50% of teens have micronutrient deficiencies 10 years after weight-loss surgery
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Key takeaways:
- At 10 years after weight-loss surgery, the prevalence of adolescents with multiple micronutrient deficiencies rose.
- Vitamin A and iron deficiencies were more common after gastric bypass vs. sleeve gastrectomy.
SAN ANTONIO — Half of adolescents had two or more micronutrient deficiencies 10 years after metabolic and bariatric surgery, with deficiencies more common after Roux-en-Y gastric bypass, according to a presentation at ObesityWeek.
“Individuals with obesity are at risk for micronutrient deficiency after bariatric surgery, and the risk increases postoperatively. Adverse effects such as anemia, osteoporosis and neurologic deficits can develop postoperatively if appropriate nutrition and supplementation goals are not being met,” Christine Brichta, MD, MPH, pediatric gastroenterology fellow at the Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, said during the presentation. “Previous 5-year post-bariatric surgery did show us that adolescents who underwent Roux-en-Y compared to sleeve gastrectomy had a higher prevalence of deficiencies, especially for iron.”
Brichta and colleagues conducted an analysis of 260 adolescents (mean age, 17 years; 76% girls) from the multicenter prospective observational Teen-Longitudinal Assessment of Bariatric Surgery study. All participants underwent either Roux-en-Y gastric bypass (n = 161) or vertical sleeve gastrectomy (n = 99). Researchers evaluated prevalence and incidence of micronutrient deficiencies at baseline and annually up to 10 years after metabolic and bariatric surgery.
BMI differences were similar between adolescents who underwent Roux-en-Y gastric bypass and those who underwent vertical sleeve gastrectomy after 10 years, with a BMI reduction of –20.6% (95% CI, –24.8 to –16.4) and –19.2% (95% CI, –24.8 to –13.5), respectively. Researchers observed an increase in two or more micronutrient deficiencies after both procedures from 10% at baseline to 50% after 10 years. The presence of three or more micronutrient deficiencies rose from 0% at baseline to approximately 20% in the gastric bypass group and to approximately 15% in the sleeve gastrectomy group, according to the researchers.
Compared with vertical sleeve gastrectomy, participants who underwent Roux-en-Y gastric bypass had a higher incidence of low vitamin A after 10 years (1% vs. 8%; RR = 0.37; 95% CI, 0.2-0.68; P < .01). In addition, 10 years after surgery, anemia prevalence was lower after vertical sleeve gastrectomy with 26.9% compared with 62.1% for Roux-en-Y gastric bypass (prevalence risk = 0.43; 95% CI, 0.32-0.58; P < .001).
“This provides some insight into how primary care physicians should be treating patients who have bariatric surgery, especially as adolescents transition into adulthood,” Brichta said.
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Brichta C. Oral-041. Presented at: ObesityWeek; Nov. 3-6, 2024; San Antonio.
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