Abstract
Background
A paucity of information is available on the comparative nutritional deficiencies
considering the presence of metabolic syndrome (MetS) and nutritional changes after
vertical sleeve gastrectomy (SG).
Objectives
To compare the nutritional status in patients with and without MetS before and 1 year
after SG and to investigate its association with metabolic status.
Setting
A tertiary referral center.
Methods
Retrospective study, including all patients submitted to SG between January 2011 and
July 2015. Patients were evaluated before and 12 months after surgery. MetS presence
was classified using the International Diabetes Federation/American Heart Association/National
Heart, Lung, and Blood Institute 2009 definition. Univariate and multivariate analyses
were applied to find associations between MetS, nutritional, anthropometric, and metabolic
parameters.
Results
A total of 330 patients were included and MetS was present in 47%. Preoperatively,
patients without MetS presented a higher percentage of folate deficiency (12% versus
2%, P < .001). Follow-up data were available for 202 patients. In the 1-year evaluation,
MetS patients presented significantly lower body mass index and percent excess weight
loss (70.96 ± 20.4 versus 79.55 ± 23.0, P < .001). These patients also presented lower homocysteine (11.76 ± 4.3 versus 13.66
± 7.6, P = .027) and magnesium (19.41 ± 2.1 versus 20.22 ± 1.9, P = .004) levels but higher calcium (9.27 ± .3 versus 9.16 ± .4, P = .031) and vitamin B12 (396, P 312–504.5 versus 329, P 255–433, P = .002) levels comparing with those without MetS. Multiple linear regression evidenced
that higher preoperative albumin and postoperative ferritin and homocysteine were
predictors of a lower body mass index after surgery, and higher postoperative folate
levels were associated with lower insulin-resistance.
Conclusions
The impact of SG on nutritional parameters is affected by MetS. If not treated, preoperative
deficiencies can impair postoperative metabolic status and weight loss. MetS should
be considered when evaluating bariatric surgery candidates, and preoperative supplementation
and long-term nutritional follow-up are required to prevent further nutritional deficiencies.
Key words
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Article info
Publication history
Published online: March 17, 2020
Accepted:
March 3,
2020
Received:
October 8,
2019
Identification
Copyright
© 2020 Published by Elsevier Inc. on behalf of American Society for Bariatric Surgery.
