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Other Micronutrient Deficiencies in Bariatric Surgery

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Bariatric Surgical Practice Guide

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Abstract

As the obesity epidemic continues and the number of patients undergoing bariatric surgery rises, it is important to optimize long-term nutrition after bariatric surgery in addition to monitoring weight and co-morbidities outcomes. It is important for clinicians to be aware of both pre-existing and new onset nutritional deficiencies in obese patients, to screen for and recognize symptoms of deficiency, prescribe appropriate supplementation and treat common and rare nutritional deficiencies that may emerge both in the short term and long-term post-operatively.

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References

  1. Osiezagha K, Ali S, Freeman C, Barker NC, Jabeen S, Maitra S, et al. Thiamine deficiency and delirium. Innov Clin Neurosci. 2013;10(4):26–32.

    PubMed  PubMed Central  Google Scholar 

  2. Thomson AD, Marshall EJ. The treatment of patients at risk of developing Wernicke’s encephalopathy in the community. Alcohol Alcohol Oxf Oxfs. 2006;41(2):159–67.

    Article  CAS  Google Scholar 

  3. Worden RW, Allen HM. Wernicke’s encephalopathy after gastric bypass that masqueraded as acute psychosis: a case report. Curr Surg. 2006;63(2):114–6.

    Article  PubMed  Google Scholar 

  4. Sechi G, Serra A, Pirastru MI, Sotgiu S, Rosati G. Wernicke’s encephalopathy in a woman on slimming diet. Neurology. 2002;58(11):1697–8.

    Article  PubMed  Google Scholar 

  5. Sutamnartpong P, Muengtaweepongsa S, Kulkantrakorn K. Wernicke’s encephalopathy and central pontine myelinolysis in hyperemesis gravidarum. J Neurosci Rural Pract. 2013;4(1):39–41.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Herve C, Beyne P, Lettéron P, Delacoux E. Comparison of erythrocyte transketolase activity with thiamine and thiamine phosphate ester levels in chronic alcoholic patients. Clin Chim Acta Int J Clin Chem. 1995;234(1–2):91–100.

    Article  CAS  Google Scholar 

  7. Manatakis DK, Georgopoulos N. A fatal case of Wernicke’s encephalopathy after sleeve gastrectomy for morbid obesity. Case Rep Surg. 2014;2014:281210.

    PubMed  PubMed Central  Google Scholar 

  8. Lakhani SV, Shah HN, Alexander K, Finelli FC, Kirkpatrick JR, Koch TR. Small intestinal bacterial overgrowth and thiamine deficiency after Roux-en-Y gastric bypass surgery in obese patients. Nutr Res. 2008;28(5):293–8.

    Article  CAS  PubMed  Google Scholar 

  9. Aasheim ET. Wernicke encephalopathy after bariatric surgery: a systematic review. Ann Surg. 2008;248(5):714–20.

    PubMed  Google Scholar 

  10. Becker DA, Balcer LJ, Galetta SL. The neurological complications of nutritional deficiency following bariatric surgery. J Obes. 2012;2012:608534.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Allied Health Sciences Section Ad Hoc Nutrition Committee, Aills L, Blankenship J, Buffington C, Furtado M, Parrott J. ASMBS Allied Health Nutritional Guidelines for the surgical weight loss patient. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2008;4(5 Suppl):S73–108.

    Google Scholar 

  12. Bertinato J, L’Abbé MR. Maintaining copper homeostasis: regulation of copper-trafficking proteins in response to copper deficiency or overload. J Nutr Biochem. 2004;15(6):316–22.

    Article  CAS  PubMed  Google Scholar 

  13. Fiske DN, McCoy HE, Kitchens CS. Zinc-induced sideroblastic anemia: report of a case, review of the literature, and description of the hematologic syndrome. Am J Hematol. 1994;46(2):147–50.

    Article  CAS  PubMed  Google Scholar 

  14. Btaiche IF, Yeh AY, Wu IJ, Khalidi N. Neurologic dysfunction and pancytopenia secondary to acquired copper deficiency following duodenal switch: case report and review of the literature. Nutr Clin Pract Off Publ Am Soc Parenter Enter Nutr. 2011;26(5):583–92.

    Article  Google Scholar 

  15. Balsa JA, Botella-Carretero JI, Gómez-Martín JM, Peromingo R, Arrieta F, Santiuste C, et al. Copper and zinc serum levels after derivative bariatric surgery: differences between Roux-en-Y Gastric bypass and biliopancreatic diversion. Obes Surg. 2011;21(6):744–50.

    Article  PubMed  Google Scholar 

  16. Kumar N. Copper deficiency myelopathy (human swayback). Mayo Clin Proc. 2006;81(10):1371–84.

    Article  CAS  PubMed  Google Scholar 

  17. Kumar N, Ahlskog JE, Gross JB. Acquired hypocupremia after gastric surgery. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2004;2(12):1074–9.

