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Published in: Obesity Surgery 6/2024

25-04-2024 | Obesity | Original Contributions

Changes in Nutritional Outcomes After Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis

Authors: Leizhen Duan, Yan Wang, Lingling Cheng, Jun Wang

Published in: Obesity Surgery | Issue 6/2024

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Abstract

Background

Bariatric surgery (BS) is the most effective treatment for severe obesity and it has beneficial effects on glycemic control and metabolism outcomes. However, the effects of BS on nutritional outcomes are controversial. Therefore, we aimed to evaluate the changes in several nutritional outcomes after Roux-en-Y gastric bypass (RYGB).

Methods

A comprehensive search was performed using the following databases: PubMed, Embase, Web of Science, Cochrane Library, WanFang and Chinese National Knowledge Infrastructure. The following outcomes were evaluated: vitamin A, 25-hydroxyvitamin D [25(OH)D], calcium, phosphorus, parathormone (PTH), iron, ferritin, vitamin B12, folate, and zinc. The pooled outcomes were expressed as standard mean difference (SMD) and 95% confidence interval (CI) using a random effects model.

Results

Fifty-six studies including 5645 individuals with obesity met the inclusion criteria. Serum 25(OH)D (SMD = 0.78, 95%CI 0.38 to 1.20, P < 0.001), phosphorus (SMD = 0.48, 95%CI 0.22 to 0.74, P < 0.001), PTH (SMD = 0.35, 95%CI 0.11 to 0.59, P = 0.005), vitamin B12 (SMD = 1.11, 95%CI 0.41 to 1.80, P = 0.002), and folate (SMD = 1.53, 95%CI 0.77 to 2.28, P < 0.001) significantly increased after RYGB compared with the baseline. Serum ferritin (SMD =  − 1.67, 95%CI − 2.57 to − 0.77, P < 0.001), vitamin A (SMD =  − 0.64, 95%CI − 0.99 to − 0.29, P < 0.001), and plasma zinc (SMD =  − 0.58, 95%CI − 1.09 to − 0.06, P = 0.027) significantly decreased after RYGB. No significant changes in serum calcium (SMD =  − 0.14, 95%CI − 0.40 to 0.11, P = 0.219) and iron (SMD = 0.26, 95%CI − 0.11 to 0.64, P = 0.165) were observed after RYGB.

Conclusions

Despite the increased levels of 25(OH)D, phosphorus, vitamin B12 and folate, this meta-analysis revealed the unfavorable nutritional consequences after RYGB.

Graphical Abstract

Appendix
Available only for authorised users
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Metadata
Title
Changes in Nutritional Outcomes After Roux-en-Y Gastric Bypass: A Systematic Review and Meta-Analysis
Authors
Leizhen Duan
Yan Wang
Lingling Cheng
Jun Wang
Publication date
25-04-2024
Publisher
Springer US
Published in
Obesity Surgery / Issue 6/2024
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-024-07232-2

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