Nutrient Deficiency After Bariatric Surgery in Adolescents: A Systematic Review and Meta-Analysis
Obes Surg 2023 Nov 22. doi: 10.1007/s11695-023-06955-y
Faraneh Zolfaghari 1, Yasaman Khorshidi 1, Nazanin Moslehi 2, Mahdieh Golzarand 3, Golaleh Asghari 4
Objective: This systematic review and meta-analysis study aimed to estimate changes in blood nutrient concentrations and nutrient deficiencies in adolescents following bariatric surgery.
Methods: We searched PubMed, Scopus, and the Web of Science to find studies published between January 2000 and August 2023. Observational studies reporting the mean blood concentration of nutrients before and after bariatric surgery or the proportion of nutrient deficiencies after the surgery in healthy adolescents were selected.
Results: Fifteen studies were included. Gastric bypass and sleeve gastrostomy were the most common types of surgery. vitamin d, iron, or ferritin, vitamin B12, calcium, and folic acid were the most studied nutrients, respectively. Other nutrients examined in the studies included zinc, phosphorus, and albumin. The serum ferritin increased by 21 mcg/L (95% CI = 10.0, 32.0 mcg/L) after the surgery, but there were no significant alterations in other nutrients. The postoperative prevalence of low albumin, ferritin, vitamin d, and vitamin B12 levels was 10%, 49%, 41%, and 20%, respectively. Also, 23% had an iron deficiency, and 10% had a calcium deficiency after bariatric surgery.
Conclusions: The serum ferritin level increased following bariatric surgery in adolescents. vitamin d and ferritin deficiencies were estimated to be present in more than one-third of adolescents after the surgery.
53 References
- Alman KL, Lister NB, Garnett SP, Gow ML, Aldwell K, Jebeile H. Dietetic management of obesity and severe obesity in children and adolescents: A scoping review of guidelines. Obes Rev. 2020;22(1):e13132. - PubMed - DOI
- Ogden CL, Fryar CD, Hales CM, Carroll MD, Aoki Y, Freedman DS. Differences in Obesity Prevalence by Demographics and Urbanization in US Children and Adolescents, 2013–2016. JAMA. 2018;319(23):2410–8. - PubMed - PMC - DOI
- Alvarez-Leite JI. Nutrient deficiencies secondary to bariatric surgery. Curr Opin Clin Nutr Metab Care. 2004;7(5):569–75. - PubMed - DOI
- Zolotarjova J, Ten Velde G, Vreugdenhil ACE. Effects of multidisciplinary interventions on weight loss and health outcomes in children and adolescents with morbid obesity. Obes Rev. 2018;19(7):931–46. - PubMed - DOI
- Eisenberg D, Shikora SA, Aarts E, Aminian A, Angrisani L, Cohen RV, et al. 2022 american society for metabolic and bariatric surgery (asmbs) and international federation for the surgery of obesity and metabolic disorders (ifso): indications for metabolic and bariatric surgery. Surg Obes Relat Dis. 2022;18(12):1345–56. - PubMed - DOI
- Beamish AJ, Reinehr T. Should bariatric surgery be performed in adolescents? Eur J Endocrinol. 2017;176(4):D1–15. - PubMed - DOI
- Montastier E, du Rieu MC, Tuyeras G, Ritz P. Long-term nutritional follow-up post bariatric surgery. Curr Opin Clin Nutr Metab Care. 2018;21(5):388–93. - PubMed - DOI
- Abu-Abeid S, Gavert N, Klausner JM, Szold A. Bariatric surgery in adolescence. J Pediatr Surg. 2003;38(9):1379–82. - PubMed - DOI
- Capella JF, Capella RF. Bariatric surgery in adolescence is this the best age to operate? Obes Surg. 2003;13(6):826–32. - PubMed - DOI
- Dolan K, Creighton L, Hopkins G, Fielding G. Laparoscopic gastric banding in morbidly obese adolescents. Obes Surg. 2003;13(1):101–4. - PubMed - DOI
- Inge TH, Courcoulas AP, Jenkins TM, Michalsky MP, Helmrath MA, Brandt ML, et al. Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents. N Engl J Med. 2016;374(2):113–23. - PubMed - DOI
- Stanford FC, Mushannen T, Cortez P, Campoverde Reyes KJ, Lee H, Gee DW, et al. Comparison of Short and Long-Term Outcomes of Metabolic and Bariatric Surgery in Adolescents and Adults. Front Endocrinol (Lausanne). 2020;11:157. - PubMed - DOI
- Strauss RS, Bradley LJ, Brolin RE. Gastric bypass surgery in adolescents with morbid obesity. J Pediatr. 2001;138(4):499–504. - PubMed - DOI
- Sugerman HJ, Sugerman EL, DeMaria EJ, Kellum JM, Kennedy C, Mowery Y, et al. Bariatric surgery for severely obese adolescents. J Gastrointest Surg. 2003;7(1):102–8. - PubMed - DOI
- Davies D, Baxter J, Baxter J. Nutritional deficiencies after bariatric surgery. Obes Surg. 2007;17(9):1150–8. - PubMed - DOI
- Gletsu-Miller N, Wright BN. Mineral malnutrition following bariatric surgery. Adv Nutr. 2013;4(5):506–17. - PubMed - PMC - DOI
- Shankar P, Boylan M, Sriram K. Micronutrient deficiencies after bariatric surgery. Nutrition. 2010;26(11–12):1031–7. - PubMed - DOI
- Xanthakos SA. Nutritional deficiencies in obesity and after bariatric surgery. Pediatr Clin. 2009;56(5):1105–21.
