Factors Associated with Nutritional Deficiency Biomarkers in Candidates for Bariatric Surgery: A Cross-Sectional Study in a Peruvian High-Resolution Clinic

Overview

Journal Nutrients

Date 2022 Jan 11

PMID 35010957

Authors

Adrian Riva-Moscoso

Raisa N Martinez-Rivera

Gianfranco Cotrina-Susanibar

Fortunato S Principe-Meneses

Diego Urrunaga-Pastor

Gustavo Salinas-Sedo

Carlos J Toro-Huamanchumo

Affiliations

Soon will be listed here.

Abstract

Previous studies have described multiple nutritional deficiencies after bariatric surgery (BS). However, few studies have evaluated these deficiencies prior to BS, specifically in Latin America. This study aimed to determine the factors associated with nutritional deficiency biomarkers in candidates for BS in Peru. We included adults of both sexes, aged 18 to 59 years, admitted to a Peruvian clinic with a body mass index (BMI) ≥30 kg/m; they were candidates for BS from 2017 to 2020. We considered the serum levels of hemoglobin and albumin (in tertiles) as the nutritional deficiency biomarkers. In order to assess the associated factors, we calculated crude (cPR) and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95%CI). We analyzed 255 patients: 63.1% were males, with a mean age of 37.1 ± 10.3 years and mean hemoglobin and albumin values of 14.0 ± 1.5 g/dL and 4.6 ± 0.4 g/dL, respectively. We found that males (aPR = 1.86; 95%CI: 1.26-2.73; = 0.002), participants between 30 and 49 (aPR = 2.02; 95%CI: 1.24-3.28; = 0.004) or 50 years or more (aPR = 2.42; 95%CI: 1.35-4.35; = 0.003), participants with a BMI ≥40 kg/m (aPR = 1.68; 95%CI: 1.09-2.60; = 0.018), participants with impaired high-density lipoprotein levels (aPR = 1.43; 95%CI: 1.01-2.05; = 0.049) and individuals in the high tertile of C-reactive protein (aPR = 6.94; 95%CI: 3.37-14.32; < 0.003) had a higher probability of being in the lower tertile of albumin. In addition, we found that the male sex (aPR = 6.94; 95%CI: 3.37-14.32; < 0.001) and elevated cholesterol levels (aPR = 0.71; 95%CI: 0.52-0.97; = 0.034) were associated with the lowest hemoglobin tertile. In our setting, nutritional deficiency biomarkers were associated with sociodemographic, anthropometric and laboratory markers. The pre-bariatric surgery correction of nutritional deficiencies is essential, and can prevent major complications after surgery.

Citing Articles

Identification of independent risk factors for hypoalbuminemia in patients with CKD stages 3 and 4: the construction of a nomogram.

Wang C, Jiang M, Ma J, Yuan M, Liao L, Duan H Front Nutr. 2024; 11:1453240.

PMID: 39545043 PMC: 11562854. DOI: 10.3389/fnut.2024.1453240.

Nutritional status of Saudi obese patients undergoing laparoscopic sleeve gastrectomy, one-year follow-up study.

Alqahtani S, Alfawaz H, Awwad F, Almnaizel A, AlOtaibi A, Bajaber A Br J Nutr. 2024; 132(11):1454-1465.

PMID: 39512156 PMC: 11660312. DOI: 10.1017/S0007114524002460.

The Relationship Between Childhood Trauma and Body Image, Self-Esteem and Eating Attitudes in Patients undergoing Bariatric Surgery.

Berberoglu Z, Hocaoglu C Turk Psikiyatri Derg. 2024; 35(2):116-126.

PMID: 38842153 PMC: 11164075. DOI: 10.5080/u26831.

References

Cabrerizo S, Cuadras D, Gomez-Busto F, Artaza-Artabe I, Marin-Ciancas F, Malafarina V . Serum albumin and health in older people: Review and meta analysis. Maturitas. 2015; 81(1):17-27. DOI: 10.1016/j.maturitas.2015.02.009. View

Al-Mutawa A, Anderson A, AlSabah S, Al-Mutawa M . Nutritional Status of Bariatric Surgery Candidates. Nutrients. 2018; 10(1). PMC: 5793295. DOI: 10.3390/nu10010067. View

Ben-Porat T, Elazary R, Yuval J, Wieder A, Khalaileh A, Weiss R . Nutritional deficiencies after sleeve gastrectomy: can they be predicted preoperatively?. Surg Obes Relat Dis. 2015; 11(5):1029-36. DOI: 10.1016/j.soard.2015.02.018. View

Monteiro C, Conde W, Lu B, Popkin B . Obesity and inequities in health in the developing world. Int J Obes Relat Metab Disord. 2004; 28(9):1181-6. DOI: 10.1038/sj.ijo.0802716. View

