Research Progression of Zinc Deficiency after Gastric Bypass Surgery_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

XUE Songlin ,  WANG Chongshu

Department of General Surgery， Affiliated Hospital of North Sichuan Medical College， Nanchong 637000， Sichuan Province， China;

Corresponding author：

WANG Chongshu, Email: chongshu-wang@163.com

Keywords：

Obesity; Type 2 diabetes mellitus; Gastric bypass surgery; Zinc deficiency

Video：

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Objective 　To summarize and analyze the research progression of zinc deficiency in patients with type 2 diabetes mellitus or obesity after Roux-en-Y gastric bypass （RYGB） surgery.
Method 　The domestic and international published literatures about zinc deficiency after RYGB in recent years were reviewed.
Results 　There was a degree of zinc deficiency after RYGB surgery， its mechanisms had not been fully clarified， which were related to reduced intake and absorption of zinc， protein malnutrition， dietary factors， and specific ways of surgery and the zinc supplementation programmes after operation would also affect the postoperative zinc nutritional status.
Conclusions 　Reasons for zinc deficiency after RYGB surgery are multifaceted and have not been clarified. Further research is needed to provide experimental and theoretical basis for management of zinc nutritional status after RYGB surgery.

Citation： XUE Songlin,WANG Chongshu. Research Progression of Zinc Deficiency after Gastric Bypass Surgery. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2013, 20(5): 574-578. doi: Copy