    Google Scholar 

  18. Griffith DP, Liff DA, Ziegler TR, Esper GJ, Winton EF. Acquired copper deficiency: a potentially serious and preventable complication following gastric bypass surgery. Obes Silver Spring Md. 2009;17(4):827–31.

    Article  CAS  Google Scholar 

  19. O’Donnell KB, Simmons M. Early-onset copper deficiency following Roux-en-Y gastric bypass. Nutr Clin Pract Off Publ Am Soc Parenter Enter Nutr. 2011;26(1):66–9.

    Article  Google Scholar 

  20. Naismith RT, Shepherd JB, Weihl CC, Tutlam NT, Cross AH. Acute and bilateral blindness due to optic neuropathy associated with copper deficiency. Arch Neurol. 2009;66(8):1025–7.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Pineles SL, Wilson CA, Balcer LJ, Slater R, Galetta SL. Combined optic neuropathy and myelopathy secondary to copper deficiency. Surv Ophthalmol. 2010;55(4):386–92.

    Article  PubMed  Google Scholar 

  22. Shahidzadeh R, Sridhar S. Profound copper deficiency in a patient with gastric bypass. Am J Gastroenterol. 2008;103(10):2660–2.

    Article  PubMed  Google Scholar 

  23. Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, McMahon MM, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obes Silver Spring Md. 2013;21 Suppl 1:S1–27.

    Article  CAS  Google Scholar 

  24. Papamargaritis D, Aasheim ET, Sampson B, le Roux CW. Copper, selenium and zinc levels after bariatric surgery in patients recommended to take multivitamin-mineral supplementation. J Trace Elem Med Biol Organ Soc Miner Trace Elem GMS. 2015;31:167–72.

    Article  CAS  Google Scholar 

  25. Papp LV, Holmgren A, Khanna KK. Selenium and selenoproteins in health and disease. Antioxid Redox Signal. 2010;12(7):793–5.

    Article  CAS  PubMed  Google Scholar 

  26. Freeth A, Prajuabpansri P, Victory JM, Jenkins P. Assessment of selenium in Roux-en-Y gastric bypass and gastric banding surgery. Obes Surg. 2012;22(11):1660–5.

    Article  PubMed  Google Scholar 

  27. Prasad AS. Discovery of human zinc deficiency: its impact on human health and disease. Adv Nutr Bethesda Md. 2013;4(2):176–90.

    Article  CAS  Google Scholar 

  28. Tuerk MJ, Fazel N. Zinc deficiency. Curr Opin Gastroenterol. 2009;25(2):136–43.

    Article  CAS  PubMed  Google Scholar 

  29. Schwartz JR, Marsh RG, Draelos ZD. Zinc and skin health: overview of physiology and pharmacology. Dermatol Surg Off Publ Am Soc Dermatol Surg Al. 2005;31(7 Pt 2):837–47; discussion 847.

    CAS  Google Scholar 

  30. Sturniolo GC, Montino MC, Rossetto L, Martin A, D’Inca R, D’Odorico A, et al. Inhibition of gastric acid secretion reduces zinc absorption in man. J Am Coll Nutr. 1991;10(4):372–5.

    Article  CAS  PubMed  Google Scholar 

  31. Sallé A, Demarsy D, Poirier AL, Lelièvre B, Topart P, Guilloteau G, et al. Zinc deficiency: a frequent and underestimated complication after bariatric surgery. Obes Surg. 2010;20(12):1660–70.

    Article  PubMed  Google Scholar 

  32. Ruz M, Carrasco F, Rojas P, Codoceo J, Inostroza J, Basfi-fer K, et al. Zinc absorption and zinc status are reduced after Roux-en-Y gastric bypass: a randomized study using 2 supplements. Am J Clin Nutr. 2011;94(4):1004–11.

    Article  CAS  PubMed  Google Scholar 

  33. King JC. Determinants of maternal zinc status during pregnancy. Am J Clin Nutr. 2000;71(5 Suppl):1334S–43.

    CAS  PubMed  Google Scholar 

  34. Castillo-Durán C, Weisstaub G. Zinc supplementation and growth of the fetus and low birth weight infant. J Nutr. 2003;133(5 Suppl 1):1494S–7.

    PubMed  Google Scholar 

  35. Gibson RS. Zinc nutrition in developing countries. Nutr Res Rev. 1994;7(1):151–73.

    Article  CAS  PubMed  Google Scholar 

  36. Gehrer S, Kern B, Peters T, Christoffel-Courtin C, Peterli R. Fewer nutrient deficiencies after laparoscopic sleeve gastrectomy (LSG) than after laparoscopic Roux-Y-gastric bypass (LRYGB)-a prospective study. Obes Surg. 2010;20(4):447–53.

    Article  PubMed  Google Scholar 

  37. Moizé V, Andreu A, Flores L, Torres F, Ibarzabal A, Delgado S, et al. Long-term dietary intake and nutritional deficiencies following sleeve gastrectomy or Roux-En-Y gastric bypass in a mediterranean population. J Acad Nutr Diet. 2013;113(3):400–10.

