Skip to main content

Advertisement

Log in

Trace Element Status and Inflammation Parameters after 6 Months of Roux-en-Y Gastric Bypass

  • Physiology Research
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Knowledge about the practical consequences of the nutritional status of Fe, Zn, and Cu and inflammation in obesity is limited. The objective of this study was to evaluate changes on trace element status and their potential associations with selected inflammation parameters in patients after Roux-en-Y gastric bypass (RYGBP).

Methods

Sixty-three women (mean age, 36.9 ± 9.2 years, body mass index, 43.8 ± 4.3 kg/m2) were evaluated at baseline and 6 months after RYGBP. Anthropometric (weight, waist circumference), body composition (fat mass and fat-free mass), dietary (nutrient intakes), and metabolic and inflammation (glucose, insulin, HOMA-IR, adiponectin, HDL-cholesterol, LDL-cholesterol, triglycerides, hs-CRP, leukocytes, polymorphonuclear neutrophils (PMN)) parameters were determined in addition to selected indices of Fe, Zn, and Cu status.

Results

All but one (HDL-cholesterol) metabolic and inflammation parameters had significant differences when compared before and after RYGBP. Hemoglobin, serum ferritin, the size of the rapidly exchangeable zinc pool, and plasma copper decreased after RYGBP. Plasma and hair zinc, as well as zinc protoporphyrin increased. The change in Hb was significantly associated (p < 0.05) to the change in leukocytes (r = 0.33) and adiponectin (r = −0.44). Zinc protoporphyrin change was associated to the change in PMN (r = 0.32) and HDL-cholesterol (r = −0.29). No other associations between the changes of the rest of Fe, Zn, and Cu parameters with the changes of any of the metabolic and inflammation parameters were observed.

Conclusion

RYGBP produced significant weight and fat mass losses, with improvement of metabolic and inflammation parameters. Iron, zinc, and copper status were impaired after the surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: A systematic review and meta-analysis. JAMA. 2004;292:1724–37.

    Article  PubMed  CAS  Google Scholar 

  2. Carrasco F, Klaassen J, Papapietro K, et al. Propuesta y fundamentos para una norma de manejo quirúrgico del paciente obeso (A proposal of guidelines for surgical management of obesity). Rev Méd Chile. 2004;133:699–706.

    Google Scholar 

  3. Ocón J, Pérez S, Gimeno S, et al. Eficacia y complicaciones de la cirugía bariátrica en el tratamiento de la obesidad mórbida. Nutr Hosp. 2005;20:409–14.

    Google Scholar 

  4. Sjöström L, Lindroos AK, Peltonen M, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–93.

    Article  PubMed  Google Scholar 

  5. Vásquez LA, Pazos F, Berrazueta JR, et al. Effects of changes in body weight and insulin resistance on inflammation and endothelial function in morbid obesity after bariatric surgery. J Clin Endocrinol Metab. 2005;90:316–22.

    Article  Google Scholar 

  6. Vendrell J, Broch M, Vilarrasa N, et al. Resistin, adiponectin, ghrelin, leptin and proinflammatory cytokines: relationships in obesity. Obes Res. 2004;12:962–71.

    Article  PubMed  CAS  Google Scholar 

  7. Holdstock C, Lind L, Engström BE, et al. CRP reduction following gastric bypass surgery is most pronounced in insulin-sensitive subjects. Int J Obes. 2005;29:1275–80.

    Article  CAS  Google Scholar 

  8. Williams IL, Chowienczyk PJ, Wheatcroft SB, et al. Endothelial function and weight loss in obese humans. Obes Surg. 2005;15:1055–60.

    Article  PubMed  Google Scholar 

  9. Emery CF, Fondow MD, Schneider CM, et al. Gastric bypass surgery is associated with reduced inflammation and less depression: a preliminary investigation. Obes Surg. 2007;17:759–63.

    Article  PubMed  Google Scholar 

  10. Csendes A, Burdiles P, Papapietro K, et al. Results of gastric bypass plus resection of the distal excluded gastric segment in patients with morbid obesity. J Gastrointest Surg. 2005;9:121–31.

    Article  PubMed  Google Scholar 

  11. Alvarez-Leite J. Nutrient deficiencies secondary to bariatric surgery. Curr Opin Clin Nutr Metab Care. 2004;7:569–75.

    Article  PubMed  Google Scholar 

  12. Kushner RF. Micronutrient deficiencies and bariatric surgery. Curr Opin Endocrinol Diabetes. 2006;13:405–11.

    Article  CAS  Google Scholar 

  13. Madan AK, Orth WS, Tichansky DS, et al. Vitamin and trace mineral levels after laparoscopic gastric bypass. Obes Surg. 2006;16:603–6.

    Article  PubMed  Google Scholar 

  14. Ruz M, Carrasco F, Rojas P, et al. Iron absorption and iron status are reduced after Roux-en-Y gastric bypass. Am J Clin Nutr. 2009;90:527–32.

    Article  PubMed  CAS  Google Scholar 

  15. Ruz M, Rojas P, Csendes A, et al. Bariatric surgery affects zinc and iron absorption and nutritional status in morbidly obese patients. Ann Nutr Metab 2009; 55 (suppl 1): 153 (abstract).

