Evidence for the Necessity to Systematically Assess Micronutrient Status Prior to Bariatric Surgery

Background Bariatric surgery has been proven the most effective treatment of morbid obesity, but micronutrient deficiency following bariatric surgery is a major concern. Increasing evidence points to a generally poor micronutrient status in obese subjects. Methods We assessed micronutrient status in 232 morbidly obese subjects (BMI ≥ 35 kg/m 2 ) prior to bariatric surgery. Serum albumin, calcium, phosphate, magnesium, ferritin, hemoglobin, zinc, folate, vitamin B 12 , 25-OH vitamin D 3 , and intact parathormone (iPTH) were determined. In a sub-sample of 89 subjects, we additionally assessed copper, selenium, vitamin B 1 , B 3 , B 6 , A, and E levels. Results Deficiencies were found in 12.5% of the subjects for albumin, 8.0% for phosphate, 4.7% for magnesium, 6.9% for ferritin, 6.9% for hemoglobin, 24.6% for zinc, 3.4% for folate, and 18.1% for vitamin B 12 . In addition, 25.4% showed a severe 25-OH vitamin D 3 deficiency, which was accompanied by a secondary hyperparathyroidism in 36.6% cases. Prevalence of albumin deficiency ( p