Evaluación a largo plazo del estado nutricional, composición corporal y densidad mineral ósea en mujeres operadas de bypass gástrico: impacto del nivel socioeconómico

Abstract

Roux-en-Y gastric bypass (RYGBP) has had a positive impact on co-morbidities associated with obesity. However, in the long-term it can induce micronutrient deficiencies. Aim: To perform a complete nutritional assessment in a group of women previously operated of RYGBP, from different socioeconomic levels (SEL). Patients and Methods: Thirty three women (19 high SEL and 14 low SEL), were assessed by dietary recalls, anthropometric measurements, muscle strength, bone mineral density, routine clinical laboratory, serum levels of vitamin B12, 25OHvitamin D, folate, calcium, ferritine, ceruloplasmin and indicators of bone turnover (parathohormone, osteocalcin and urinary pyridinolines). Their values were compared to those of 30 control women (18 high SEL and 12 low SEL). Results: Low SEL operated women consumed fewer vitamin and mineral supplements compared with their high SEL pairs. No cases of vitamin B12, folic acid or copper deficiencies were detected. Frequency of iron deficiency was similar in patients and controls. Vitamin D insufficiency was higher among patients than in controls (p =0,047), regardless SEL. Patients had also a higher frequency of high serum PTH and osteocalcin and urinary pyridinoline levels. However, no differences in bone mineral density were observed between operated women and controls. Conclusions: Vitamin and mineral deficiencies were lower than expected among operated women. However, problems associated with vitamin D deficiency were highly prevalent among patients operated of RYGBP, irrespective SEL. These alterations were only detectable through specific markers at this stage, because they did not translate into lower bone mineral density (BMD) of surgical patients, probably due to the higher pre-operative BMD of these morbid obese patients