Background:
Bariatric surgery is rapidly developing in Asia in the last few years due to the increasing prevalence in obesity and diabetes. However, bariatric surgery patients are at risk for nutritional deficiency after surgery, namely protein, vitamin B12, D along with iron and calcium. Aim of this study is to evaluate the nutritional outcome in patients undergo Roux-en-Y gastric bypass (RYBG) in Hong Kong.
Methods:
Clinical data of patients undergo RYGB between 2013 and 2016 were collected retrospectively. All Patients were assessed by dietitians before and after surgery to ensure adequate nutrition intake both in macronutrients and micronutrients. Multivitamin, calcium and iron oral supplements are prescribed after surgery according to international guideline. Dietary protein intake are estimated during consultation and serum level of hemoglobin, albumin, iron, vitamin D and B12 are measured before and 12months after surgery.
Results:
Seventeen patients (7 female and 10 male) with mean age of 40.2±8.0 are included for analysis. Weight loss was observed in all patients postoperatively 12 months, with mean BMI dropped from 37.3±7.8 kg/m2 to 27.8±9.8 kg/m2 (p<0.05). Protein intake was significantly improved at post-operation 12 months (34.3±16.1 vs 55.7±13.7g, p <0.05). There were no significant change in plasma albumin, iron, total vitamin D and haemoglobin level. Serum vitamin B12 level is within normal range but it was significantly reduced (172.2±127.1 vs 78±41.2pmol/L, p < 0.05) despite oral supplement prescribed.
Conclusion:
Micronutrients need to be supplemented and monitored regularly in RYBP patients and parental supplement of Vitamin B12 may be necessary 12 months after surgery. Careful postsurgical monitoring and surveillance in a multidisciplinary approach can help avoiding the nutritional deficiencies problem.