Prevalence of Micronutrient Deficiencies in Preoperative Bariatric Patients in a New Zealand Tertiary Centre

Authors List

Jeram, M., Counties Manukau District Health Board, Auckland, New Zealand  Coomarasamy, C., Counties Manukau District Health Board, Auckland, New Zealand  MacCormick, A., The University of Auckland, Auckland New Zealand; Counties Manukau District Health Board, Auckland, New Zealand

Introduction: A potential complication of bariatric surgery is the development of nutritional deficiencies.  It is important to detect micronutrient deficiency preoperatively to prevent worsening deficiency postoperatively (1).

Aims: To assess prevalence of micronutrient deficiencies in preoperative bariatric patients in a multi-ethnic New Zealand cohort and to examine for ethnic differences. 

Methods: Retrospective analysis of 573 patients that underwent bariatric surgery at Counties Manukau District Health Board was carried out. Mean preoperative levels of albumin, calcium, phosphate, folate, vitamin B12, vitamin D, magnesium, haemoglobin, haematocrit, mean cell volume, mean cell haemoglobin, ferritin, iron and transferrin were compared across ethnicities. Chi square, fisher exact test and multiple logistic regression was used to assess for differences in prevalence of micronutrient deficiencies across ethnicities.

Results: The most common micronutrient deficiency was vitamin D (30.85%). There were statistically significant differences in vitamin­ D deficiency across ethnicites (p <0.0001). Asians had the highest prevalence of vitamin D deficiency (60%), followed by Pacifica (44.57%) and Māori (31.68%). Asians were more likely to have vitamin D deficiency compared to NZ Europeans (OR = 14.93, p <0.001). Vitamin D deficiency was associated with higher BMI (OR = 1.05, p = 0.008). The second most common deficiency was iron (21.1%). Asians had the highest prevalence of iron deficiency (44%), followed by Māori (27.95%), and Pacifica (19.57%) (p=0.0064). Compared to NZ Europeans, Asians (OR = 4.26) and Māori (OR = 1.78) were more likely to be iron deficient (p = 0.004). Female gender was associated with iron deficiency (OR = 2.12, p = 0.007).

Conclusion: Vitamin D and iron are the most common micronutrient deficiencies among preoperative bariatric patients in this cohort and ethnic differences were seen. There may be a role for preoperative supplementation for these at-risk ethnic groups. 

1.    Al-Mutawa, A., et al., Nutritional Status of Bariatric Surgery Candidates. Nutrients, 2018. 10(1).

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