Evaluation of Vitamin and Trace Element Requirements after Sleeve Gastrectomy at Long Term.
Nutritional deficiencies are common after bariatric surgery, but data are scarce after sleeve gastrectomy (SG) at long term.



We performed a prospective nutritional status evaluation before and at 2 and 5 years after SG in morbid obese patients receiving mulvitamin and mineral supplementation at a Spanish university hospital. One hundred seventy-six patients (49.3 ± 9.1 years and 46.7 ± 7.4 kg/m2) were evaluated; 51 of them were followed during 5 years. Anthropometric, compliance supplementation intake, and micronutrient evaluation were performed.



Baseline concentrations were below normal values for 25(OH) vitamin D (73%), folic acid (16.5%), cobalamin (6.9%), pyridoxine (12%), thiamine (3.4%), and copper (0.5%). Anemia was found in 23%. In 49% of the subjects, at least one micronutrient deficiency was found at 2 years after SG. Vitamin D deficiency persisted at 2 and 5 years higher than 30% of patients. Frequencies of deficiencies for folic acid, B12, B6, and B1 vitamins decreased significantly after 2 years with normalization at 5 years. Copper deficiency increased between 1 and 2 years and it persisted at 5 years after SG. Vitamin supplementation compliance decreased progressively from the first year after surgery (94.8 to 81% at 2 years and to 53% 5 years after surgery).



Vitamin D deficiency is the most prevalent long-term nutritional deficiency after SG. About half of patients show some micronutrient deficiency at medium long term, despite supplementation. A proactive follow-up is required to ensure a personalized and adequate supplementation in all surgically treated obese patients including those in which SG has been performed.
Endocrinology and Nutrition Service, Department of Medicine, Universitat Autònoma de Barcelona, Germans Trias i Pujol University Hospital and Research Institute, Carretera de Canyet sn, 08916, Badalona, Spain. spellitero.germanstrias@gencat.cat.
Silvia
S
Pellitero
Endocrinology and Nutrition Service, Department of Medicine, Universitat Autònoma de Barcelona, Germans Trias i Pujol University Hospital and Research Institute, Carretera de Canyet sn, 08916, Badalona, Spain.
Eva
E
Martínez
Endocrinology and Nutrition Service, Department of Medicine, Universitat Autònoma de Barcelona, Germans Trias i Pujol University Hospital and Research Institute, Carretera de Canyet sn, 08916, Badalona, Spain.
Rocío
R
Puig
Clinical Biochemistry Service, Germans Trias i Pujol University Hospital and Research Institute, Badalona, Barcelona, Spain.
Alba
A
Leis
Endocrinology and Nutrition Service, Hospital Santa Tecla, Tarragona, Spain.
Roxanna
R
Zavala
Clinical Biochemistry Service, Germans Trias i Pujol University Hospital and Research Institute, Badalona, Barcelona, Spain.
María Luisa
ML
Granada
Clinical Biochemistry Service, Germans Trias i Pujol University Hospital and Research Institute, Badalona, Barcelona, Spain.
Cruz
C
Pastor
Surgery Department, Germans Trias i Pujol University Hospital and Research Institute, Badalona, Spain.
Pau
P
Moreno
Surgery Department, Germans Trias i Pujol University Hospital and Research Institute, Badalona, Spain.
Jordi
J
Tarascó
Surgery Department, Germans Trias i Pujol University Hospital and Research Institute, Badalona, Spain.
Jose
J
Balibrea
Endocrinology and Nutrition Service, Department of Medicine, Universitat Autònoma de Barcelona, Germans Trias i Pujol University Hospital and Research Institute, Carretera de Canyet sn, 08916, Badalona, Spain.
Manel
M
Puig-Domingo
D000328:Adult; D000740:Anemia / Q000097:blood / Q000175:diagnosis; D019587:Dietary Supplements; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis* / Q000209:etiology; D018977:Micronutrients / Q000097:blood / Q000172:deficiency; D008875:Middle Aged; D009752:Nutritional Status; D009767:Obesity, Morbid / Q000097:blood / Q000601:surgery*; D011446:Prospective Studies; D014131:Trace Elements / Q000097:blood* / Q000172:deficiency*; D014808:Vitamin D Deficiency / Q000097:blood / Q000209:etiology; D014815:Vitamins / Q000097:blood*
D018977:Micronutrients; D014131:Trace Elements; D014815:Vitamins
Bariatric surgery; Nutritional deficiencies; Obesity; Sleeve gastrectomy; Vitamins supplementation