HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Supplemental data All Versions of this Article: 90/1/15    most recent ajcn.2009.27583v1 Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Aasheim, E. T Articles by Bøhmer, T. PubMed PubMed Citation Articles by Aasheim, E. T Articles by Bøhmer, T. Agricola Articles by Aasheim, E. T Articles by Bøhmer, T.

Vitamin status after bariatric surgery: a randomized study of gastric bypass and duodenal switch^1,2,3

¹ From the Department of Medicine (ETA and TB), the Department of Gastrointestinal Surgery (TTS and TM), Hormone Laboratory (ETA), and the Department of Nutrition and Dietetics (SEH), Oslo University Hospital Aker, Oslo, Norway; the Faculty of Medicine, University of Oslo, Oslo, Norway (ETA, TTS, SEH, and TB); and the Department of Surgery and Gastrosurgical Research, Sahlgrenska University Hospital, Göteborg, Sweden (SB, ME, and TO).

² Supported by research fellowship grants from South Eastern Norway Regional Health Authority (to ETA, TTS, and SEH) and grants for biochemical analyses from South Eastern Norway Regional Health Authority (AUS-20-2006) and Aker University Hospital (06/3060) (both to ETA).

³ Address correspondence to ET Aasheim, Hormone Laboratory, Oslo University Hospital Aker, 0514 Oslo, Norway. E-mail: e.t.aasheim{at}medisin.uio.no.

Background: Bariatric surgery is widely performed to induce weight loss.

Objective: The objective was to examine changes in vitamin status after 2 bariatric surgical techniques.

Design: A randomized controlled trial was conducted in 2 Scandinavian hospitals. The subjects were 60 superobese patients [body mass index (BMI; in kg/m²): 50–60]. The surgical interventions were either laparoscopic Roux-en-Y gastric bypass or laparoscopic biliopancreatic diversion with duodenal switch. All patients received multivitamins, iron, calcium, and vitamin D supplements. Gastric bypass patients also received a vitamin B-12 substitute. The patients were examined before surgery and 6 wk, 6 mo, and 1 y after surgery.

Results: Of 60 surgically treated patients, 59 completed the follow-up. After surgery, duodenal switch patients had lower mean vitamin A and 25-hydroxyvitamin D concentrations and a steeper decline in thiamine concentrations than did the gastric bypass patients. Other vitamins (riboflavin, vitamin B-6, vitamin C, and vitamin E adjusted for serum lipids) did not change differently in the surgical groups, and concentrations were either stable or increased. Furthermore, duodenal switch patients had lower hemoglobin and total cholesterol concentrations and a lower BMI (mean reduction: 41% compared with 30%) than did gastric bypass patients 1 y after surgery. Additional dietary supplement use was more frequent among duodenal switch patients (55%) than among gastric bypass patients (26%).

Conclusions: Compared with gastric bypass, duodenal switch may be associated with a greater risk of vitamin A and D deficiencies in the first year after surgery and of thiamine deficiency in the initial months after surgery. Patients who undergo these 2 surgical interventions may require different monitoring and supplementation regimens in the first year after surgery. This trial was registered at clinicaltrials.gov as NCT00327912.