Jiwani S, Carrillo-Larco R, Hernandez-Vasquez A, Barrientos-Gutierrez T, Basto-Abreu A, Gutierrez L . The shift of obesity burden by socioeconomic status between 1998 and 2017 in Latin America and the Caribbean: a cross-sectional series study. Lancet Glob Health. 2019; 7(12):e1644-e1654. PMC: 7613084. DOI: 10.1016/S2214-109X(19)30421-8. View

de Paris F, Padoin A, Mottin C, de Paris M . Assessment of Changes in Body Composition During the First Postoperative Year After Bariatric Surgery. Obes Surg. 2019; 29(9):3054-3061. DOI: 10.1007/s11695-019-03980-8. View

de Luis D, Pacheco D, Izaola O, Terroba M, Cuellar L, Cabezas G . Micronutrient status in morbidly obese women before bariatric surgery. Surg Obes Relat Dis. 2011; 9(2):323-7. DOI: 10.1016/j.soard.2011.09.015. View

Angrisani L, Santonicola A, Iovino P, Vitiello A, Higa K, Himpens J . IFSO Worldwide Survey 2016: Primary, Endoluminal, and Revisional Procedures. Obes Surg. 2018; 28(12):3783-3794. DOI: 10.1007/s11695-018-3450-2. View

Toro-Huamanchumo C, Moran-Marinos C, Salazar-Alarcon J, Barros-Sevillano S, Huamanchumo-Suyon M, Salinas-Sedo G . Latin American Research on Bariatric Surgery: a Bibliometric Study. Obes Surg. 2020; 31(4):1869-1876. DOI: 10.1007/s11695-020-05058-2. View

10.

Keller U . Nutritional Laboratory Markers in Malnutrition. J Clin Med. 2019; 8(6). PMC: 6616535. DOI: 10.3390/jcm8060775. View

11.

Aarts E, van Wageningen B, Janssen I, Berends F . Prevalence of Anemia and Related Deficiencies in the First Year following Laparoscopic Gastric Bypass for Morbid Obesity. J Obes. 2012; 2012:193705. PMC: 3317129. DOI: 10.1155/2012/193705. View

12.

Lupoli R, Lembo E, Saldalamacchia G, Avola C, Angrisani L, Capaldo B . Bariatric surgery and long-term nutritional issues. World J Diabetes. 2017; 8(11):464-474. PMC: 5700383. DOI: 10.4239/wjd.v8.i11.464. View

13.

Poitou Bernert C, Ciangura C, Coupaye M, Czernichow S, Bouillot J, Basdevant A . Nutritional deficiency after gastric bypass: diagnosis, prevention and treatment. Diabetes Metab. 2007; 33(1):13-24. DOI: 10.1016/j.diabet.2006.11.004. View

14.

Barr M, Tabone L, Cox S, Brode C, Szoka N, Olfert I . Bariatric Surgery Outcomes in Appalachia Influenced by Surgery Type, Diabetes, and Depression. Obes Surg. 2019; 29(4):1222-1228. PMC: 6511994. DOI: 10.1007/s11695-018-03650-1. View

15.

Csendes J A, Papapietro V K, Burgos L A, Lanzarini S E, Canobra L M . [Results of gastric bypass for morbid obesity after a follow up of seven to 10 years]. Rev Med Chil. 2012; 139(11):1414-20. DOI: /S0034-98872011001100004. View

16.

Wang C, Guan B, Yang W, Yang J, Cao G, Lee S . Prevalence of electrolyte and nutritional deficiencies in Chinese bariatric surgery candidates. Surg Obes Relat Dis. 2016; 12(3):629-634. DOI: 10.1016/j.soard.2015.12.009. View

17.

Alexandrou A, Armeni E, Kouskouni E, Tsoka E, Diamantis T, Lambrinoudaki I . Cross-sectional long-term micronutrient deficiencies after sleeve gastrectomy versus Roux-en-Y gastric bypass: a pilot study. Surg Obes Relat Dis. 2013; 10(2):262-8. DOI: 10.1016/j.soard.2013.07.014. View

18.

Wolf E, Utech M, Stehle P, Busing M, Stoffel-Wagner B, Ellinger S . Preoperative micronutrient status in morbidly obese patients before undergoing bariatric surgery: results of a cross-sectional study. Surg Obes Relat Dis. 2015; 11(5):1157-63. DOI: 10.1016/j.soard.2015.03.018. View

19.

Pellegrini M, Rahimi F, Boschetti S, Devecchi A, De Francesco A, Mancino M . Pre-operative micronutrient deficiencies in patients with severe obesity candidates for bariatric surgery. J Endocrinol Invest. 2020; 44(7):1413-1423. PMC: 8195915. DOI: 10.1007/s40618-020-01439-7. View

20.

Chen J, Shen C, Lee W, Tsai P, Lee Y . Protein deficiency after gastric bypass: The role of common limb length in revision surgery. Surg Obes Relat Dis. 2019; 15(3):441-446. DOI: 10.1016/j.soard.2018.12.037. View