Objectives

The objective of the present study was to assess trace element status in morbidly obese subjects before and one year after Roux-en-Y gastric bypass (RYGB) in order to identify possible deficiencies.

Methods

The study population included 46 patients in the age range 27–59 years, the majority (85%) were women. The enrolled patients attended an eight week course on lifestyle changes before bariatric surgery. After RYGB they were recommended daily micronutrient supplements with a commonly used multivitamin-mineral tablet in addition to intramuscular vitamin B₁₂ injections (1 mg) every third month for 12 months. Whole blood concentrations of Cu, Mn, Se and Zn were determined using high resolution inductively coupled plasma mass spectrometry.

Results

During the 12 months follow up after bariatric surgery, the patients had lost 32.3 kg and median whole blood concentrations of Cu (-16%) were reduced, Mn (+14%) and Zn (+6%) were increased, while the Se values were essentially unchanged. Compared with reference ranges, median postoperative concentrations of all essential trace elements were either below (Zn) or in the lower reference range (Cu, Mn, Se).

Conclusion

Essential trace elements were below or in the lower reference range twelve months after RYGB. Our results indicate a need for updated guidelines in Nordic countries for trace metal monitoring and supplements in patients after bariatric surgery, especially when gastric bypass surgery is used. Further studies are required to explore and prevent trace element deficiency related to obesity and bariatric surgery.

中文翻译：

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Roux-en-Y胃绕道手术前后挪威肥胖患者的必需微量元素：铜、锰、硒和锌

目标

本研究的目的是评估病态肥胖受试者在 Roux-en-Y 胃绕道术 (RYGB) 之前和之后一年的微量元素状态，以确定可能的缺陷。

方法

研究人群包括 46 名年龄在 27-59 岁之间的患者，其中大多数 (85%) 是女性。入组患者在减肥手术前参加了为期八周的生活方式改变课程。在 RYGB 之后，他们被推荐每天补充微量营养素和常用的多种维生素矿物质片，此外还每三个月注射一次维生素 B ₁₂（1 毫克），持续 12 个月。使用高分辨率电感耦合等离子体质谱法测定 Cu、Mn、Se 和 Zn 的全血浓度。

结果

在减肥手术后的 12 个月随访期间，患者体重减轻了 32.3 kg，全血中 Cu (-16%) 浓度降低，Mn (+14%) 和 Zn (+6%) 增加，而 Se值基本不变。与参考范围相比，所有必需微量元素的术后中位数浓度要么低于（Zn），要么在较低的参考范围（Cu、Mn、Se）。

结论

RYGB 后 12 个月，必需微量元素低于或低于参考范围。我们的结果表明，北欧国家需要更新指南，以对减肥手术后的患者进行痕量金属监测和补充，尤其是在使用胃绕道手术时。需要进一步的研究来探索和预防与肥胖和减肥手术相关的微量元素缺乏症。