Hair loss in sleeve gastrectomy subjects: effects of designed supplements for nutritional deficiencies

Abstract

Aim: Hair loss is a common complication after bariatric surgery that is related to nutritional deficiencies. The aim of this study was to evaluate the prevalence of micronutrient deficiencies preoperative and postoperative and their relationship with hair loss 12 months after bariatric surgery (BS) in those younger and older than 45 years of age, with or without a prescription for supplements.

Methods: In this prospective study, performed between 2018 and 2020 on patients undergoing laparoscopic sleeve gastrectomy (LSG) (not generally BS) in our hospital, the patients were categorized into two main groups of with or without a prescription for supplements. In addition, each main group was divided into age subgroups. Then, complete clinical and biological nutritional assessments were performed in these four subgroups, before and after surgery. Hair loss related to nutritional deficiencies were systematically recorded at 12 months after LSG.

Results: In total, 1224 patients undergoing LSG were enrolled into the study. Nutritional deficits in some variables were even tripled after LSG in both the younger and older groups without a prescription for supplements. In the group with a prescription for supplements, nutritional deficiencies declined postoperatively. The postoperative deficits in the group without a prescription for supplements were frequently in iron (41.83% for younger group; 44.44% for older group) and zinc (42.15% for younger group; 43.79% for older group). In the group with a prescription for supplements, hair loss was less common than in the group without a prescription for supplements postoperatively.

Conclusion: Preoperative monitoring of the combination of several nutritional deficits could be used to identify patients at risk and prevent the onset of deficiencies and their consequences after BS. Identification and correction of micronutrient deficiencies were essential for treating hair loss.

Keywords

Sleeve gastrectomy / hair loss / older ages

References

[1] Hales CM,Fryar CD.Prevalence of obesity among adults and youth: United States, 2015-2016.NCHS Data Brief2017;288:1-8

[2] Fontaine KR,Wang C,Allison DB.Years of life lost due to obesity.JAMA2003;289:187-93

[3] Berrington de Gonzalez A,Cerhan JR.Body-mass index and mortality among 1.46 million white adults.N Engl J Med2010;363:2211-9 PMCID:PMC3066051

[4] Studies Collaboration. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies.Lancet2009;373:1083-96 PMCID:PMC2662372

[5] Pischon T,Hoffmann K.General and abdominal adiposity and risk of death in Europe.N Engl J Med2008;359:2105-20

[6] Vaamonde JG.Obesidad y sobrepeso.Medicine - Programa de Formación Médica Continuada Acreditado2020;13:767-76

[7] Chooi YC,Magkos F.The epidemiology of obesity.Metabolism2019;92:6-10

[8] Fried M,Oppert JM.International Federation for Surgery of Obesity and Metabolic Disorders-European Chapter (IFSO-EC), European Association for the Study of Obesity (EASO), European Association for the Study of Obesity Obesity Management Task Force (EASO OMTF). Interdisciplinary European guidelines on metabolic and bariatric surgery.Obes Surg2014;24:42-55

[9] Campos GM,Browning MG,Mazzini GS.Changes in utilization of bariatric surgery in the United States from 1993 to 2016.Ann Surg2020;271:201-9

[10] Dogan K,Aarts EO,van Laarhoven CJHM.Long-term nutritional status in patients following Roux-en-Y gastric bypass surgery.Clin Nutr2018;37:612-7

[11] Ledoux S,Bogard C.Long-term evolution of nutritional deficiencies after gastric bypass: an assessment according to compliance to medical care.Ann Surg2014;259:1104-10

[12] Kheirvari M,Jaafarinejad H.The advantages and disadvantages of sleeve gastrectomy; clinical laboratory to bedside review.Heliyon2020;6:e03496 PMCID:PMC7052082

[13] Tabbara M,Bossi M,Genser L.Rare neurological complications after sleeve gastrectomy.Obes Surg2016;26:2843-8

[14] Punchai S,Meister KM,Brethauer SA.Neurologic manifestations of vitamin B deficiency after bariatric surgery.Obes Surg2017;27:2079-82

[15] Via MA.Nutritional and micronutrient care of bariatric surgery patients: current evidence update.Curr Obes Rep2017;6:286-96

[16] Folope V,Déchelotte P.Carences nutritionnelles liées à la chirurgie de l’obésité.Gastroentérologie Clinique et Biologique2007;31:369-77

[17] Ruiz-Tovar J,Zubiaga L.OBELCHE groupMaintenance of multivitamin supplements after sleeve gastrectomy.Obes Surg2016;26:2324-30

[18] Katsogridaki G,Sioka E.Hair loss after laparoscopic sleeve gastrectomy.Obes Surg2018;28:3929-34

[19] Kheirvari M,Eshghjoo S.Diagnostic value of erythrocyte sedimentation rate levels as a predictor of staple-line leakage in bariatric surgery.Bariatr Surg Pract Patient Care2020;15:231-5

[20] Coupaye M,Breuil MC.Comparison of nutritional status during the first year after sleeve gastrectomy and Roux-en-Y gastric bypass.Obes Surg2014;24:276-83

[21] Caron M,Lescelleur O.Long-term nutritional impact of sleeve gastrectomy.Surg Obes Relat Dis2017;13:1664-73

[22] Al-Mutawa A,Anderson AK.Evaluation of nutritional status post laparoscopic sleeve gastrectomy-5-year outcomes.Obes Surg2018;28:1473-83

[23] Pellitero S,Puig R.Evaluation of vitamin and trace element requirements after sleeve gastrectomy at long term.Obes Surg2017;27:1674-82

[24] Ruiz-tovar J,Llavero C.Hair loss in females after sleeve gastrectomy: predictive value of serum zinc and iron levels.The American Surgeon2014;80:466-71

[25] Rojas P,Basfi-fer K.Alopecia in women with severe and morbid obesity who undergo bariatric surgery.Nutr Hosp2011;26:856-62

[26] Tang L,Canner JK,Steele KE.Prevalence and predictors of postoperative thiamine deficiency after vertical sleeve gastrectomy.Surg Obes Relat Dis2018;14:943-50