Nutritional deficiencies in bariatric surgery candidates

Abstract

Background: To assess the prevalence of nutritional deficiencies amongst people who suffer from morbid obesity and are candidates for bariatric surgery and to evaluate the relations between pre-operative nutritional deficiencies and demographic data and co-morbidities.

Methods: Preoperative blood tests of 114 patients (83 women and 31 men) were collected. The blood tests included plasma chemistry (including albumin, total protein, iron, ferritin, vitamin B12, folic acid, parathyroid hormone (PTH), calcium, and phosphorous) and a blood count (for hemoglobin and mean corpuscular volume (MCV)). Demographic and socio-economic details were collected from all patients.

Results: Mean age, weight, and BMI of the patients were 38 years (15-77), 122.9 kg (87-250), and 44.3 kg/m(2) (35.3-74.9), respectively. The prevalence of pre-operative nutritional deficiencies were: 35% for iron, 24% for folic acid, 24% for ferritin, 3.6% for vitamin B12, 2% for phosphorous, and 0.9% for calcium, Hb and MCV level was low in 19%. High levels of PTH were found among 39% of the patients. No hypoalbuminemia was encountered. Low iron was more common in females relative to men (40.8 vs.14.3%, p = 0.04) as well as ferritin levels (31.8 vs. 0%, p = 0.001). Men showed a greater prevalence of anemia (35.5% and 12% respectively, p = 0.01) relative to women. Patients with BMI > 50 kg/m(2) were at greater risk for low folic acid (OR = 14.57, 95% CI:1.4-151.34). Patients with high income were less likely to have iron deficiency (OR = 0.19, 95% CI:0.038-0.971).

Conclusions: A high prevalence of nutritional deficiencies was found amongst bariatric surgery candidates suffering from morbid obesity.