Article: The effect of Roux-en-Y gastric bypass on zinc nutritional status

Background: Researchers have found that zinc nutritional status in obese and diabetic subjects is altered: low zinc concentrations in plasma and erythrocytes, with high urinary zinc excretion, were observed. This study evaluated the effect of Roux-en-Y gastric bypass (RYGBP) on plasma, erythrocyte and urinary zinc concentration.

Methods: 22 morbidly obese patients were studied before and 6 months after RYGBP. Fasting blood sample and 24-hour urine were collected in the pre- and postoperative phases. A software analyzed the diet information from 3-day food records after RYGBP. Zinc nutritional status was evaluated by determination of the concentration of this mineral in plasma and erythrocytes, and the urinary excretion of zinc / 24 hours by atomic absorption spectrophotometry.

Results: The diets consumed by the patients had adequate average concentrations of zinc. Zinc concentration in plasma, erythrocytes and urine were within the values of normality before RYGBP, with mean values of 93.25 +/- 19.34 microg/dL, 43.85 +/- 7.76 microg Zn/gHb and 583.05 +/- 359.30 microg Zn/24 hours, respectively. At 6 months after RYGBP, there was a change in these parameters to 69.82 +/- 10.95 microg/dL, 51.80 +/- 6.92 microg Zn/gHb, 535.29 +/- 216.40 microg Zn/24 hours in the concentration of plasma, erythrocyte and urinary zinc.

Conclusion: These results suggest that RYGBP promoted, besides change in body composition, an alteration in the zinc plasma and erythrocytes concentrations which in the medium and long term, could cause problems for these patients.

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References

1.

do Nascimento Marreiro D, Fisberg M, Cozzolino S . Zinc nutritional status and its relationships with hyperinsulinemia in obese children and adolescents. Biol Trace Elem Res. 2004; 100(2):137-49. DOI: 10.1385/bter:100:2:137. View

2.

Basiotis P, Welsh S, Cronin F, Kelsay J, Mertz W . Number of days of food intake records required to estimate individual and group nutrient intakes with defined confidence. J Nutr. 1987; 117(9):1638-41. DOI: 10.1093/jn/117.9.1638. View

3.

Cominetti C, Garrido Jr A, Cozzolino S . Zinc nutritional status of morbidly obese patients before and after Roux-en-Y gastric bypass: a preliminary report. Obes Surg. 2006; 16(4):448-53. DOI: 10.1381/096089206776327305. View

4.

Kennedy M, Failla M . Zinc metabolism in genetically obese (ob/ob) mice. J Nutr. 1987; 117(5):886-93. DOI: 10.1093/jn/117.5.886. View

5.

Whitehouse R, Prasad A, Rabbani P, Cossack Z . Zinc in plasma, neutrophils, lymphocytes, and erythrocytes as determined by flameless atomic absorption spectrophotometry. Clin Chem. 1982; 28(3):475-80. View

6.

Di Martino G, Matera M, De Martino B, Vacca C, Di Martino S, Rossi F . Relationship between zinc and obesity. J Med. 1993; 24(2-3):177-83. View

7.

Chen M, Liou S, Lin P, Yang V, Alexander P, Lin W . Effects of zinc supplementation on the plasma glucose level and insulin activity in genetically obese (ob/ob) mice. Biol Trace Elem Res. 1998; 61(3):303-11. DOI: 10.1007/BF02789090. View

8.

Bray G, Tartaglia L . Medicinal strategies in the treatment of obesity. Nature. 2000; 404(6778):672-7. DOI: 10.1038/35007544. View

9.

Begin-Heick N, Rowe J, HEICK H . Zinc supplementation attenuates insulin secretory activity in pancreatic islets of the ob/ob mouse. Diabetes. 1985; 34(2):179-84. DOI: 10.2337/diab.34.2.179. View

10.

do Nascimento Marreiro D, Fisberg M, Cozzolino S . Zinc nutritional status in obese children and adolescents. Biol Trace Elem Res. 2002; 86(2):107-22. DOI: 10.1385/bter:86:2:107. View

11.

Kiilerich S, Christensen M, Naestoft J, Christiansen C . Determination of zinc in serum and urine by atomic absorption spectrophotometry; relationship between serum levels of zinc and proteins in 104 normal subjects. Clin Chim Acta. 1980; 105(2):231-9. DOI: 10.1016/0009-8981(80)90465-9. View

12.

Levine A, McClain C, Handwerger B, Brown D, Morley J . Tissue zinc status of genetically diabetic and streptozotocin-induced diabetic mice. Am J Clin Nutr. 1983; 37(3):382-6. DOI: 10.1093/ajcn/37.3.382. View

The Effect of Roux-en-Y Gastric Bypass on Zinc Nutritional Status