1.	中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2010年版)[J]. 中国糖尿病杂志， 2012， 20(1)：S1-S37.
2.	杨维东，刘洁生，彭喜春. 微量元素与健康[M]. 武汉：华中科技大学出版社， 2007：40-52.
3.	Pires LV， Martins LM， Geloneze B， et al. The effect of Roux-en-Ygastric bypass on zinc nutritional status[J]. Obes Surg， 2007， 17(5)：617-621.
4.	Sallé A， Demarsy D， Poirier AL， et al. Zinc deficiency：afrequent and underestimated complication after bariatric surgery[J]. Obes Surg， 2010， 20(12)：1660-1670.
5.	Dalcanale L， Oliveira CP， Faintuch J， et al. Long-term nutritional outcome after gastric bypass[J]. Obes Surg， 2010， 20(2)：181-187.
6.	沈慧，秦海宏，王福俤，等. 锌营养状况评价指标研究进展[J]. 国外医学：卫生学分册， 2006， 33(5)：291-296.
7.	Cominetti C， Garrido AB Jr， Cozzolino SM. Zinc nutritional statusof morbidly obese patients before and after Roux-en-Y gastric bypass：a preliminary report[J]. Obes Surg， 2006， 16(4)：448-453.
8.	Lowe NM， Fekete K， Decsi T. Methods of assessment of zinc status in humans：a systematic review[J]. Am J Clin Nutr， 2009， 89(6)：2040S-2051S.
9.	Maret W， Sandstead HH. Zinc requirements and the risks and benefits of zinc supplementation[J]. J Trace Elem Med Biol， 2006， 20(1)：3-18.
10.	Ruz M， Carrasco F， Rojas P， et al. Zinc absorption and zinc status are reduced after Roux-en-Y gastric bypass：a randomized study using 2 supplements[J]. Am J Clin Nutr， 2011， 94(4)：1004-1011.
11.	Rosa FT， de Oliveira-Penaforte FR， de Arruda Leme I， et al.Altered plasma response to zinc and iron tolerance test after Roux-en-Y gastric bypass[J]. Surg Obes Relat Dis， 2011， 7(3)：309-314.
12.	Rojas P， Carrasco F， Codoceo J， et al. Trace element status and inflammation parameters after 6 months of Roux-en-Y gastricbypass[J]. Obes Surg， 2011， 21(5)：561-568.
13.	Suter M， Calmes JM， Paroz A， et al. A new questionnaire for quick assessment of food tolerance after bariatric surgery[J]. Obes Surg， 2007， 17(1)：2-8.
14.	de Zwaan M， Hilbert A， Swan-Kremeier L， et al. Comprehensiveinterview assessment of eating behavior 18-35 months after gastricbypass surgery for morbid obesity[J]. Surg Obes Relat Dis， 2010， 6(1)：79-85.
15.	Ernst B， Thurnheer M， Wilms B， et al. Differential changes in dietary habits after gastric bypass versus gastric banding operations[J]. Obes Surg， 2009， 19(3)：274-280.
16.	于昱，罗绪刚，吕林，等. 动物小肠锌吸收特点及其机制的研究进展[J]. 肠外与肠内营养， 2006， 13(3)：179-183， 187.
17.	Lee HH， Prasad AS， Brewer GJ， et al. Zinc absorption in human small intestine[J]. Am J Physiol， 1989， 256(1 Pt 1)：G87-G91.
18.	Krebs NF. Overview of zinc absorption and excretion in the humangastrointestinal tract[J]. J Nutr， 2000， 130(5S Suppl)：1374S-1377S.
19.	Hambidge KM， Miller LV， Westcott JE， et al. Zinc bioavailability and homeostasis[J]. Am J Clin Nutr， 2010， 91(5)：1478S-1483S.
20.	Ponsky TA， Brody F， Pucci E. Alterations in gastrointestinal physiology after Roux-en-Y gastric bypass[J]. J Am Coll Surg， 2005， 201(1)：125-131.
21.	金瑛，马冠生. 植酸与矿物质的生物利用率[J]. 国外医学：卫生学分册， 2005， 32(3)：141-144.
22.	Troost FJ， Brummer RJ， Dainty JR， et al. Iron supplements inhibitzinc but not copper absorption in vivo in ileostomy subjects[J]. Am J Clin Nutr， 2003， 78(5)：1018-1023.
23.	Toh SY， Zarshenas N， Jorgensen J. Prevalence of nutrientdeficiencies in bariatric patients[J]. Nutrition， 2009， 25(11-12)：.
24.	施娟，陈佳慧，王崇树. 2型糖尿病外科治疗的现状与思考[J]. 川北医学院学报， 2011， 26(5)：455-458.
25.	王春敏，李丽秋. 人体肠道正常菌群的研究进展[J]. 中国微生态学杂志， 2010， 22(8)：760-762.
26.	Machado JD， Campos CS， Lopes Dah Silva C， et al. Intestinal bacterial overgrowth after Roux-en-Y gastric bypass[J]. Obes Surg， 2008， 18(1)：139-143.
27.	Lakhani SV， Shah HN， Alexander K， et al. Small intestinal bacterial overgrowth and thiamine deficiency after Roux-en-Y gastric bypass surgery in obese patients[J]. Nutr Res， 2008， 28(5)：293-298.
28.	Bal BS， Finelli FC， Shope TR， et al. Nutritional deficiencies afterbariatric surgery[J]. Nat Rev Endocrinol， 2012， 8(9)：544-556.
29.	Balsa JA， Botella-Carretero JI， Gómez-Martín JM， et al. Copperand zinc serum levels after derivative bariatric surgery：differences between Roux-en-Y gastric bypass and biliopancreatic diversion[J]. Obes Surg， 2011， 21(6)：744-750.
30.	Orci L， Chilcott M， Huber O. Short versus long Roux-limb length in Roux-en-Y gastric bypass surgery for the treatment of morbid and super obesity：a systematic review of the literature[J]. Obes Surg， 2011， 21(6)：797-804.
31.	Pinheiro JS， Schiavon CA， Pereira PB， et al. Long-long limb Roux-en-Y gastric bypass is more efficacious in treatment of type 2 diabetes and lipid disorders in super-obese patients[J]. Surg Obes Relat Dis， 2008， 4(4)：521-525.
32.	Kashyap SR， Gatmaitan P， Brethauer S， et al. Bariatric surgery for type 2 diabetes：weighing the impact for obese patients[J]. Cleve Clin J Med， 2010， 77(7)：468-476.
33.	Gasteyger C， Suter M， Gaillard RC， et al. Nutritional deficienciesafter Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation[J]. Am J Clin Nutr， 2008， 87(5)：1128-1133.
34.	Koch TR， Finelli FC. Postoperative metabolic and nutritional complications of bariatric surgery[J]. Gastroenterol Clin North Am， 2010， 39(1)：109-124.
35.	Higa K， Ho T， Tercero F， et al. Laparoscopic Roux-en-Y gastric bypass：10-year follow-up[J]. Surg Obes Relat Dis， 2011， 7(4)：516-525.
36.	刘斌，王瑜，王烈，等. 正确认识胃旁路术后并发症[J]. 中国现代普通外科进展， 2010， 13(10)：806-808.
37.	-1156.

