Zinc Deficiency after Gastric Bypass for Morbid Obesity: a Systematic Review.

Kamal K Mahawar, Aparna Govil Bhasker, Vivek Bindal, Yitka Graham, Usha Dudeja, Muffazal Lakdawala, Peter K Small

Journal: Obesity surgery 2017;27(2):522-529

PMID: 27885534

Abstract

Up to 50% of patients have zinc deficiency before bariatric surgery. Roux-en-Y gastric bypass (RYGB) is the commonest bariatric procedure worldwide. It can further exacerbate zinc deficiency by reducing intake as well as absorption. The British Obesity and Metabolic Surgery Society, therefore, recommends that zinc level should be monitored routinely following gastric bypass. However, the American guidance does not recommend such monitoring for all RYGB patients and reserves it for patients with 'specific findings'. This review concludes that clinically relevant Zn deficiency is rare after RYGB. Routine monitoring of zinc levels is hence unnecessary for asymptomatic patients after RYGB and should be reserved for patients with skin lesions, hair loss, pica, dysgeusia, hypogonadism or erectile dysfunction in male patients, and unexplained iron deficiency anaemia.

Address: Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK. [email protected].; Indian Bariatric Research Network, Kolkata, India. [email protected].; Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, SR1 3SD, UK. [email protected].; Indian Bariatric Research Network, Kolkata, India.; Centre for Obesity and Digestive Surgery, Mumbai, India and Institute of Minimal Invasive Surgical Sciences and Research Center, Saifee Hospital, Mumbai, India.; Institute of Minimal Access, Metabolic and Bariatric Surgery (iMAS) and Institute of Robotic Surgery (IRS), Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, 110060, India.; Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.; Department of Pharmacy, Health and Well-being, University of Sunderland, Sunderland, SR1 3SD, UK.; Super Specialty Paediatric Hospital and Post Graduate Training Institute, Sector 30, Noida, Uttar Pradesh, 201303, India.

DOI: 10.1007/s11695-016-2474-8