An evaluation of micronutrient status in severe obesity and follow-up assessment after bariatric surgery: A retrospective single-center study

Abstract

Background: Micronutrient deficiency is common in obesity despite surplus weight and high caloric intake. Further exacerbation is often seen after bariatric surgery due to the resultant dietary restrictions, and physiological and anatomical alterations. Owing to the rising prevalence of obesity in India with a simultaneous surge in bariatric surgeries, an account of micronutrient status is required. This will help in identifying susceptible individuals and setting up priorities for prevention and intervention. Subjects and Methods: A retrospective study was designed to analyze the data collected before and until 1 year (3, 6, and 12 months) after bariatric surgery in individuals with severe obesity (body mass index ≥35 kg/m2, n = 150). We included the assessment of nutritional parameters, namely, serum iron, ferritin, total iron-binding capacity, Vitamin B12, folic acid, homocysteine, calcium, phosphorus, Vitamin D, and parathormone along with anthropometric and routine biochemical investigations. Results: Deficiency of Vitamin D was most prevalent (52%) at baseline, followed by anemia (21%). Ferritin deficiency was 9.3%, followed by iron (8.0%), Vitamin B12(7.3%), and folate deficiency (4.7%) at baseline. There was a remarkable improvement in Vitamin D deficiency (26%), whereas the percent prevalence of other micronutrients has shown deterioration in 12 months after bariatric surgery. No significant difference existed in the prevalence of micronutrient deficiency between laparoscopic sleeve gastrectomy (n = 75) and laparoscopic Roux-en-Y gastric bypass surgery (n = 75) over the 12-month follow-up period. Conclusion: Micronutrient deficiencies persisted after bariatric surgery underlining the need for fine adjustment of supplementations and monitoring compliance to ensure the best patient outcomes.