    Google Scholar 

  16. Krones CJ, Klosterhalfen B, Butz N, et al. Effect of zinc pretreatment on pulmonary endothelial cells in vitro and pulmonary function in a porcine model of endotoxemia. J Surg Res. 2005;123:251–6.

    Article  PubMed  CAS  Google Scholar 

  17. Uritski R, Barshack I, Bilkis I, Ghebremeskel K, Reifen R. Dietary iron affects inflammatory status in a rat model of colitis. J Nutr. 2004;134:2251–5.

    PubMed  CAS  Google Scholar 

  18. Bo S, Durazzo M, Gambino R, et al. Associations of dietary and serum copper with inflammation, oxidative stress, and metabolic variables in adults. J Nutr. 2008;138:305–10.

    PubMed  CAS  Google Scholar 

  19. National Institutes of Health Consensus Development Conference Statement. Gastrointestinal surgery for severe obesity. Am J Clin Nutr. 1992;55:615S–9S.

    Google Scholar 

  20. Buchwald H. Consensus Conference Statement Bariatric surgery for morbid obesity: Health implications for patients, health professionals, and third-party payers. J Am Coll Surg. 2005;200:593–604.

    Article  PubMed  Google Scholar 

  21. Food and Nutrition Board, Institute of Medicine. Dietary references for calcium, phosphorus, magnesium, vitamin D and fluoride. Washington, DC: National Academy Press, 1977.

  22. Food and Nutrition Board, Institute of Medicine. Dietary references for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium and zinc. Washington, DC: National Academy Press, 2001.

  23. Gibson. RS. Principles of nutritional assessment. Second edition. New York: Oxford University press, 2005.

  24. Schmidt FH. Enzymatic determination of glucose and fructose simultaneously. Klin Wochenschr. 1961;39:1244–7.

    Article  PubMed  CAS  Google Scholar 

  25. Allain CC, Poon LS, Chan CS, et al. Enzymatic determination of total cholesterol. Clin Chem. 1974;20:470–5.

    PubMed  CAS  Google Scholar 

  26. Sugiuchi H, Uji Y, Okabe H, et al. Direct measurement of high-density lipoprotein cholesterol in serum with polyethylene glycol-modified enzymes and sulfated alpha-cyclodextrin. Clin Chem. 1995;41:717–23.

    PubMed  CAS  Google Scholar 

  27. Kohlmeier M. Direct enzymic measurement of glycerides in serum and in lipoprotein fractions. Clin Chem. 1986;32:63–6.

    PubMed  CAS  Google Scholar 

  28. Resnick HE, Jones K, Ruotolo G, et al. Insulin resistance, the metabolic syndrome, and risk of incident cardiovascular disease in nondiabetic American Indians. The Strong Heart Study. Diabetes Care. 2003;26:861–7.

    Article  PubMed  Google Scholar 

  29. Eda S, Kaufmann J, Roos W, et al. Development of a new microparticle-enhanced turbidimetric assay for C-reactive protein with superior features in analytical sensitivity and dynamic range. J Clin Lab Anal. 1998;12:137–44.

    Article  PubMed  CAS  Google Scholar 

  30. Schmidt-Hebbel H, Pennacchiotti I. Tabla de composición química de alimentos Chilenos. Facultad de Ciencias Químicas y Farmacéuticas, Universidad de Chile, [Food composition table of Chilean foods]. Santiago: Faculty of Chemical and Pharmaceutical Sciences, University of Chile, 1985.

  31. Fischer DS, Price DC. A simple serum iron method using the new sensitive chromogen tripyridyl-s-triazine. Clin Chem. 1964;10:21–31.

    Article  PubMed  CAS  Google Scholar 

  32. INACG. Measurement of iron status. A report of the International Anemia Consultative Group. Washington, DC: The Nutrition Foundation, 1985.

  33. Smith JC, Butrimovitz GP, Purdy WC. Direct measurement of zinc in plasma by atomic absorption spectroscopy. Clin Chem. 1979;25:1487–91.

    PubMed  CAS  Google Scholar 

  34. Miller LV, Hambidge KM, Naake VL, et al. Size of the zinc pools that exchange rapidly with plasma zinc in humans: alternative techniques for measuring and relation to dietary zinc intake. J Nutr. 1994;124:268–76.

    PubMed  CAS  Google Scholar 

  35. Snedecor GW, Cochran WG. Statistical methods. 8th ed. Ames, Iowa: The Iowa State University Press; 1989.

    Google Scholar 

  36. Carrasco F, Papapietro K, Csendes A, et al. Changes in resting energy expenditure and body composition after weight loss following Roux-en-Y gastric bypass. Obes Surg. 2007;17:608–16.

    Article  PubMed  Google Scholar 

  37. Holdstock C, Engström BE, Öhrvall M, et al. Ghrelin and adipose tissue regulatory peptides: effect of gastric bypass in obese humans. J Clin Endocrinol Metab. 2003;88:3177–83.