    Article  PubMed  Google Scholar 

  38. Thurnheer M, Bisang P, Ernst B, Schultes B. A novel distal very long Roux-en Y gastric bypass (DVLRYGB) as a primary bariatric procedure--complication rates, weight loss, and nutritional/metabolic changes in the first 355 patients. Obes Surg. 2012;22(9):1427–36.

    Article  PubMed  Google Scholar 

  39. Rojas P, Gosch M, Basfi-fer K, Carrasco F, Codoceo J, Inostroza J, et al. Alopecia in women with severe and morbid obesity who undergo bariatric surgery. Nutr Hosp. 2011;26(4):856–62.

    CAS  PubMed  Google Scholar 

  40. Chaves GV, Pereira SE, Saboya CJ, Ramalho A. Nutritional status of vitamin A in morbid obesity before and after Roux-en-Y gastric bypass. Obes Surg. 2007;17(7):970–6.

    Article  PubMed  Google Scholar 

  41. Zalesin KC, Miller WM, Franklin B, Mudugal D, Rao Buragadda A, Boura J, et al. Vitamin a deficiency after gastric bypass surgery: an underreported postoperative complication. J Obes. 2011;2011: pii:760695.

    Google Scholar 

  42. Slater GH, Ren CJ, Siegel N, Williams T, Barr D, Wolfe B, et al. Serum fat-soluble vitamin deficiency and abnormal calcium metabolism after malabsorptive bariatric surgery. J Gastrointest Surg Off J Soc Surg Aliment Tract. 2004;8(1):48–55; discussion 54–5.

    Article  Google Scholar 

  43. Dolan K, Hatzifotis M, Newbury L, Lowe N, Fielding G. A clinical and nutritional comparison of biliopancreatic diversion with and without duodenal switch. Ann Surg. 2004;240(1):51–6.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Brolin RE, Kenler HA, Gorman JH, Cody RP. Long-limb gastric bypass in the superobese. A prospective randomized study. Ann Surg. 1992;215(4):387–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Lee WB, Hamilton SM, Harris JP, Schwab IR. Ocular complications of hypovitaminosis a after bariatric surgery. Ophthalmology. 2005;112(6):1031–4.

    Article  PubMed  Google Scholar 

  46. Pereira S, Saboya C, Chaves G, Ramalho A. Class III obesity and its relationship with the nutritional status of vitamin A in pre- and postoperative gastric bypass. Obes Surg. 2009;19(6):738–44.

    Article  PubMed  Google Scholar 

  47. Dror DK, Allen LH. Vitamin E deficiency in developing countries. Food Nutr Bull. 2011;32(2):124–43.

    Article  PubMed  Google Scholar 

  48. Shearer MJ, Fu X, Booth SL. Vitamin K nutrition, metabolism, and requirements: current concepts and future research. Adv Nutr Bethesda Md. 2012;3(2):182–95.

    Article  CAS  Google Scholar 

  49. Homan J, Ruinemans-Koerts J, Aarts EO, Janssen IMC, Berends FJ, de Boer H. Management of vitamin K deficiency after biliopancreatic diversion with or without duodenal switch. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2016;12(2):338–44.

    Article  Google Scholar 

  50. Van Mieghem T, Van Schoubroeck D, Depiere M, Debeer A, Hanssens M. Fetal cerebral hemorrhage caused by vitamin K deficiency after complicated bariatric surgery. Obstet Gynecol. 2008;112(2 Pt 2):434–6.

    Article  PubMed  Google Scholar 

  51. Eerdekens A, Debeer A, Van Hoey G, De Borger C, Sachar V, Guelinckx I, et al. Maternal bariatric surgery: adverse outcomes in neonates. Eur J Pediatr. 2010;169(2):191–6.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Bariatric Division, Upper Gastrointestinal Surgery and Minimal Access Surgery Unit, GEM Hospital and Research Centre, Coimbatore, India

    Parimala Devi MSc & Praveen Raj Palanivelu MS, DNB, DNB(SGE), FALS, FMAS

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  1. Parimala Devi MSc
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  2. Praveen Raj Palanivelu MS, DNB, DNB(SGE), FALS, FMAS
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Correspondence to Parimala Devi MSc .

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Editors and Affiliations

  1. Bariatric Division, Upper Gastrointestinal Surgery and Minimal Access Surgery Unit, GEM Hospital and Research Centre, Coimbatore, Tamil Nadu, India

    Saravana Kumar

  2. Bariatric Division, Upper Gastrointestinal Surgery and Minimal Access Surgery Unit, GEM Hospital and Research Centre, Coimbatore, Tamil Nadu, India

    Rachel Maria Gomes

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Devi, P., Palanivelu, P.R. (2017). Other Micronutrient Deficiencies in Bariatric Surgery. In: Kumar, S., Gomes, R. (eds) Bariatric Surgical Practice Guide. Springer, Singapore. https://doi.org/10.1007/978-981-10-2705-5_36

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  • DOI: https://doi.org/10.1007/978-981-10-2705-5_36

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