Protein malnutrition incidence comparison after gastric bypass versus biliopancreatic diversion

Background: bariatric surgery is widely employed nowadays. Nutritional complications following malabsorptive bariatric surgery are common. Objectives: to compare protein malnutrition incidence, the amount of protein intake and the influence of various risk factors in patients undergoing Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD). Methods: retrospective study comparing the development of hypoalbuminemia in 92 patients undergoing BPD and 121 RYGB, before surgery and 3, 6, 12, 18 and 24 months after it. Protein intake was estimated by serum prealbumin. The influence of prior body mass index (BMI), age and sex was analyzed. Results: hypoprealbuminemia was found in around 40% of patients 3 months after both procedures, decreasing to about 10% after 2 years of surgery. Hypoalbuminemia incidence was close to 20% in the first post-surgery year in BPD, persisting in 10-15% of cases thereafter. After RYGB, hypoalbuminemia incidence was lower (5-9% in all postoperative follow-up measurements). During the first year after surgery, hypoalbuminemia was more frequent after BPD than after RYGB (at the 3rd month (OR:3.9; p=0.006; 95%CI:1.5-10.4), 6th (OR:5.0; p=0.002; 95% CI:1.8-13.8), and at the 12th month (OR:4.4;p=0.007;95%;CI:1.5-12.8)), but not after the first year. A higher preoperative BMI favored it (OR: 1.03; p=0.046; 95% CI:1-1.06), as well as greater age during the first 6 months. Conclusion: Patients with BPD had a higher risk for hypoproteinemia than those undergoing RYGB, especially during the first year post-surgery. Higher preoperative BMI, and age (in the short-term period) could have a significant inverse relation to hypoproteinemia.

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Main Authors: Suárez Llanos,José Pablo, Fuentes Ferrer,Manuel, Álvarez-Sala-Walther,Luis, García Bray,Bruno, Medina González,Laura, Bretón Lesmes,Irene, Moreno Esteban,Basilio
Format: Digital revista
Language:English
Published: Grupo Arán 2015
Online Access:http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112015000700013
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spelling oai:scielo:S0212-161120150007000132018-02-10Protein malnutrition incidence comparison after gastric bypass versus biliopancreatic diversionSuárez Llanos,José PabloFuentes Ferrer,ManuelÁlvarez-Sala-Walther,LuisGarcía Bray,BrunoMedina González,LauraBretón Lesmes,IreneMoreno Esteban,Basilio Obesity Bariatric surgery Protein malnutrition Prealbumin Serum albumin Background: bariatric surgery is widely employed nowadays. Nutritional complications following malabsorptive bariatric surgery are common. Objectives: to compare protein malnutrition incidence, the amount of protein intake and the influence of various risk factors in patients undergoing Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD). Methods: retrospective study comparing the development of hypoalbuminemia in 92 patients undergoing BPD and 121 RYGB, before surgery and 3, 6, 12, 18 and 24 months after it. Protein intake was estimated by serum prealbumin. The influence of prior body mass index (BMI), age and sex was analyzed. Results: hypoprealbuminemia was found in around 40% of patients 3 months after both procedures, decreasing to about 10% after 2 years of surgery. Hypoalbuminemia incidence was close to 20% in the first post-surgery year in BPD, persisting in 10-15% of cases thereafter. After RYGB, hypoalbuminemia incidence was lower (5-9% in all postoperative follow-up measurements). During the first year after surgery, hypoalbuminemia was more frequent after BPD than after RYGB (at the 3rd month (OR:3.9; p=0.006; 95%CI:1.5-10.4), 6th (OR:5.0; p=0.002; 95% CI:1.8-13.8), and at the 12th month (OR:4.4;p=0.007;95%;CI:1.5-12.8)), but not after the first year. A higher preoperative BMI favored it (OR: 1.03; p=0.046; 95% CI:1-1.06), as well as greater age during the first 6 months. Conclusion: Patients with BPD had a higher risk for hypoproteinemia than those undergoing RYGB, especially during the first year post-surgery. Higher preoperative BMI, and age (in the short-term period) could have a significant inverse relation to hypoproteinemia.Grupo AránNutrición Hospitalaria v.32 n.1 20152015-07-01journal articletext/htmlhttp://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112015000700013en
institution SCIELO
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country España
countrycode ES
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libraryname SciELO
language English
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author Suárez Llanos,José Pablo
Fuentes Ferrer,Manuel
Álvarez-Sala-Walther,Luis
García Bray,Bruno
Medina González,Laura
Bretón Lesmes,Irene
Moreno Esteban,Basilio
spellingShingle Suárez Llanos,José Pablo
Fuentes Ferrer,Manuel
Álvarez-Sala-Walther,Luis
García Bray,Bruno
Medina González,Laura
Bretón Lesmes,Irene
Moreno Esteban,Basilio
Protein malnutrition incidence comparison after gastric bypass versus biliopancreatic diversion
author_facet Suárez Llanos,José Pablo
Fuentes Ferrer,Manuel
Álvarez-Sala-Walther,Luis
García Bray,Bruno
Medina González,Laura
Bretón Lesmes,Irene
Moreno Esteban,Basilio
author_sort Suárez Llanos,José Pablo
title Protein malnutrition incidence comparison after gastric bypass versus biliopancreatic diversion
title_short Protein malnutrition incidence comparison after gastric bypass versus biliopancreatic diversion
title_full Protein malnutrition incidence comparison after gastric bypass versus biliopancreatic diversion
title_fullStr Protein malnutrition incidence comparison after gastric bypass versus biliopancreatic diversion
title_full_unstemmed Protein malnutrition incidence comparison after gastric bypass versus biliopancreatic diversion
title_sort protein malnutrition incidence comparison after gastric bypass versus biliopancreatic diversion
description Background: bariatric surgery is widely employed nowadays. Nutritional complications following malabsorptive bariatric surgery are common. Objectives: to compare protein malnutrition incidence, the amount of protein intake and the influence of various risk factors in patients undergoing Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion (BPD). Methods: retrospective study comparing the development of hypoalbuminemia in 92 patients undergoing BPD and 121 RYGB, before surgery and 3, 6, 12, 18 and 24 months after it. Protein intake was estimated by serum prealbumin. The influence of prior body mass index (BMI), age and sex was analyzed. Results: hypoprealbuminemia was found in around 40% of patients 3 months after both procedures, decreasing to about 10% after 2 years of surgery. Hypoalbuminemia incidence was close to 20% in the first post-surgery year in BPD, persisting in 10-15% of cases thereafter. After RYGB, hypoalbuminemia incidence was lower (5-9% in all postoperative follow-up measurements). During the first year after surgery, hypoalbuminemia was more frequent after BPD than after RYGB (at the 3rd month (OR:3.9; p=0.006; 95%CI:1.5-10.4), 6th (OR:5.0; p=0.002; 95% CI:1.8-13.8), and at the 12th month (OR:4.4;p=0.007;95%;CI:1.5-12.8)), but not after the first year. A higher preoperative BMI favored it (OR: 1.03; p=0.046; 95% CI:1-1.06), as well as greater age during the first 6 months. Conclusion: Patients with BPD had a higher risk for hypoproteinemia than those undergoing RYGB, especially during the first year post-surgery. Higher preoperative BMI, and age (in the short-term period) could have a significant inverse relation to hypoproteinemia.
publisher Grupo Arán
publishDate 2015
url http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112015000700013
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