Nutrient Status and Supplement Use During Pregnancy Following Metabolic Bariatric Surgery: A Multicenter Observational Cohort Study.

IF 2.9 3区医学 Q1 SURGERY Obesity Surgery Pub Date : 2024-10-01 Epub Date: 2024-08-14 DOI:10.1007/s11695-024-07446-4

Laura Heusschen, Agnes A M Berendsen, Arianne C van Bon, Judith O E H van Laar, Ineke Krabbendam, Eric J Hazebroek

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Abstract

Introduction: Pregnant women with a history of metabolic bariatric surgery (MBS) are at high risk of developing nutrient deficiencies, leading to greater challenges to reach nutritional requirements. This study compared nutrient status of women using specialized "weight loss surgery" multivitamin supplementation (WLS-MVS) to those using standard supplementation (sMVS) during pregnancy following MBS.

Methods: Multicenter observational cohort study including 119 pregnant women at 41.0 (18.5-70.0) months after Roux-en-Y gastric bypass (RYGB, n = 80) or sleeve gastrectomy (SG, n = 39). Routine blood samples were analyzed every trimester (T1, T2, T3), and micronutrient serum levels were compared between WLS-MVS and sMVS users.

Results: During pregnancy after RYGB, WLS-MVS users demonstrated higher serum concentrations of hemoglobin (7.4 [7.2, 7.5] vs. 7.0 [6.8, 7.3] mmol/L), ferritin (23.2 [15.0, 35.7] vs. 13.7 [8.4, 22.4] µg/L), and folic acid (31.4 [28.7, 34.2] vs. 25.4 [21.3, 29.4] nmol/L) and lower serum vitamin B6 levels (T1: 90.6 [82.0, 99.8] vs. 132.1 [114.6, 152.4] nmol/L) compared to sMVS users. Iron deficiencies and elevated serum vitamin B6 levels were less prevalent in the WLS-MVS group. During pregnancy after SG, WLS-MVS users showed higher serum vitamin D concentrations (89.7 [77.6, 101.8] vs. 65.4 [53.3, 77.4] nmol/L) and lower serum vitamin B1 concentrations (T2: 137.4 [124.2, 150.6] vs. 161.6 [149.0, 174.1] nmol/L, T3: 133.9 [120.1, 147.7] vs. 154.7 [141.9, 167.5] nmol/L) compared to sMVS users.

Conclusion: Low maternal concentrations of micronutrients are highly prevalent during pregnancy after MBS. The use of specialized multivitamin supplementation generally resulted in higher serum levels during pregnancy compared to standard supplementation. Future research is needed to investigate how supplementation strategies can be optimized for this high-risk population.

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代谢减肥手术后妊娠期间的营养状况和补充剂使用情况：一项多中心观察队列研究。

导言：有代谢性减肥手术（MBS）史的孕妇极易出现营养素缺乏症，这给达到营养要求带来了更大的挑战。本研究比较了代谢性减重手术后怀孕期间使用专门的 "减重手术 "多种维生素补充剂（WLS-MVS）和使用标准补充剂（sMVS）的妇女的营养状况：多中心观察性队列研究：119 名孕妇在接受 Roux-en-Y 胃旁路术（RYGB，n = 80）或袖状胃切除术（SG，n = 39）后 41.0（18.5-70.0）个月时的情况。每三个月（T1、T2、T3）对常规血样进行分析，并比较WLS-MVS和sMVS使用者的微量营养素血清水平：结果：RYGB术后妊娠期间，WLS-MVS使用者的血红蛋白（7.4 [7.2, 7.5] vs. 7.0 [6.8, 7.3] mmol/L）、铁蛋白（23.2 [15.0, 35.7] vs. 13.7 [8.4, 22.4] µg/L）、叶酸（31.4 [28.7, 34.2] vs. 25.4 [21.3, 29.4] nmol/L）和血清维生素 B6 水平（T1：90.6 [82.0, 99.8] vs. 132.1 [114.6, 152.4] nmol/L）均低于 sMVS 使用者。在 WLS-MVS 组中，铁缺乏症和血清维生素 B6 水平升高的发生率较低。在 SG 后怀孕期间，WLS-MVS 使用者的血清维生素 D 浓度较高（89.7 [77.6, 101.8] vs. 65.4 [53.3, 77.4] nmol/L），血清维生素 B1 浓度较低（T2：137.4 [124.2, 150.6] vs. 161.6 [149.0, 174.1] nmol/L，T3: 133.9 [120.1, 147.7] vs. 154.7 [141.9, 167.5] nmol/L）：结论：母体微量营养素浓度过低的现象在妊娠合并甲状腺功能亢进症后的妊娠期非常普遍。与标准补充剂相比，使用专门的多种维生素补充剂通常会提高孕期血清中的微量营养素水平。未来的研究需要探讨如何针对这一高风险人群优化补充策略。

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来源期刊

Obesity Surgery 医学-外科

CiteScore

5.80

自引率

24.10%

发文量

567

审稿时长

3-6 weeks

期刊介绍： Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions. Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.