Bariatric surgery linked to vitamin D and ferritin deficiencies in adolescents

"Serum ferritin increased by 21 mcg/L after bariatric surgery in adolescents," the researchers reported. "Deficiencies of ferritin, albumin, vitamin B12, vitamin D, iron, and calcium after bariatric surgery were estimated to be 9-49% in adolescents."

The systematic review and meta-analysis study was conducted by Faraneh Zolfaghari, Shahid Beheshti University of Medical Sciences, Tehran, Iran, and colleagues to estimate changes in blood nutrient concentrations and nutrient deficiencies in adolescents following bariatric surgery. 

For this purpose, the researchers searched online databases to find studies published between 2000 and 2023. They selected observational studies reporting the mean blood concentration of nutrients before and after bariatric surgery or the proportion of nutrient deficiencies after the surgery in healthy adolescents. A total of fifteen studies were included.

Based on the study, the researchers reported the following findings:

• Gastric bypass and sleeve gastrostomy were the most common types of surgery.
• Vitamin D, iron, ferritin, vitamin B12, calcium, and folic acid were the most studied nutrients, respectively.
• Other nutrients examined in the studies included zinc, phosphorus, and albumin.
• The serum ferritin increased by 21 mcg/L (95% CI = 10.0, 32.0 mcg/L) after the surgery, but there were no significant alterations in other nutrients.
• The postoperative prevalence of low albumin, ferritin, vitamin D, and vitamin B12 levels was 10%, 49%, 41%, and 20%, respectively.
• 23% had an iron deficiency, and 10% had a calcium deficiency after bariatric surgery.

The findings revealed an increase in serum ferritin levels following bariatric surgery in adolescents. Ferritin and vitamin D deficiencies were estimated to be present in more than one-third of adolescents after the surgery.

"Our findings highlight the need for correcting and assessing adolescents' nutritional status before and after bariatric surgery to reduce nutritional deficiencies after the surgery," they concluded.

Reference:

Zolfaghari, F., Khorshidi, Y., Moslehi, N. et al. Nutrient Deficiency After Bariatric Surgery in Adolescents: A Systematic Review and Meta-Analysis. OBES SURG (2023). https://doi.org/10.1007/s11695-023-06955-y