- Wells GA, Shea B, O’Connell D, Peterson J, Welch V, Losos M, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Oxford; 2000.
- Nyaga VN, Arbyn M, Aerts M. Metaprop: a Stata command to perform meta-analysis of binomial data. Arch Publ Health = Arch belg Sante Publique. 2014;72(1):39. - DOI
- Aryannezhad S, Hosseinpanah F, Khalaj A, Mahdavi M, Valizadeh M, Akhavirad SMB, et al. Comparison of the one-year outcomes of bariatric surgery in adolescents and young adults: a matched case-control study, Tehran Obesity Treatment Study (TOTS). Surg Today. 2021;51(11):1764–74. - PubMed - DOI
- Carbajo MA, Gonzalez-Ramirez G, Jimenez JM, Luque-de-Leon E, Ortiz-de-Solorzano J, Castro MJ, et al. A 5-year follow-up in children and adolescents undergoing One-Anastomosis Gastric Bypass (OAGB) at a European IFSO Excellence Center (EAC-BS). Obes Surg. 2019;29(9):2739–44. - PubMed - DOI
- Dobritoiu D, Buza M, Catanescu E, Copaescu C. Excellent short- and medium-term result of bariatric surgery in adolescence a single center study. Chirurgia. 2019;114(6):753–60. - PubMed - DOI
- Elhag W, El Ansari W. Nutritional deficiencies among adolescents before and after sleeve gastrectomy: first study with 9-year follow-up. Obes Surg. 2022;32(2):284–94. - PubMed - DOI
- Elhag W, El Ansari W, Abdulrazzaq S, Abdullah A, Elsherif M, Elgenaied I. Evolution of 29 anthropometric, nutritional, and cardiometabolic parameters among morbidly obese adolescents 2 years post sleeve gastrectomy. Obes Surg. 2018;28(2):474–82. - PubMed - DOI
- Goldberg HR, Chin VL, Zitsman JL, Zhang C, Williams KM, Oberfield S, et al. Bariatric surgery in adolescents: Is routine nutrient supplementation sufficient to avoid anemia following bariatric surgery? Nutr Clin Pract. 2017;32(4):502–7. - PubMed - PMC - DOI
- Inge TH, Jenkins TM, Xanthakos SA, Dixon JB, Daniels SR, Zeller MH, et al. Long-term outcomes of bariatric surgery in adolescents with severe obesity (FABS-5+): a prospective follow-up analysis. Lancet Diabetes Endocrinol. 2017;5(3):165–73. - PubMed - PMC - DOI
- Maffazioli GD, Stanford FC, Campoverde Reyes KJ, Stanley TL, Singhal V, Corey KE, et al. Comparing outcomes of two types of bariatric surgery in an adolescent obese population: Roux-en-y gastric bypass vs sleeve gastrectomy. Front Pediatr. 2016;4(JUL):78. - PubMed - PMC
- Nadler EP, Youn HA, Ren CJ, Fielding GA. An update on 73 US obese pediatric patients treated with laparoscopic adjustable gastric banding: comorbidity resolution and compliance data. J Pediatr Surg. 2008;43(1):141–6. - PubMed - DOI
- Nocca D, Nedelcu M, Nedelcu A, Noel P, Leger P, Skalli M, et al. Laparoscopic sleeve gastrectomy for late adolescent population. Obes Surg. 2014;24(6):861–5. - PubMed - DOI
- Olbers T, Beamish AJ, Gronowitz E, Flodmark CE, Dahlgren J, Bruze G, et al. Laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity (AMOS): a prospective, 5-year, Swedish nationwide study. Lancet Diabetes Endocrinol. 2017;5(3):174–83. - PubMed - PMC - DOI
- Santos D, Lopes T, Jesus P, Cruz S, Cordeiro A, Pereira S, et al. Bone Metabolism in Adolescents and Adults Undergoing Roux-En-Y Gastric Bypass: a Comparative Study. Obes Surg. 2019;29(7):2144–50. - PubMed - DOI
- Weiner A, Cowell A, McMahon DJ, Tao R, Zitsman J, Oberfield SE, et al. The effects of adolescent laparoscopic adjustable gastric band and sleeve gastrectomy on markers of bone health and bone turnover. Clin Obes. 2020;10(6):e12411. - PubMed - PMC - DOI
- Xanthakos SA, Khoury JC, Inge TH, Jenkins TM, Modi AC, Michalsky MP, et al. Nutritional Risks in Adolescents After Bariatric Surgery. Clin Gastroenterol Hepatol. 2020;18(5):1070–81. - PubMed - DOI
- Yiğit MV, Bahçe ZŞ. Long-Term Results of Adolescent Patients who Underwent Laparoscopic Sleeve Gastrectomy. Indian J Surg. 2023.
