Screening and diagnosis of micronutrient deficiencies before and after bariatric surgery.

Autor: Gudzune KA; Division of General Internal Medicine, Department of Medicine, The Johns Hopkins University School of Medicine, 2024 E. Monument St, Room 2-611, Baltimore, MD, 21287, USA, gudzune@jhu.edu., Huizinga MM, Chang HY, Asamoah V, Gadgil M, Clark JM
Jazyk: angličtina
Zdroj: Obesity surgery [Obes Surg] 2013 Oct; Vol. 23 (10), pp. 1581-9.
DOI: 10.1007/s11695-013-0919-x
Abstrakt: Background: Micronutrient deficiencies are key concerns after bariatric surgery. We describe the prevalence of perioperative testing and diagnosis of micronutrient deficiencies among a cohort of insured bariatric surgery patients.
Methods: We used claims data from seven health insurers to identify bariatric surgery patients from 2002-2008. Our outcomes were perioperative claims for vitamin D, B12, folate, and iron testing and diagnosed deficiencies. We analyzed results by bariatric surgery type: Roux-en-Y gastric bypass (RYGB), restrictive, and malabsorptive. We calculated the prevalence of testing and deficiency diagnosis, and performed multivariate logistic regression to determine the association with surgery type.
Results: Of 21,345 eligible patients, 84% underwent RYGB. The pre-surgical testing prevalence for all micronutrients was <25%. The testing prevalence during the first 12 months after surgery varied: vitamin D (12%), vitamin B12 (60%), folate (47%) and iron (49%), and declined during 13-24 and 25-36 months. The deficiency prevalence during 0-12 months post-survey varied: vitamin D (34%), vitamin B12 (20%), folate (13%), and iron (10%). The odds of vitamin B12, folate, and iron deficiency during 0-12 months were significantly lower for restrictive as compared to RYGB, but were not different during 13-24 and 25-36 months post-surgery. The odds of vitamin D deficiency were significantly greater for malabsorptive as compared to RYGB during all post-surgical periods.
Conclusion: Many patients did not receive micronutrient testing pre- or post-surgery, yet deficiencies were relatively common among those tested. These results highlight the need for surgeons and primary care providers to test all bariatric surgery patients for micronutrient deficiencies.
Databáze: MEDLINE
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