title: Cross-sectional long-term micronutrient deficiencies after sleeve gastrectomy versus Roux-en-Y gastric bypass: a pilot study.
abstract: BACKGROUND
  Nutritional deficiencies are highly prevalent in obese patients. Bariatric surgery has been associated with adverse effects on homeostasis of significant vitamins and micronutrients, mainly after gastric bypass. The aim of the present study was to compare the extent of long-term postsurgical nutritional deficiencies between Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG).
  
  
  METHODS
  This cross-sectional, pilot study included 95 patients who underwent RYGB or SG surgery with a mean follow-up of 4 years. Demographic, anthropometric, and biochemical parameters were compared according to the type of surgery.
  
  
  RESULTS
  Both types of surgery were associated with significant nutritional deficiencies. Vitamin B12 deficiency was significantly higher in patients with RYGB compared with SG (42.1% versus 5%, P = .003). The type of surgery was associated neither with anemia nor with iron or folate deficiency (SG versus RYGB: anemia, 54.2% versus 64.3%, P = .418; folate deficiency, 20% versus 18.4%, P = .884; iron deficiency, 30% versus 36.4%, P = .635).
  
  
  CONCLUSIONS
  During a mean follow up period of 4 years postRYGB or SG, patients were identified with several micronutrient deficiencies, including vitamin D, folate, and vitamin B12. SG may have a more favorable effect on the metabolism of vitamin B12 compared with RYGB, being associated with less malabsorption. Adherence to supplemental iron and vitamin intake is of primary significance in all cases of bariatric surgery.
authors.affiliation: 1st Department of Surgery, Laiko Athens General Hospital, University of Athens, 17 Agiou Thoma St, GR-11527 Athens, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Alexandrou
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens.
authors.forename: Eleni
authors.initials: E
authors.lastname: Armeni
authors.affiliation: Biochemical and Hormonal Laboratory, Aretaieio Hospital, University of Athens.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Kouskouni
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Tsoka
authors.affiliation: 1st Department of Surgery, Laiko Athens General Hospital, University of Athens, 17 Agiou Thoma St, GR-11527 Athens, Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Diamantis
authors.affiliation: 2nd Department of Obstetrics and Gynecology, Aretaieio Hospital, University of Athens. Electronic address: ilambrinoudaki@aretaieio.uoa.gr.
authors.forename: Irene
authors.initials: I
authors.lastname: Lambrinoudaki
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D044342:Malnutrition / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism; D018977:Micronutrients / Q000172:deficiency*; D009767:Obesity, Morbid / Q000601:surgery*; D010865:Pilot Projects; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D018977:Micronutrients
keywords: Bariatric surgery; Nutritional deficiency; Roux-en-Y gastric bypass; Sleeve gastrectomy