Endocrine Abstracts

Aim: Nutritional abnormalities are common after bariatric surgery and it is vitally important to assess and replace them pre-operatively to ease management post-operatively. The aim of our study was to assess the prevalence of various metabolic abnormalities at first visit to a tertiary combined bariatric endocrine clinic.

Methods: Data was collected on 200 patients referred for consideration of bariatric surgery. Being a retrospective analysis and therefore accepting the limitation of availability of all data on every patient, further statistical evaluation was done.

Results: Mean weight was 139 kg, mean BMI was 50.1 kg/m².

Haemoglobin <12 gm/dl in 6.1% (one microcytic and 11 normocytic).

B12 deficiency in 2% (none of these patient anaemic).

Folate deficiency in 14.5% (none of these patient anaemic).

Albumin <35 g/l in 14.5%.

Total cholesterol >5 mmol/l in 41.3%.

Alanine transaminase >40 IU/l in 29%.

Adjusted calcium deficient in 6.1%; vitamin D deficient in 41.4% (only 6% of these had low calcium); and PTH levels consistent with secondary hyperaparathyroidism in 46.0%.

Thyroid checked: 13.2% had pre-existent thyroid abnormality and 3% subclinical hypothyroidism.

Conclusion: A significant proportion of patients referred for assessment for bariatric surgery have myriad of biochemical abnormalities. Low levels of micronutrients may not manifest as hard biochemical end points in most patients. It is therefore vitally important that nutritional deficiencies and biochemical changes are actively assessed and identified, investigated and treated as appropriate in patients with morbid obesity, before proceeding with bariatric surgery.