1. 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2010年版)[J]. 中国糖尿病杂志， 2012， 20(1)：S1-S37.
2. 杨维东，刘洁生，彭喜春. 微量元素与健康[M]. 武汉：华中科技大学出版社， 2007：40-52.
3. Pires LV， Martins LM， Geloneze B， et al. The effect of Roux-en-Ygastric bypass on zinc nutritional status[J]. Obes Surg， 2007， 17(5)：617-621.
4. Sallé A， Demarsy D， Poirier AL， et al. Zinc deficiency：afrequent and underestimated complication after bariatric surgery[J]. Obes Surg， 2010， 20(12)：1660-1670.
5. Dalcanale L， Oliveira CP， Faintuch J， et al. Long-term nutritional outcome after gastric bypass[J]. Obes Surg， 2010， 20(2)：181-187.
6. 沈慧，秦海宏，王福俤，等. 锌营养状况评价指标研究进展[J]. 国外医学：卫生学分册， 2006， 33(5)：291-296.
7. Cominetti C， Garrido AB Jr， Cozzolino SM. Zinc nutritional statusof morbidly obese patients before and after Roux-en-Y gastric bypass：a preliminary report[J]. Obes Surg， 2006， 16(4)：448-453.
8. Lowe NM， Fekete K， Decsi T. Methods of assessment of zinc status in humans：a systematic review[J]. Am J Clin Nutr， 2009， 89(6)：2040S-2051S.
9. Maret W， Sandstead HH. Zinc requirements and the risks and benefits of zinc supplementation[J]. J Trace Elem Med Biol， 2006， 20(1)：3-18.
10. Ruz M， Carrasco F， Rojas P， et al. Zinc absorption and zinc status are reduced after Roux-en-Y gastric bypass：a randomized study using 2 supplements[J]. Am J Clin Nutr， 2011， 94(4)：1004-1011.
11. Rosa FT， de Oliveira-Penaforte FR， de Arruda Leme I， et al.Altered plasma response to zinc and iron tolerance test after Roux-en-Y gastric bypass[J]. Surg Obes Relat Dis， 2011， 7(3)：309-314.
12. Rojas P， Carrasco F， Codoceo J， et al. Trace element status and inflammation parameters after 6 months of Roux-en-Y gastricbypass[J]. Obes Surg， 2011， 21(5)：561-568.
13. Suter M， Calmes JM， Paroz A， et al. A new questionnaire for quick assessment of food tolerance after bariatric surgery[J]. Obes Surg， 2007， 17(1)：2-8.
14. de Zwaan M， Hilbert A， Swan-Kremeier L， et al. Comprehensiveinterview assessment of eating behavior 18-35 months after gastricbypass surgery for morbid obesity[J]. Surg Obes Relat Dis， 2010， 6(1)：79-85.
15. Ernst B， Thurnheer M， Wilms B， et al. Differential changes in dietary habits after gastric bypass versus gastric banding operations[J]. Obes Surg， 2009， 19(3)：274-280.
16. 于昱，罗绪刚，吕林，等. 动物小肠锌吸收特点及其机制的研究进展[J]. 肠外与肠内营养， 2006， 13(3)：179-183， 187.
17. Lee HH， Prasad AS， Brewer GJ， et al. Zinc absorption in human small intestine[J]. Am J Physiol， 1989， 256(1 Pt 1)：G87-G91.
18. Krebs NF. Overview of zinc absorption and excretion in the humangastrointestinal tract[J]. J Nutr， 2000， 130(5S Suppl)：1374S-1377S.
19. Hambidge KM， Miller LV， Westcott JE， et al. Zinc bioavailability and homeostasis[J]. Am J Clin Nutr， 2010， 91(5)：1478S-1483S.
