Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Ophthalmology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
ASH 2024 Annual Meeting 2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on adolescent vaping

LIVE: Wednesday 29th January, 18:00-19:30 CET

Growing numbers of young people are using e-cigarettes, despite warnings of respiratory effects and addiction. How can doctors tackle the epidemic, and what health effects should you prepare to manage in your clinics?
ADVANCED SEARCH
Log in
Top
Obesity Surgery

04-01-2025 | Obesity | Review

Copper Deficiency: A Frequently Overlooked Complication After MBS—A Systematic Review and Meta-analysis

Authors: Bangrong Xu, Taifu Xiao, Jinze Li, Qiyu Lu, Yi Zhang, Baosheng Wan, Daoming Liang

Published in: Obesity Surgery

Login to get access

Abstract

This study reviews the prevalence of copper (Cu) deficiency in patients for metabolic and bariatric surgery (MBS), as well as the long-term outcomes related to the prevalence of Cu deficiency after undergoing MBS. A systematic literature search and meta-analysis were conducted in PubMed, Web of Science, and Scopus for articles published by August 31, 2024. The search terms included metabolic and bariatric surgery, weight loss surgery, metabolic surgery, obesity surgery, sleeve gastrectomy, gastric banding, gastric bypass, duodenal switch, duodenojejunal bypass, copper, copper deficiency, and hypocuposemia. After PRISMA screening, 43 studies with a total of 49 patients with obesity were included in this meta-analysis. The results demonstrated that the prevalence of Cu deficiency after MBS at 1-, 2-, 3-, and 4-year follow-up was found to be 16%, 28%, 21%, and 16%, respectively. Additionally, hypocuposemia was observed to be more prevalent in patients with BPD compared with other types of surgery. Copper deficiency is frequently observed in patients following MBS, particularly those who have undergone BPD procedures. Therefore, it is imperative for patients to undergo postoperative follow-up and nutritional monitoring, along with targeted interventions.
Literature
1.
Arterburn DE, Telem DA, Kushner RF, et al. Benefits and risks of bariatric surgery in adults. Jama. 2020;324(9):879.PubMedCrossRef
2.
3.
Kwon Y, Ha J, Lee Y H, et al. Comparative risk of anemia and related micronutrient deficiencies after Roux‐en‐Y gastric bypass and sleeve gastrectomy in patients with obesity: an updated meta‐analysis of randomized controlled trials. Obes Rev. 2022;23(4). https://​doi.​org/​10.​1111/​obr.​13419
4.
Gasmi A, Bjørklund G, Mujawdiya PK, et al. Micronutrients deficiencies in patients after bariatric surgery. Eur J Nutr. 2021;61(1):55–67.PubMedCrossRef
5.
Yang H, Liu C-N, Wolf RM, et al. Obesity is associated with copper elevation in serum and tissues. Metallomics. 2019;11(8):1363–71.PubMedCrossRef
6.
Altarelli M, Ben-Hamouda N, Schneider A, et al. Copper deficiency: causes, manifestations, and treatment. Nutr Clin Pract. 2019;34(4):504–13.PubMedCrossRef
7.
Rassa Shahidzadeh MD. The rationale for antibiotics in IBS. Am J Gastroenterol. 2008:???-???
8.
Stroup DF, Berlin JA, Morton SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. Jama. 2000;283(15):2008–12.PubMedCrossRef
9.
Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1.PubMedPubMedCentralCrossRef
10.
11.
Parretti HM, Subramanian A, Adderley NJ, et al. Post-bariatric surgery nutritional follow-up in primary care: a population-based cohort study. Br J Gen Pract: J R Coll Gen Pract. 2021;71(707):e441–9.CrossRef
12.
Aryannezhad S, Hosseinpanah F, Khalaj A, et al. Comparison of the one-year outcomes of bariatric surgery in adolescents and young adults: a matched case-control study, Tehran Obesity Treatment Study (TOTS). Surg Today. 2021;51(11):1764–74.PubMedCrossRef
13.
Menser T, Muniz Castro J, Lopez A, et al. Post-bariatric surgery lab tests: are they excessive and redundant? Surg Endosc. 2020;34(10):4626–31.PubMedCrossRef
14.
Calderón B, Gómez-Martín JM, Cuadrado-Ayuso M, et al. Circulating zinc and copper levels are associated with sperm quality in obese men after metabolic surgery: a pilot study. Nutrients. 2020;12(11):3354.PubMedPubMedCentralCrossRef
15.
Asghari G, Khalaj A, Ghadimi M, et al. Prevalence of micronutrient deficiencies prior to bariatric surgery: Tehran Obesity Treatment Study (TOTS). Obes Surg. 2018;28(8):2465–72.PubMedCrossRef
