Evolution of micronutrient status in morbidly obese adults undergoing bariatric surgery

Abstract

Background: Obesity as a global health problem has increased significantly. It is a chronic disease associated with significant morbidity and mortality. Since conventional treatments are not enough, bariatric surgery has had a considerable efficacy in relation to weight loss and reduction in the prevalence of comorbidities associated with it, however, the micronutrient deficits already existing in obesity may be altered even after the surgical intervention.  The aim of this study will be to describe the behavior of micronutrient deficits in adults undergoing laparoscopic vertical sleeve gastrectomy.). Material and methods: An observational, retrospective, analytical and longitudinal design with a cross-sectional component, of an adult population between 21 and 70 years of age, both biological sexes, with a diagnosis of morbid obesity (BMI) greater than or equal to 40 kg/m) submitted to a GVM, followed up for a minimum of 12 months post-surgery. The data of interest were weight loss, the presence of anemia, and deficiency of folic acid, vitamin B12, and vitamin D, preoperatively and at 3.6 and 12 months post- surgery, as well as the trajectory of these parameters over time according to sex. 
Results: 268 patients were included, 54% (n= 145) were men, the mean age at the time of surgery was 43.4 years. Most had a history of obesity from one of their parents and developed obesity in childhood or adolescence. The percentage of patients with a percentage of excess weight lost (PEPP) greater than or equal to 50% was 86.9% at 12 months. The prevalence of anemia was higher at 12 postoperative months and the deficiency of folic acid, vitamin B12 and vitamin D predominated at the preoperative moment, steadily reducing from 3 to 12 postoperative months. No differences were observed between sexes. 
Conclusion: Bariatric surgery continues to be an effective technique of choice for sustained and rapid weight loss compared to conventional treatments for morbid obesity. It is necessary to monitor the status of micronutrients in the long term, encourage and motivate the use of supplementation together with a long-term individualized interdisciplinary follow-up, as nodal requirements for the improvement and/or resolution of deficits

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