    Article  PubMed  CAS  Google Scholar 

  38. Kopp HP. Krzyzanowska, Mohlig M, et al. Effects of marked weight loss on plasma levels of adiponectin, markers of chronic subclinical inflammation and insulin resistance in morbidly obese women. Int J Obes. 2005;29:766–71.

    Article  CAS  Google Scholar 

  39. Ouchi N, Kihara S, Funahashi T, et al. Reciprocal association of c-reactive protein with adiponectin in blood stream and adipose tissue. Circulation. 2003;107:671–4.

    Article  PubMed  CAS  Google Scholar 

  40. Faraj M, Havel P, Phélis S, et al. Plasma acylation-stimulating protein, adiponectin, Leptin and Ghrelin before and after weight loss induced by gastric bypass surgery in morbidly obese subjects. J Clin Endocrinol Metab. 2003;88:1594–602.

    Article  PubMed  CAS  Google Scholar 

  41. Poitou Bernert C, Ciangura C, Coupaye M, et al. Nutritional deficiency after gastric bypass: diagnosis, prevention and treatment. Diabetes Metabol. 2007;33:13–24.

    Article  CAS  Google Scholar 

  42. Mizon C, Ruz M, Csendes A, et al. Persistent anemia after Roux-en-Y gastric bypass. Nutrition. 2007;23:277–80.

    Article  PubMed  Google Scholar 

  43. Ruz M, Solomons NW, Mejia LA, et al. Alteration of circulating micronutrients with overt and occult infections in anaemic Guatemalan preschool children. Int J Food Sci Nutr. 1995;46:257–65.

    Article  PubMed  CAS  Google Scholar 

  44. Ruz M, Cavan KR, Bettger WJ, et al. Development of a dietary model for the study of mild zinc deficiency in humans and evaluation of some biochemical and functional indices of zinc status. Am J Clin Nutr. 1991;53:1295–303.

    PubMed  CAS  Google Scholar 

  45. Krebs NF, Hambidge KM, Westcott JE, et al. Exchangeable zinc pool size in infants is related to key variables of zinc homeostasis. J Nutr. 2003;133:1498S–501S.

    PubMed  CAS  Google Scholar 

  46. Krebs NF, Westcott JL, Rodden DJ, et al. Exchangeable zinc pool size at birth is smaller in small-for-gestational-age than in appropriate-for-gestational-age preterm infants. Am J Clin Nutr. 2006;84:1340–3.

    PubMed  CAS  Google Scholar 

  47. Valko M, Rhodes CJ, Moncol J, et al. Free radicals, metals and antioxidants in oxidative stress-induced cancer. Chem Bol Interact. 2006;160:1–40.

    Article  CAS  Google Scholar 

  48. Klotz LO, Kroncke KD, Buchczyk DP, et al. Role of copper, zinc, selenium and tellurium in the cellular defense against oxidative and nitrosative stress. J Nutr 2003: 1448S–1451S

  49. Powell SR. The antioxidant properties of zinc. J Nutr. 2000;130:1447S–54S.

    PubMed  CAS  Google Scholar 

  50. Reiterer G, Toborek M, Henning B. Peroxisome proliferators activated receptors alpha and gamma require zinc for their anti-inflammatory properties in porcine vascular endothelial cells. J Nutr. 2004;134:1711–5.

    PubMed  CAS  Google Scholar 

  51. Schuschke DA. Dietary copper in the physiology of the microcirculation. J Nutr. 1997;127:2274–81.

    PubMed  CAS  Google Scholar 

Download references

Acknowledgments

PR, MR, FC, MO, FP, JC, and JI participated in the study design and data interpretation. PR, JC, JI, and FC implemented the study. KB conducted the assessment and analyzed the dietary intake component. AC and JR performed the surgical procedures; KP, AC, and JR carried out the post-surgical controls. PR and MR had principal responsibility for the data analysis.

The authors thank Dr. Daniel Lopez de Romaña by reviewing the manuscript for English grammar and composition.

The authors are indebted to Dr. Guillermo Watkins, Dr. Juan C.Díaz, Dr. Fernando Maluenda, and Dr. Ittalo Braguetto from the Department of Surgery, University Clinical Hospital who performed a significant number of the surgical procedures and to the Nutritionists Ms. Emma Díaz and Ms. Andrea Riffo for their invaluable collaboration in the dietary control of the subjects. The authors thank Dr. Michael Hambidge, Dr. Nancy Krebs, Jamie Westcott, and Lei Sian from the University of Colorado, Denver, for the zinc stable isotopes determinations.

Conflict of interest disclosure

The authors have no commercial associations that might be a conflict of interest in relation to this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Manuel Ruz.

Additional information

This study was supported by the National Fund for Science and Technology, Fondecyt: Grants1080576 and 1040765.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rojas, P., Carrasco, F., Codoceo, J. et al. Trace Element Status and Inflammation Parameters after 6 Months of Roux-en-Y Gastric Bypass. OBES SURG 21, 561–568 (2011). https://doi.org/10.1007/s11695-011-0368-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-011-0368-3

Keywords

Navigation