Medium term post-bariatric surgery deficit of vitamin B12 is predicted by deficit at time of surgery

Autor: Jean-Louis Guéant, Didier Quilliot, Zhen Li, Rosa-Maria Guéant-Rodriguez, David Meyre, Laurent Brunaud, Alice Mangeon, M.-A. Sirveaux, Darlène Antoine
Přispěvatelé: Nutrition-Génétique et Exposition aux Risques Environnementaux (NGERE), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service d'Endocrinologie - Diabète - Nutrition [CHRU Nancy], Unité Multidisciplinaire de Chirurgie de l'Obésité [CHRU Nancy], McMaster University [Hamilton, Ontario], Service d'Hépato-gastro-entérologie [CHRU Nancy], This work was financed by FHU ARRIMAGE, CHRU of Nancy and University of Lorraine, the AGIR grant of Universite de Lorraine and CHRU of Nancy and the French PIA project « Lorraine Universite d’Excellence », reference ANR-15-IDEX-04-LUE., IMPACT GEENAGE, ANR-15-IDEX-0004,LUE (ISITE),Lorraine Université d'Excellence(2016), ANR-15-IDEX-0004,LUE,Isite LUE(2015), CCSD, Accord Elsevier, ISITE - Isite LUE - - LUE2015 - ANR-15-IDEX-0004 - IDEX - VALID
Rok vydání: 2021
Předmět:
Male
0301 basic medicine
[SDV]Life Sciences [q-bio]
Bariatric Surgery
Critical Care and Intensive Care Medicine
Postoperative Complications
0302 clinical medicine
Risk Factors
Nonalcoholic fatty liver disease
Longitudinal Studies
Micronutrients
Postoperative Period
Prospective Studies
Homocysteine
[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology
Nutrition and Dietetics
Middle Aged
Micronutrient
Obesity
Morbid
3. Good health
[SDV] Life Sciences [q-bio]
Vitamin B 12
Preoperative Period
Cohort
Deficiency
Female
Multivitamin
Cohort study
Adult
medicine.medical_specialty
Nutritional Status
030209 endocrinology & metabolism
03 medical and health sciences
Folates
Predictive Value of Tests
medicine
Vitamin D and neurology
Humans
Obesity
Vitamin B12
B12
030109 nutrition & dietetics
business.industry
[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology
Vitamin B 12 Deficiency
medicine.disease
[SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology
Surgery
[SDV.AEN] Life Sciences [q-bio]/Food and Nutrition
Dietary Supplements
business
[SDV.AEN]Life Sciences [q-bio]/Food and Nutrition
[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Follow-Up Studies
Zdroj: Clinical Nutrition
Clinical Nutrition, Elsevier, 2020, ⟨10.1016/j.clnu.2020.04.029⟩
Clinical Nutrition, 2021, 40 (1), pp.87-93. ⟨10.1016/j.clnu.2020.04.029⟩
ISSN: 0261-5614
Popis: Summary Background Patients with morbid obesity have a high risk of deficits in micronutrients, after bariatric surgery. The reasons why systematic use of multivitamin and trace element supplements cannot prevent all deficits are complex and should deserve more attention. Little is known about the influence of micronutrient deficits at surgery. Aim This present study aimed to explore the deficit in vitamin B12 vs other micronutrients during the follow-up of a French cohort of cases with bariatric surgery under systematic multivitamin/trace elements supplementation and to determine whether it was influenced by clinical, metabolic characteristics at surgery. Methods We prospectively enrolled obese patients with bariatric surgery (laparoscopic gastric bypass or laparoscopic sleeve gastrectomy) between 2013 and 2018 (OBESEPI/ALDEPI Cohort, NCT02663388). They received a daily multivitamin/micronutrients supplement. Follow-up data at 4 visits, 2, 12, 18 and 24 months after surgery, were collected. Results The highest rate of deficits was observed at visit 1 for vitamin D (35.7%), iron (21.9%) and folate (10.2%). Except B12, the deficits of all micronutrients decreased in later visits. In contrast, cases with vitamin B12 deficit decreased from 13.5% at surgery to 2.0% at visit 1, and increased in later visits, with a maximum of 12.0% at visit 3. Vitamin B12 concentration at surgery was the single predictor of B12 deficit at visit 3. It was also associated with age, and APRI score, an index of nonalcoholic fatty liver disease (NAFLD), in multivariate analysis. Conclusions The failure of systematic supplementation with multivitamin/trace elements tablets to prevent specific deficits illustrates the need for adapted specific supplementations, in some cases. The worsening of B12 deficit rate in the 18–24 months follow-up depends in part to low B12 at time of surgery. A special consideration should be devoted to this subset of patients. The cohort study was registered at clinicaltrials.gov as NCT02663388.
Databáze: OpenAIRE
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