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Hyperhomocysteinemia After Gastroplasty for Severe Obesity
Vitamin Deficiencies After
Instances of Hyperhomocysteinemia After Gastroplasty for Severe Obesity
Severe obesity exposes patients to an increased risk of cardiovascular mortality. Gastroplasty has been shown to induce substantial weight loss and to improve the atherogenic profile of severely obese subjects. However, vitamin deficiencies after gastroplasty have been reported. Because hyperhomocysteinemia, an independent risk factor for cardiovascular disease, is influenced by nutritional status (and especially by folate intake), we hypothesized that a marginal folate deficiency induced by gastroplasty could promote hyperhomocysteinemia.
Thus, plasma homocysteine concentrations were measured by high-performance liquid chromatography in 53 severely obese patients, before and 1 year after vertical gastroplasty.
Plasma homocysteine concentrations increased, on an average, from 9.9 ± 0.4 to 12.8 ± 0.6 µmol/L. This increase in homocysteine levels was observed in two thirds of the subjects, leading to clear-cut hyperhomocysteinemia in 32%. The changes in homocysteine concentrations were correlated to weight loss and to decrease in plasma folate concentrations. Whereas gastroplasty induced a mean 32-kg weight loss and a striking improvement in conventional risk factors, the occurrence of iatrogenic hyperhomocysteinemia might hamper the benefit of surgery on cardiovascular risk in most of the patients.
Our results further support use of a systematic efficient folate supplementation after gastroplasty.
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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2017 Bariatric-Surgery.Info - Terms - Contact - Information - Resources