16.
Pellitero S, Martínez E, Puig R, et al. Evaluation of vitamin and trace element requirements after sleeve gastrectomy at long term. Obes Surg. 2017;27(7):1674–82.PubMedCrossRef
17.
Papamargaritis D, Aasheim ET, Sampson B, et al. Copper, selenium and zinc levels after bariatric surgery in patients recommended to take multivitamin-mineral supplementation. J Trace Elem Med Biol: Organ Soc Min Trace Elem (GMS). 2015;31:167–72.CrossRef
18.
de Luis DA, Pacheco D, Izaola O, et al. Micronutrient status in morbidly obese women before bariatric surgery. Surg Obes Relat Dis: Off J Am Soc Bariatric Surg. 2013;9(2):323–7.CrossRef
19.
Gletsu-Miller N, Broderius M, Frediani JK, et al. Incidence and prevalence of copper deficiency following roux-en-y gastric bypass surgery. Int J Obes. 2012;36(3):328–35.CrossRef
20.
Balsa JA, Botella-Carretero JI, GóMEZ-MARTíN JM, et al. Copper and zinc serum levels after derivative bariatric surgery: differences between Roux-en-Y Gastric bypass and biliopancreatic diversion. Obes Surg. 2011;21(6):744–50.PubMedCrossRef
21.
de Luis DA, Pacheco D, Izaola O, et al. Zinc and copper serum levels of morbidly obese patients before and after biliopancreatic diversion: 4 years of follow-up. J Gastrointest Surg: Off J Soc Surg Aliment Tract. 2011;15(12):2178–81.CrossRef
22.
de Luis DA, Pacheco D, Izaola O, et al. Clinical results and nutritional consequences of biliopancreatic diversion: three years of follow-up. Ann Nutr Metab. 2008;53(3–4):234–9.PubMedCrossRef
23.
Griffith DP, Liff DA, Ziegler TR, et al. Acquired copper deficiency: a potentially serious and preventable complication following gastric bypass surgery. Obesity. 2012;17(4):827–31.CrossRef
24.
Rounis E, Laing CM, Davenport A. Acute neurological presentation due to copper deficiency in a hemodialysis patient following gastric bypass surgery. Clin Nephrol. 2010;74(5):389–92.PubMed
25.
Goldberg ME, Laczek J, Napierkowski JJ. Copper deficiency: a rare cause of ataxia following gastric bypass surgery. Am J Gastroenterol. 2008;103(5):1318–9.PubMedCrossRef
26.
Arnold AJ, Tkach A, Wile DJ. Copper deficiency myeloneuropathy in a patient with previous bariatric surgery. Can Med Assoc J. 2019;191(31):E866–E866.CrossRef
27.
28.
29.
Shah AR, Tamhankar MA. Optic neuropathy associated with copper deficiency after gastric bypass surgery. RETIN Cases Brief Rep. 2014;8(1):73–6.PubMedCrossRef
30.
O’Donnell KB, Simmons M. Early-onset copper deficiency following Roux-en-y gastric bypass. Nutr Clin Pract. 2017;26(1):66–9.CrossRef
31.
Abusabeib A, el Ansari W, Elhag W. First case report of acquired copper deficiency following revisional single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) leading to severe pancytopenia with refractory anemia. Obes Surg. 2020;30(12):5131–4.PubMedPubMedCentralCrossRef
32.
Choi EH, Strum W. Hypocupremia-related myeloneuropathy following gastrojejunal bypass surgery. Ann Nutr Metab. 2010;57(3–4):190–2.PubMedCrossRef
33.
Btaiche IF, Yeh AY, Wu IJ, et al. Neurologic dysfunction and pancytopenia secondary to acquired copper deficiency following duodenal switch. Nutr Clin Pract. 2011;26(5):583–92.PubMedCrossRef
34.
35.
Tatineni V, An JY, Leffew MR, et al. Anemia from A to zinc: hypocupremia in the setting of gastric bypass and zinc excess. Clin Case Rep. 2020;8(4):745–50.PubMedPubMedCentralCrossRef
36.
Moon N, Aryan M, Westerveld D, et al. Clinical manifestations of copper deficiency: a case report and review of the literature. Nutr Clin Pract. 2020;36(5):1080–5.PubMedCrossRef
37.
Pineles SL, Wilson CA, Balcer LJ, et al. Combined optic neuropathy and myelopathy secondary to copper deficiency. Surv Ophthalmol. 2010;55(4):386–92.PubMedCrossRef
38.
Wilson HO, Datta DBN. Complications from micronutrient deficiency following bariatric surgery. Ann Clin Biochem: Int J Lab Med. 2014;51(6):705–9.CrossRef
39.
Robinson SD, Cooper B, Leday TV. Copper deficiency (hypocupremia) and pancytopenia late after gastric bypass surgery. Bayl Univ Med Cent Proc. 2017;26(4):382–6.CrossRef
40.
41.
Plantone D, Primiano G, Renna R, et al. Copper deficiency myelopathy: a report of two cases. J Spinal Cord Med. 2014;38(4):559–62.PubMedCrossRef
42.
King D, Siau K, Senthil L, et al. Copper deficiency myelopathy after upper gastrointestinal surgery. Nutr Clin Pract. 2017;33(4):515–9.PubMedCrossRef
