title: Increased plasma magnesium concentrations 3 years after biliopancreatic diversion with duodenal switch.
abstract: BACKGROUND
  Biliopancreatic diversion with duodenal switch, BPD-DS, is a surgical procedure for treatment of super obese patients. It renders very good weight results and it strongly reduces the incidence of type 2 diabetes. One important mechanism of weight reduction after BPD-DS is malabsorption. Hypomagnesemia is an established cardiovascular risk factor. While it is well-known that magnesium levels decline after jejuno-ileal bypass and increase after gastric bypass surgery, information on how magnesium status is affected by BPD-DS is scant. The aim of the present study was to evaluate plasma magnesium concentrations (P-Mg) after BPD-DS.
  
  
  METHODS
  Thirty-one patients, all Caucasians (9 diabetics, 12 men, age 38 ± 8 years, weight 159 ± 22 kg, body mass index (BMI) 53.9 ± 5.2 kg/m(2)) underwent BPD-DS. We evaluated weight, glycated hemoglobin levels (HbA1c) and P-Mg preoperatively as well as at 1 and 3 years after surgery. All subjects were treated with vitamin and mineral substitution after surgery, including 100 mg of magnesium salt. P-Mg was analyzed with respect to changes over time, correlation to BMI and HbA1c levels before and 3 years after surgery.
  
  
  RESULTS
  The plasma magnesium concentrations increased by 15 % from 0.77 ± 0.07 to 0.88 ± 0.09 mmol/l over 3 years (p < 0.001). The weight loss was 71 ± 25 kg. No patient had diabetes at follow-up. No correlations between P-Mg and BMI or HbA1c were seen.
  
  
  CONCLUSIONS
  Although exerting much of its weight-reducing effect by a malabsorptive mechanism, BPD-DS yields a rise in P-Mg 3 years postoperatively, possibly contributing to the improved metabolic state after this operation.
authors: Department of Surgical Sciences, Uppsala University Hospital, 75185, Uppsala, Sweden. jakob.hedberg@surgsci.uu.se
authors: Jakob
authors: J
authors: Hedberg
authors: Arvo
authors: A
authors: Haenni
mesh_terms: D000328:Adult; D015904:Biliopancreatic Diversion; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood* / Q000503:physiopathology / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D004386:Duodenum / Q000601:surgery*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D006996:Hypocalcemia / Q000097:blood; D008274:Magnesium / Q000097:blood*; D008275:Magnesium Deficiency / Q000151:congenital; D008297:Male; D009767:Obesity, Morbid / Q000097:blood* / Q000503:physiopathology / Q000601:surgery; D015499:Renal Tubular Transport, Inborn Errors / Q000097:blood; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014815:Vitamins / Q000627:therapeutic use; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D008274:Magnesium; D014815:Vitamins; C517652:hemoglobin A1c protein, human