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胃旁路手术和袖状胃切除术后的微量营养素和蛋白质缺乏:1年随访

Micronutrient and Protein Deficiencies After Gastric Bypass and Sleeve Gastrectomy: a 1-year Follow-up.

作者信息

Verger Eric O, Aron-Wisnewsky Judith, Dao Maria Carlota, Kayser Brandon D, Oppert Jean-Michel, Bouillot Jean-Luc, Torcivia Adriana, Clément Karine

机构信息

Institute of Cardiometabolism and Nutrition, ICAN, Pitié-Salpêtrière Hospital, Nutrition Department, Assistance Publique-Hôpitaux de Paris, 75013, Paris, France.

INSERM, UMR_S U1166, NutriOmics team, 75013, Paris, France.

出版信息

Obes Surg. 2016 Apr;26(4):785-96. doi: 10.1007/s11695-015-1803-7.

Abstract

BACKGROUND

Roux-en-Y gastric bypass (GBP) and sleeve gastrectomy (SG) have increased dramatically, potentially increasing the prevalence of nutritional deficiencies. The aim of this study was to analyze the effects of food restriction during the first year after bariatric surgery (BS) on nutritional parameters.

METHODS

Twenty-two and 30 obese patients undergoing GBP and SG were prospectively followed at baseline and 3, 6, and 12 months after BS (N = 14 and N = 19 at T12). We evaluated food intake and nutrient adequacy (T0, T3, T12), as well as serum vitamin and mineral concentration (T0, T3, T6, T12).

RESULTS

At baseline, GBP and SG patients had similar clinical characteristics, food intake, nutrient adequacy, and serum concentration. The drastic energy and food reduction led to very low probabilities of adequacy for nutrients similar in both models (T3, T12). Serum analysis demonstrated a continuous decrease in prealbumin during the follow-up, indicating mild protein depletion in 37 and 38% of GBP patients and 57 and 52% of SG patients, respectively, at T3 and T12. Conversely, despite the low probabilities of adequacy observed at T3 and T12, systematic multivitamin and mineral supplementation after GBP and SG prevented most nutritional deficiencies.

CONCLUSIONS

GBP and SG have comparable effects in terms of energy and food restriction and subsequent risk of micronutrient and protein deficiencies in the first year post BS. Such results advocate for a cautious monitoring of protein intake after GPB and SG and a systematic multivitamin and mineral supplementation in the first year after SG.

摘要

背景

Roux-en-Y胃旁路术(GBP)和袖状胃切除术(SG)的实施率急剧上升,这可能会增加营养缺乏症的患病率。本研究旨在分析减肥手术后(BS)第一年食物限制对营养参数的影响。

方法

对22例接受GBP手术和30例接受SG手术的肥胖患者进行前瞻性随访,在基线时以及BS术后3、6和12个月进行观察(T12时分别为N = 14例和N = 19例)。我们评估了食物摄入量和营养充足性(T0、T3、T12),以及血清维生素和矿物质浓度(T0、T3、T6、T12)。

结果

在基线时,GBP组和SG组患者具有相似的临床特征、食物摄入量、营养充足性和血清浓度。两种手术方式中,能量和食物摄入量的大幅减少导致营养充足的可能性极低(T3、T12)。血清分析显示,随访期间前白蛋白持续下降,表明在T3和T12时,分别有37%和38%的GBP患者以及57%和52%的SG患者存在轻度蛋白质消耗。相反,尽管在T3和T12时观察到营养充足的可能性较低,但GBP和SG术后系统性补充多种维生素和矿物质可预防大多数营养缺乏症。

结论

在BS术后第一年,GBP和SG在能量和食物限制以及随后的微量营养素和蛋白质缺乏风险方面具有相似的效果。这些结果提倡在GBP和SG术后谨慎监测蛋白质摄入量,并在SG术后第一年系统性补充多种维生素和矿物质。

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