- Chakhtoura MT, Nakhoul NN, Shawwa K, Mantzoros C, Fuleihan GAEH. Hypovitaminosis D in bariatric surgery: a systematic review of observational studies. Metabolism. 2016;65(4):574–85. - PubMed - DOI
- Enani G, Bilgic E, Lebedeva E, Delisle M, Vergis A, Hardy K. The incidence of iron deficiency anemia post-Roux-en-Y gastric bypass and sleeve gastrectomy: a systematic review. Surg Endosc. 2020;34(7):3002–10. - PubMed - DOI
- Gu L, Fu R, Chen P, Du N, Chen S, Mao D, et al. In terms of nutrition, the most suitable method for bariatric surgery: laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass? A systematic review and meta-analysis. Obes Surg. 2020;30(5):2003–14. - PubMed - DOI
- Lewis C-A, de Jersey S, Hopkins G, Hickman I, Osland E. Does bariatric surgery cause vitamin A, B1, C or E deficiency? A systematic review. Obes Surg. 2018;28(11):3640–57. - PubMed - DOI
- Mahawar KK, Bhasker AG, Bindal V, Graham Y, Dudeja U, Lakdawala M, et al. Zinc deficiency after gastric bypass for morbid obesity: a systematic review. Obes Surg. 2017;27(2):522–9. - PubMed - DOI
- Shahmiri SS, Eghbali F, Ismaeil A, Gholizadeh B, Khalooeifard R, Valizadeh R, et al. Selenium deficiency after bariatric surgery, incidence and symptoms: a systematic review and meta-analysis. Obes Surg. 2022;32(5):1719–25. - PubMed - DOI
- Sherf-Dagan S, Buch A, Ben-Porat T, Sakran N, Sinai T. Vitamin E status among bariatric surgery patients: a systematic review. Surg Obes Relat Dis. 2021;17(4):816–30. - PubMed - DOI
- Sherf-Dagan S, Goldenshluger A, Azran C, Sakran N, Sinai T, Ben-Porat T. Vitamin K–what is known regarding bariatric surgery patients: a systematic review. Surg Obes Relat Dis. 2019;15(8):1402–13. - PubMed - DOI
- Xanthakos SA. Nutritional deficiencies in obesity and after bariatric surgery. Pediatr Clin North Am. 2009;56(5):1105–21. - PubMed - PMC - DOI
- Stevens GA, Finucane MM, De-Regil LM, Paciorek CJ, Flaxman SR, Branca F, et al. Global, regional, and national trends in haemoglobin concentration and prevalence of total and severe anaemia in children and pregnant and non-pregnant women for 1995–2011: a systematic analysis of population-representative data. Lancet Glob Health. 2013;1(1):e16–25. - PubMed - PMC - DOI
- More S, Shivkumar V, Gangane N, Shende S. Effects of iron deficiency on cognitive function in school going adolescent females in rural area of central India. Anemia. 2013;2013.
- Gordon CM, DePeter KC, Feldman HA, Grace E, Emans SJ. Prevalence of vitamin d deficiency among healthy adolescents. Arch Pediatr Adolesc Med. 2004;158(6):531–7. - PubMed - DOI
- Lehtonen-Veromaa MK, Möttönen TT, Nuotio IO, Irjala K, Leino AE, Viikari JS. vitamin d and attainment of peak bone mass among peripubertal Finnish girls: a 3-y prospective study. Am J Clin Nutr. 2002;76(6):1446–53. - PubMed - DOI
- Relation of body fat indexes to vitamin d status and deficiency among obese adolescents. Am J Clin Nutr. 2009;90(3):459-67.
- Harel Z, Flanagan P, Forcier M, Harel D. Low vitamin d status among obese adolescents: prevalence and response to treatment. J Adolesc Health. 2011;48(5):448–52. - PubMed - DOI
- Kremer R, Campbell PP, Reinhardt T, Gilsanz V. vitamin d status and its relationship to body fat, final height, and peak bone mass in young women. J Clin Endocrinol Metab. 2009;94(1):67–73. - PubMed - DOI
- Hatun S, Islam O, Cizmecioglu F, Kara B, Babaoglu K, Berk F, et al. Subclinical vitamin d deficiency is increased in adolescent girls who wear concealing clothing. J Nutr. 2005;135(2):218–22. - PubMed - DOI
- Abrams SA. Calcium and vitamin d requirements for optimal bone mass during adolescence. Curr Opin Clin Nutr Metab Care. 2011;14(6):605–9. - PubMed - DOI
Vitamin D interactions with poor gut (Celiac, IBD, and Bariatric surgery) – several studies
15+ Vitamin D Life pages with BARIATRIC in title
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