BACKGROUND Nutritional deficiencies are a well-recognized long-term complication following bariatric surgery. The presence of preoperative deficiencies has been shown to be predictive of postoperative deficiencies. OBJECTIVE The aim of the study was to investigate the prevalence of micronutrient deficiency in a large sample of patients with severe obesity preoperatively, and to determine whether such deficiencies may be related to patient's sex, body mass index, or ethnic subgroup. DESIGN A cross-sectional study of data collected at the time of the preoperative evaluation. PARTICIPANTS/SETTING Data were collected during the preoperative evaluation of 872 bariatric surgery candidates in a university hospital in Israel between 2011 and 2018. The patients were 72.9% women, with a mean age of 37.9±12.1 years and mean body mass index of 42.4±4.7 MAIN OUTCOME MEASURES: Nutritional deficiencies according to blood assays. Data on anthropometrics, comorbidities, and demographic characteristics was also collected. STATISTICAL ANALYSES Baseline differences between patient subgroups were analyzed using independent-samples t test, analysis of variance, or χ2 test. RESULTS Deficiencies of vitamin D, iron, folate, vitamin B-12, elevated parathyroid hormone and low transferrin saturation were present in 75.2%, 42.6%, 28.5%, 8.5%, 35.5%, and 70% of patients, respectively. Nutritional deficiencies were significantly more common among women compared with men for iron (45.9% vs 33.5%; P=0.002), low transferrin saturation (77.7% vs 44.6%; P<0.001), vitamin D (77.5% vs 69.2%; P=0.019) and elevated parathyroid hormone level (39.5% vs 22.9%; P=0.002). Iron, transferrin saturation, and vitamin D deficiencies were more prevalent in Arab patients compared with Jewish patients: 59.6% vs 36%; P<0.001, 80.2% vs 62.8%; P=0.003, and 85.1% vs 71.6%; P<0.001, respectively. Vitamin D and iron deficiency were more common among higher body mass index subgroups (P=0.004 and P=0.040, respectively). CONCLUSIONS The results indicate a high prevalence of nutritional deficiencies, mainly of iron and vitamin D in bariatric surgery candidates. Patients at higher risk for nutritional deficiencies include those with higher body mass index, women, and Arabs.

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重度肥胖患者术前营养缺乏：术前评估应重点关注哪些方面？

背景营养缺乏是公认的减肥手术后的长期并发症。术前缺陷的存在已被证明可以预测术后缺陷。目的 本研究的目的是调查术前大量严重肥胖患者微量营养素缺乏的患病率，并确定此类缺乏是否与患者的性别、体重指数或种族亚群有关。设计 对术前评估时收集的数据进行横断面研究。参与者/设置 2011 年至 2018 年期间，在以色列一家大学医院对 872 名减肥手术候选人进行术前评估期间收集了数据。患者为 72.9% 的女性，平均年龄为 37.9±12.1 岁，平均体重指数为 42.4± 4. 7 主要结局指标：根据血液分析确定的营养缺乏。还收集了有关人体测量学、合并症和人口统计学特征的数据。统计分析 使用独立样本 t 检验、方差分析或 χ2 检验分析患者亚组之间的基线差异。结果 维生素 D、铁、叶酸、维生素 B-12、甲状旁腺激素升高和转铁蛋白饱和度低的患者分别占 75.2%、42.6%、28.5%、8.5%、35.5% 和 70%。与男性相比，女性在铁（45.9% 对 33.5%；P=0.002）、转铁蛋白饱和度低（77.7% 对 44.6%；P<0.001）、维生素 D（77.5% 对 69.2%；P =0.019) 和甲状旁腺激素水平升高（39.5% 对 22.9%；P=0.002）。铁，转铁蛋白饱和度，与犹太患者相比，阿拉伯患者中维生素 D 缺乏症更为普遍：59.6% 对 36%；P<0.001，80.2% vs 62.8%；P=0.003，85.1% vs 71.6%；P<0.001，分别。维生素 D 和铁缺乏在体重指数较高的亚组中更为常见（分别为 P=0.004 和 P=0.040）。结论 结果表明，在减肥手术候选人中，营养缺乏的发生率很高，主要是铁和维生素 D。营养缺乏风险较高的患者包括体重指数较高的患者、女性和阿拉伯人。分别）。结论 结果表明，在减肥手术候选人中，营养缺乏的发生率很高，主要是铁和维生素 D。营养缺乏风险较高的患者包括体重指数较高的患者、女性和阿拉伯人。分别）。结论 结果表明，在减肥手术候选人中，营养缺乏的发生率很高，主要是铁和维生素 D。营养缺乏风险较高的患者包括体重指数较高的患者、女性和阿拉伯人。