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Bariyatrik Cerrahi ve Uzun Dönem Beslenme Sorunları

Yıl 2021, Cilt: 16 Sayı: 63, 133 - 149, 30.09.2021

Öz

Bariyatrik cerrahi; obez bireylerde, vücut ağırlık kaybı, obezite ile ilişkili eşlik eden hastalıkların ve mortalitenin azaltılması ve yaşam kalitesinin iyileştirilmesi nedeniyle oldukça etkili bir tedavi olarak kabul edilmektedir. Tüm bariyatrik prosedürler, değişken derecelerde, gastrointestinal sistemin anatomisini ve fizyolojisini değiştirir; bu değişiklikler hastaları, anemi, osteoporoz, protein malnutrisyonu gibi hastalıkların oluşmasına yol açabilecek makro ve mikro besin maddelerinin eksikliklerine karşı daha duyarlı hale getirir. Çoğu obez hastanın ameliyattan önce bir takım beslenme yetersizlikleri bulunmaktadır. Bu sebeple operasyon öncesi hastalar tam bir beslenme değerlendirmesine tabi tutulmalı ve operasyon öncesi var olan bu yetersizlikler düzeltilmelidir. Bariyatrik cerrahi ile ilişkili beslenme komplikasyonları, hastanın ihtiyaçlarına göre multivitaminlerin ve mineral takviyelerinin uygulanmasıyla yaşam boyu beslenme izlenmesi ile önlenebilir. Bu çalışmada bariyatrik cerrahi sonrası meydana gelen uzun dönem komplikasyonlar hakkında literatür bilgisi derlenmiştir.

Kaynakça

  • Alvarez, V., Carrasco, F., Cuevas, A., Valenzuela, B., Muñoz, G.,…Ghiardo, D. (2016). Mechanisms Of Long-Term Weight Regain In Patients Undergoing Sleeve Gastrectomy. Nutrition, 32(3), 303-308.
  • Alwasaidi, T.A., Alahmadi, D.K., Alrufayi, B.M., Alaofi, R.K., & Almutairi, R.S. (2020). Determining The Prevalence And Causes Of Anaemia İn Patients After Bariatric Surgery İn A Saudi Hospital. Journal of Taibah University Medical Sciences, 15(2), 129-135.
  • Ayer, Ç., Özkan, D., & Tohtak, G.K. (2020). Bariatrik Cerrahi Sonrası Makro Ve Mikro Besin Ögesi Yetersizlikleri. Güncel Gastroenteroloji, 24(2), 99-102.
  • Ben-Porat, T., Weiss, R., Sherf-Dagan, S., Nabulsi, N., Maayani, A.,… Khalaileh, A. (2020). Nutritional Deficiencies In Patients With Severe Obesity Before Bariatric Surgery: What Should Be The Focus During The Preoperative Assessment?. Journal of the Academy of Nutrition and Dietetics, 120(5), 874-884.
  • Carrasco, F., Basfi-Fer, K., Rojas, P., Csendes, A., Papapietro, K.,… Codoceo, J. (2018). Calcium Absorption May Be Affected After Either Sleeve Gastrectomy Or Roux-En-Y Gastric Bypass İn Premenopausal Women: A 2-Y Prospective Study. The American Journal of Clinical Nutrition, 108(1), 24-32.
  • Chakhtoura, M.T., Nakhoul, N.N., Shawwa, K., Mantzoros, C., & Fuleihan, G. (2016). Hypovitaminosis D In Bariatric Surgery: A Systematic Review Of Observational Studies. Metabolism: Clinical and Experimental, 65(4), 574-585.
  • Chen, Y., Yang, J., Nie, X., Song, Z., & Gu, Y. (2018). Effects Of Bariatric Surgery On Change Of Brown Adipocyte Tissue And Energy Metabolism In Obese Mice. Obesity Surgery, 28(3), 820-830. Corbeels, K., Verlinden, L., Lannoo, M., Simoens, C., Matthys, C., Verstuyf, A.,… Meulemans, A. (2018). Thin Bones: Vitamin D And Calcium Handling After Bariatric Surgery. Bone Reports, 8, 57-63.
  • DiGiorgi, M. (2012). Factors Associated With Long Term Weight Regain After Bariatric Surgery. Doktora Tezi, Columbia University Behavioral Nutrition, New York.
  • Faintuch, J., Matsuda, M., Cruz, M.E.L.F., Silva, M.M., Teivelis, M.P.,… Garrido, A.B. (2004). Severe Protein-Calorie Malnutrition After Bariatric Procedures. Obesity Surgery, 14(2), 175-181.
  • Gallo, S. & Cheskin, L.J. (2020). Treatment Of Obesity: Beyond The Diet. Gastroenterology Clinics of North America,.50(1), 113-125.
  • Galyean, S., Sawant, D., & Shin, A.C. (2020). Personalized Nutrition For Management Of Micronutrient Deficiency—Literature Review İn Non-Bariatric Populations And Possible Utility İn Bariatric Cohort. Obesity Surgery, 30(9), 3570-3582.
  • Guillet, C., Masgrau, A., Mishellany-Dutour, A., Blot, A., Caille, A.,… Lyon, N. (2020). Bariatric Surgery Affects Obesity-Related Protein Requirements. Clinical Nutrition ESPEN, 40, 392-400.
  • Hathorn, K., Wang, T.J., Wong, D., Redd, W.D., McCarty, T.R.,… Wynter, J. (2020). Mo 1974 Weight Regain Following Bariatrıc Surgery: A Comparison Of Weight Loss Outcomes Among Patients Seen In Medical Vs. Endobariatric Specialty Clinics. Gastroenterology, 158(6), 997-998.
  • Hayter, J. & Thomas, A. (2021). Investigation And Management Of Anaemia. United Kingdom: Medicine-Elsevier Ltd.
  • Heber, D., Greenway, F.L., Kaplan, L.M., Livingston, E., Salvador, J.,… Still, C. (2010). Endocrine And Nutritional Management Of The Post-Bariatric Surgery Patient: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, 95(11), 4823-4843.
  • Kim, J., Nimeri, A., Khorgami, Z., Chaar, M.E., Lima, A.G., & Vosburg, R.W. (2021). Metabolic Bone Changes After Bariatric Surgery: 2020 Update, American Society For Metabolic And Bariatric Surgery Clinical Issues Committee Position Statement. Surgery for Obesity and Related Diseases, 17(1), 1-8.
  • King, W.C., Hinerman, A.S. & Courcoulas, A.P. (2020). Weight Regain After Bariatric Surgery: A Systematic Literature Review And Comparison Across Studies Using A Large Reference Sample. Surgery for Obesity and Related Diseases, 16(8), 1133-1144.
  • Ko, B.J., Myung, S.K., Cho, K.H., