Meta-analysis of effects of laparoscopic Roux-en-Y gastric bypass on multiple micro-nutrient levels in obese patients / 中华临床营养杂志

ABSTRACT

Objective:To systematically evaluate the postoperative changes in several nutrient levels in obese patients who received laparoscopic Roux-en-Y gastric bypass (LRYGB).Methods:CNKI, Wan Fang, Pubmed, Web of Science and Cochrane library databases were systematically searched and studies were included based on inclusion and exclusion criteria. The Stata 11.0 was used for meta-analysis.Results:A total of 37 studies including 3 282 individuals with obesity were eligible for analysis. A significant decrease was observed after LRYGB in serum vitamin A ( SMD = -0.56, 95% CI: -0.82 to -0.31, P < 0.001), zinc ( SMD = -0.45, 95% CI: -0.89 to -0.01, P = 0.047) and iron ( SMD = -0.44, 95% CI: -0.81 to 0.62, P = 0.021). A significant increase in serum folic acid ( SMD = 0.81, 95% CI: 0.32 to 1.30, P = 0.001) and vitamin D ( SMD = 0.35, 95% CI: 0.11 to 0.58, P = 0.004) was found after laparoscopic RYGB. No significant changes in serum vitamin B 12 ( SMD = -0.22, 95% CI: -0.65 to 0.21, P = 0.309) and calcium ( SMD = -0.13, 95% CI: -0.47 to 0.22, P = 0.470) were observed. Conclusions:The changes in serum nutrient indicators in obese patients after LRYGB were not consistent in trend. The levels of vitamin A, serum iron and serum zinc were significantly decreased, while the levels of vitamin D and folic acid were significantly increased. Levels of calcium and vitamin B 12 showed no significant changes. Therefore, close monitoring of the nutritional indicators and appropriate use of nutrient supplements are recommended, in order to prevent postoperative nutritional deficiencies.