20. Ponsky TA， Brody F， Pucci E. Alterations in gastrointestinal physiology after Roux-en-Y gastric bypass[J]. J Am Coll Surg， 2005， 201(1)：125-131.
21. 金瑛，马冠生. 植酸与矿物质的生物利用率[J]. 国外医学：卫生学分册， 2005， 32(3)：141-144.
22. Troost FJ， Brummer RJ， Dainty JR， et al. Iron supplements inhibitzinc but not copper absorption in vivo in ileostomy subjects[J]. Am J Clin Nutr， 2003， 78(5)：1018-1023.
23. Toh SY， Zarshenas N， Jorgensen J. Prevalence of nutrientdeficiencies in bariatric patients[J]. Nutrition， 2009， 25(11-12)：.
24. 施娟，陈佳慧，王崇树. 2型糖尿病外科治疗的现状与思考[J]. 川北医学院学报， 2011， 26(5)：455-458.
25. 王春敏，李丽秋. 人体肠道正常菌群的研究进展[J]. 中国微生态学杂志， 2010， 22(8)：760-762.
26. Machado JD， Campos CS， Lopes Dah Silva C， et al. Intestinal bacterial overgrowth after Roux-en-Y gastric bypass[J]. Obes Surg， 2008， 18(1)：139-143.
27. Lakhani SV， Shah HN， Alexander K， et al. Small intestinal bacterial overgrowth and thiamine deficiency after Roux-en-Y gastric bypass surgery in obese patients[J]. Nutr Res， 2008， 28(5)：293-298.
28. Bal BS， Finelli FC， Shope TR， et al. Nutritional deficiencies afterbariatric surgery[J]. Nat Rev Endocrinol， 2012， 8(9)：544-556.
29. Balsa JA， Botella-Carretero JI， Gómez-Martín JM， et al. Copperand zinc serum levels after derivative bariatric surgery：differences between Roux-en-Y gastric bypass and biliopancreatic diversion[J]. Obes Surg， 2011， 21(6)：744-750.
30. Orci L， Chilcott M， Huber O. Short versus long Roux-limb length in Roux-en-Y gastric bypass surgery for the treatment of morbid and super obesity：a systematic review of the literature[J]. Obes Surg， 2011， 21(6)：797-804.
31. Pinheiro JS， Schiavon CA， Pereira PB， et al. Long-long limb Roux-en-Y gastric bypass is more efficacious in treatment of type 2 diabetes and lipid disorders in super-obese patients[J]. Surg Obes Relat Dis， 2008， 4(4)：521-525.
32. Kashyap SR， Gatmaitan P， Brethauer S， et al. Bariatric surgery for type 2 diabetes：weighing the impact for obese patients[J]. Cleve Clin J Med， 2010， 77(7)：468-476.
33. Gasteyger C， Suter M， Gaillard RC， et al. Nutritional deficienciesafter Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation[J]. Am J Clin Nutr， 2008， 87(5)：1128-1133.
34. Koch TR， Finelli FC. Postoperative metabolic and nutritional complications of bariatric surgery[J]. Gastroenterol Clin North Am， 2010， 39(1)：109-124.
35. Higa K， Ho T， Tercero F， et al. Laparoscopic Roux-en-Y gastric bypass：10-year follow-up[J]. Surg Obes Relat Dis， 2011， 7(4)：516-525.
36. 刘斌，王瑜，王烈，等. 正确认识胃旁路术后并发症[J]. 中国现代普通外科进展， 2010， 13(10)：806-808.
37. -1156.

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Research Progression of Zinc Deficiency after Gastric Bypass Surgery

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