Impact of Laparoscopic Sleeve Gastrectomy on Micronutrient Status

Purpose: The aim of this study was to examine the micronutrient status in obese patients before and after laparoscopic sleeve gastrectomy (LSG), and the potential benefit of supplementation. Materials and Methods: Fifty-three obese subjects, undergoing LSG in the Department of General Surgery at the Surgical Clinic in Munich-Bogenhausen, Germany, were included in the analysis. Body weight, body height, micronutrient status (vitamin A, E, D, B-1, B-6, B-12, folate, selenium, zinc and markers of iron status) and supplementation were assessed before and in different intervals up to 1 year postoperatively. Results: LSG led to a significant excess weight loss of 69.9 +/- 31.8% within the first year after surgery. 80% of the patients had at least one micronutrient deficiency already prior to surgery. Despite an individual adjusted recommendation for supplementation, several micronutrient deficiencies occurred in the postoperative phase, including vitamin D, B12, and A, folate, iron, zinc, and selenium deficits. Mean levels of micronutrients did not change significantly, except for vitamin A, selenium and zinc, which deteriorated during the course of the study. Conclusions: LSG caused significant weight loss within 1 year, but also led to different micronutrient deficiencies, that could not be prevented by routine recommendations for supplementation. Since several micronutrient deficiencies already existed prior to surgery, patients who undergo LSG require a careful monitoring, and likely also high-dose supplementations. Furthermore, it seems to be important to motivate patients realizing the recommended supplementation.