43.
Alhassany AAJ. Night blindness due to vitamin A deficiency associated with copper deficiency myelopathy secondary to bowel bypass surgery. Case Rep. 2014;2014(apr29 1):bcr2013202478.
44.
45.
Yarandi SS, Griffith DP, Sharma R, et al. Optic neuropathy, myelopathy, anemia, and neutropenia caused by acquired copper deficiency after gastric bypass surgery. J Clin Gastroenterol. 2014;48(10):862–5.PubMedCrossRef
46.
Tan JC, Burns DL, Jones HR. Severe ataxia, myelopathy, and peripheral neuropathy due to acquired copper deficiency in a patient with history of gastrectomy. J Parenter Enter Nutr. 2006;30(5):446–50.CrossRef
47.
Kara M, Gundogdu Y, Karsli M, et al. Simultaneous occurrence of metabolic, hematologic, neurologic and cardiac complications after Roux-en-Y gastric bypass for morbid obesity. Clin J Gastroenterol. 2016;9(5):293–7.PubMedCrossRef
48.
49.
Dixit D, Rodriguez VI, Naumann AA, et al. Multiple micronutrient deficiencies as a long-term complication of bariatric surgery. BMJ Case Rep. 2023;16(12):e254775.PubMedCrossRef
50.
51.
52.
Muskiet FA, Muskiet FD, Meiborg G, et al. Supplementation of patients with homozygous sickle cell disease with zinc, α-tocopherol, vitamin C, soybean oil, and fish oil. Am J Clin Nutr. 1991;54(4):736–44.PubMedCrossRef
53.
Maung MT, Carlson A, Olea-Flores M, et al. The molecular and cellular basis of copper dysregulation and its relationship with human pathologies. FASEB J: Off Publ Fed Am Soc Exp Biol. 2021;35(9):e21810.CrossRef
54.
55.
Chen J, Jiang Y, Shi H, et al. The molecular mechanisms of copper metabolism and its roles in human diseases. Pflugers Arch. 2020;472(10):1415–29.PubMedCrossRef
56.
Xia C, Xiao T, Hu S, et al. Long-term outcomes of iron deficiency before and after bariatric surgery: a systematic review and meta-analysis. Obes Surg. 2023;33(3):897–910.PubMedCrossRef
57.
Lewandowski Ł, Kepinska M, Milnerowicz H. The copper-zinc superoxide dismutase activity in selected diseases. Eur J Clin Invest. 2019;49(1):e13036.PubMedCrossRef
58.
Ben-Hamouda N, Charrière M, Voirol P, et al. Massive copper and selenium losses cause life-threatening deficiencies during prolonged continuous renal replacement. Nutrition. 2017;34:71–5.PubMedCrossRef
59.
Beshgetoor D, Hambidge M. Clinical conditions altering copper metabolism in humans. Am J Clin Nutr. 1998;67(5):1017S-S1021.PubMedCrossRef
60.
61.
Nishito Y, Kambe T. Absorption mechanisms of iron, copper, and zinc: an overview. J Nutr Sci Vitaminol. 2018;64(1):1–7.PubMedCrossRef
62.
Yokoi K, Konomi A. Iron deficiency without anaemia is a potential cause of fatigue: meta-analyses of randomised controlled trials and cross-sectional studies. Br J Nutr. 2017;117(10):1422–31.PubMedCrossRef
63.
Desai V, Kaler SG. Role of copper in human neurological disorders. Am J Clin Nutr. 2008;88(3):855S-S858.PubMedCrossRef
64.
65.
66.
67.
O'Kane M, Parretti HM, Pinkney J, et al. British Obesity and Metabolic Surgery Society Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery—2020 update. Obes Rev. 2020;21(11). https://​doi.​org/​10.​1111/​obr.​13087
68.
O’Kane M, Parretti HM, Pinkney J, et al. British Obesity and Metabolic Surgery Society Guidelines on perioperative and postoperative biochemical monitoring and micronutrient replacement for patients undergoing bariatric surgery-2020 update. Obes Rev: Off J Int Assoc Study Obes. 2020;21(11):e13087.CrossRef
Metadata
Title
Copper Deficiency: A Frequently Overlooked Complication After MBS—A Systematic Review and Meta-analysis
Authors
Bangrong Xu
Taifu Xiao
Jinze Li
Qiyu Lu
Yi Zhang
Baosheng Wan
Daoming Liang
Publication date
04-01-2025
Publisher
Springer US
Published in
Obesity Surgery
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-024-07569-8
SPONSORED

Mastering chronic pancreatitis pain: A multidisciplinary approach and practical solutions

  • Webinar | 06-02-2024 | 20:00 (CET)

Severe pain is the most common symptom of chronic pancreatitis. In this webinar, experts share the latest insights in pain management for chronic pancreatitis patients. Experts from a range of disciplines discuss pertinent cases and provide practical suggestions for use within clinical practice.

Sponsored by:
  • Viatris
Developed by: Springer Healthcare
Watch now
Image Credits