Evidence for diminished B12 absorption after gastric bypass: oral supplementation does not prevent low plasma B12 levels in bypass patients.
Evidence for diminished B12 absorption after gastric bypass: oral supplementation does not prevent low plasma B12 levels in bypass patients.
复制标题
胃绕道手术后 B12 吸收减少的证据：口服补充剂并不能防止绕道手术患者血浆 B12 水平降低。
DOI：
10.1080/07315724.1992.10718193
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发表时间：
1992
影响因子：
3.5
通讯作者：
Russell,RM
中科院分区：
文献类型：
--
作者：
Provenzale,D;Reinhold,RB;Golner,B;Irwin,V;Dallal,GE;Papathanasopoulos,N;Sahyoun,N;Samloff,IM;Russell,RM
对20例胃旁路手术患者术前、术后6个月和12个月的血液进行维生素和矿物质测定。值进行了比较，在9名患者的连续的食物记录。术后，所有患者都服用了含有维生素和矿物质的推荐膳食供给量（RDA）的补充剂。体重、卡路里和蛋白质摄入量以及血清总蛋白在研究期间均下降（p <0.01）。维生素B1、B2、B6、叶酸、铁和锌的膳食摄入量下降（p <0.01），但总摄入量（即，饮食+补充剂）没有降低，但铁除外。这些营养物质的血液指标术前正常，没有下降。然而，血浆维生素B12水平从术前的385 pg/ml下降到1年时的234 pg/ml（p = 0.0064），尽管维生素B12总摄入量从2.6微克/天增加到11.7微克/天（p = 0.1173）。5例患者（27.8%）在术后1年时血浆维生素B12水平异常低; 4例患者至少服用维生素B12的RDA作为补充剂。虽然口服含有微量营养素RDA的补充剂可以防止大多数维生素和矿物质的异常血液指标，但它不足以维持约30%胃旁路手术患者的正常血浆B12水平。
Vitamin and mineral assays were performed on blood in 20 gastric bypass patients preoperatively and 6 and 12 months postoperatively. Values were compared with serial food records in nine patients. Postoperatively, all patients were prescribed a supplement containing the recommended dietary allowances (RDA) for vitamins and minerals. Weight, calorie and protein intake, and total serum protein decreased over the study interval (p less than 0.01). Dietary intakes of vitamins B1, B2, B6, folate, iron and zinc fell (p less than 0.01), but total intake (i.e., diet + supplement) did not decrease with the exception of iron. Blood indicators of these nutrients were normal preoperatively and did not decline. However, plasma vitamin B12 levels decreased from 385 pg/ml preoperatively to 234 pg/ml at 1 year (p = 0.0064), despite an increase in total vitamin B12 intake from 2.6 to 11.7 micrograms/day (p = 0.1173). Five patients (27.8%) had abnormally low plasma vitamin B12 levels at 1 year postoperatively; four were taking at least the RDA for vitamin B12 as supplements. Although oral supplementation containing the RDA for micronutrients can prevent abnormal blood indicators of most vitamins and minerals, it is insufficient to maintain normal plasma B12 levels in about 30% of gastric bypass patients.