As the popularity of bariatric surgery grows, the long-term health implications of these procedures are receiving increasing scrutiny. A recent study has shed light on a critical issue—vitamin deficiencies—observed in patients several years post-surgery. Understanding these deficiencies is crucial for healthcare providers and patients to manage postoperative health effectively.
Study Parameters and Methods
The meta-analysis, encompassing 54 clinical studies with follow-up durations ranging from 5 to 17 years, aimed to identify the long-term prevalence of vitamin deficiencies in bariatric surgery patients. Researchers meticulously searched the EMBASE, PubMed, and CENTRAL databases up to June 2023. The analysis included sensitivity, subgroup, and meta-regression assessments to ensure robustness.
Key Findings and Regional Variations
The study revealed that vitamin D deficiency was the most common, affecting 35.8% of patients. Other significant deficiencies included vitamin E (16.5%), vitamin A (13.4%), vitamin K (9.6%), and vitamin B12 (8.5%). Notably, the type of surgical procedure influenced deficiency rates, with Roux-en-Y gastric bypass patients showing higher vitamin B12 deficiency compared to those undergoing sleeve gastrectomy and biliopancreatic diversion with duodenal switch (BPD-DS).
Regional differences were also prominent. European studies reported a higher prevalence of vitamin A deficiency (25.8%) compared to American studies (0.8%). Conversely, Asian studies indicated higher vitamin B12 but lower vitamin D deficiencies than their European and American counterparts. These variations underscore the need for region-specific postoperative care protocols.
Inferences and Implications
Significant inferences from the study include:
- Long-term follow-up is crucial for managing post-bariatric surgery health.
- Surgical procedure type significantly impacts vitamin deficiency rates.
- Regional variations suggest a need for tailored postoperative care.
The study’s findings highlight that despite the initial benefits of bariatric surgery, patients remain at risk for long-term nutritional deficiencies. This issue is compounded by factors such as the type of surgery and geographic location, influencing the prevalence and type of deficiencies. Consequently, there is a critical need for targeted vitamin supplementation programs tailored to the type of surgery and patient demographics to mitigate these risks.
Original Article:
Langenbecks Arch Surg. 2024 Jul 20;409(1):226. doi: 10.1007/s00423-024-03422-9.
ABSTRACT
BACKGROUND: Bariatric surgery can lead to short-mid-term vitamin deficiencies, but the long-term vitamin deficiencies is unclear. This study aimed to conduct a meta-analysis regarding the long-term prevalence (≥ 5 years) of vitamin deficiencies after bariatric surgery.
METHODS: We searched the EMBASE, PubMed, and CENTRAL databases for clinical studies until June 2023. Meta-analysis, sensitivity, subgroup, and meta-regression analyses were performed.
RESULTS: This meta-analysis included 54 articles with follow-up duration ranging from 5 to 17 years. The most prevalent vitamin deficiencies after surgery were vitamin D (35.8%), followed by vitamin E (16.5%), vitamin A (13.4%), vitamin K (9.6%), and vitamin B12 (8.5%). Subgroup analyses showed that the prevalence of vitamin A and folate deficiencies increased with the follow-up time. Roux-en-Y gastric bypass had a higher rate of vitamin B12 deficiency than sleeve gastrectomy and biliopancreatic diversion with duodenal switch (BPD-DS). Studies conducted in Europe had higher vitamin A deficiency (25.8%) than in America (0.8%); Asian studies had more vitamin B12 but less vitamin D deficiency than European and American studies. Meta-regression analysis displayed that publication year, study design, preoperative age, BMI, and quality assessment score were not associated with vitamin A, B12, D, and folate deficiencies rate.
CONCLUSION: A high prevalence of vitamin deficiencies was found after bariatric surgery in the long-term follow-up, especially vitamin D, E, A, K, and B12. The variation in study regions, surgical procedures, and follow-up time are associated with different postoperative vitamin deficiencies; it is necessary to develop more targeted vitamin supplement programs.
PMID:39030449 | DOI:10.1007/s00423-024-03422-9
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