric banding surgery.
BACKGROUND
Until recently, there was limited documented data on both dietary and serum selenium deficiency in bariatric surgery. We performed an evaluation of selenium intake and both serum selenium and glutathione peroxidase (GTP; as a functional measurement of selenium) before and after roux-en-Y (RNY) gastric bypass and gastric banding surgery.


METHODS
The endpoints obtained from the subjects included dietary intake of selenium and vitamins E and C, as well as serum levels of selenium, GTP and vitamins E. These were analyzed at pre-surgery (baseline) and 3 and 12 months post surgery.


RESULTS
Dietary deficiencies in selenium intake (38.2 % recommended daily allowance) were noted at 3 months, but not baseline or 12 months, in the gastric bypass group. No dietary deficiencies were noted in the lap band group. For both surgeries, there was a significant reduction from baseline to 3 months in both serum selenium and GTP levels (p = 0.033 and 0.0033 respectively). The serum selenium levels and GTP levels both trended back toward baseline values by 12 months without concomitant selenium supplementation. Mean GTP levels were below normal at all three time points while mean serum selenium levels were all at or above normal.


CONCLUSIONS
This study shows that RNY gastric bypass and laparoscopic adjustable gastric banding procedures, and accompanying dietary restrictions, increases the risk for disturbances of selenium and GTP homeostasis. Consideration for selenium supplementation at higher levels than the current RDA of 55 mcg daily during the first 3 months and perhaps longer should be studied further.
Department of Endocrinology, Diabetes and Metabolism and Clinical Research Division of Bassett Research Institute, Bassett Medical Center, 1 Atwell Road, Cooperstown, NY 13326, USA. amy.freeth@bassett.org
Amy
A
Freeth
Petpring
P
Prajuabpansri
Jennifer M
JM
Victory
Paul
P
Jenkins
D004038:Diet, Reducing; D019587:Dietary Supplements; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects; D015391:Gastroplasty / Q000009:adverse effects; D005979:Glutathione Peroxidase / Q000097:blood*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000097:blood* / Q000178:diet therapy / Q000601:surgery; D010865:Pilot Projects; D011184:Postoperative Period; D057234:Preoperative Period; D011446:Prospective Studies; D012643:Selenium / Q000097:blood* / Q000172:deficiency / Q000627:therapeutic use; D015431:Weight Loss
D005979:Glutathione Peroxidase; D012643:Selenium