Prevalence and Determinants of Nutritional Deficiencies at Mid-Term After Sleeve Gastrectomy

Background Several studies reported a risk of nutritional deficiencies after sleeve gastrectomy (SG). Systematic long-term multivitamin (MV) supplementation after SG is recommended by guidelines but not followed in practice in France. Objectives To assess the determinants of nutritional status at 2 years or more after SG in patients treated or not with MV. Methods Nutritional parameters were prospectively recorded in our database from 2004. All patients who came back in our institution for follow-up at 2 years or more after SG were included. The last visit available was selected. Systematic MV was stopped at 1 year after SG except if there is risk of malnutrition. A deficiency was defined by a biological deficit or the need for a specific supplement, prescribed in accordance with biological deficit. Results One hundred forty-seven patients were included with a mean follow-up of 44 +/- 17 months: 39 were still taking MV and 108 had stopped MV. Caloric and protein intake was lower, and albumin deficiencies were more frequent in patients still taking MV, as expected. The total number of deficiencies was not significantly different before and after SG even in patients without MV (3.7 +/- 1.8 vs. 3.5 +/- 1.8), but patients without MV tended to have more group B vitamin deficiencies after surgery. The main determinants of postoperative deficiencies were preoperative concentrations. Conclusion Nutritional deficiencies are not more common after than before SG, even among patients who stopped MV. The interest of targeted supplementation in patients with deficiencies rather than systematic supplementation after SG needs to be confirmed by randomized studies.