title: Copper Deficiency after Gastric Bypass for Morbid Obesity: a Systematic Review.
abstract: A large number of patients undergoing bariatric surgery are deficient in copper, and Roux-en-Y gastric bypass can further aggravate it. Delays in diagnosis and treatment of copper deficiency can leave patients with residual neurological disability. This has led to recommendation from the British Obesity and Metabolic Surgery Society that copper levels should be monitored annually after gastric bypass. This review concludes that copper deficiency in adequately supplemented patients is rare and can be adequately treated if a related haematological or neurological disorder is diagnosed. The cost of routine monitoring may therefore not be justified for adequately supplemented, asymptomatic patients who have undergone Roux-en-Y gastric bypass. The screening may however be necessary for high-risk patient groups to prevent severe complications and permanent disability.
authors.affiliation: Department of General Surgery, Sir Charles Gairdner Hospital, Nedlands, WA, 6009, Australia.
authors.forename: Parveen
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
authors.forename: Numan
authors.initials: N
authors.lastname: Hamza
authors.affiliation: Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
authors.forename: Brijesh
authors.initials: B
authors.lastname: Madhok
authors.affiliation: Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
authors.forename: Nimantha
authors.initials: N
authors.lastname: De Alwis
authors.affiliation: Department of Chemical Pathology, Homerton University Hospital NHS Trust, London, UK.
authors.forename: Manisha
authors.initials: M
authors.lastname: Sharma
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, Imperial College London, London, UK.
authors.forename: Alexander Dimitri
authors.initials: AD
authors.lastname: Miras
authors.affiliation: Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK. kamal_mahawar@hotmail.com.
authors.forename: Kamal K
authors.initials: KK
authors.lastname: Mahawar
mesh_terms: D003300:Copper / Q000172:deficiency*; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006402:Hematologic Diseases / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008134:Long-Term Care / Q000379:methods; D008297:Male; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology; D009767:Obesity, Morbid / Q000601:surgery*
chemical_list: D003300:Copper
keywords: Bariatric surgery; Copper; Gastric bypass; Morbid obesity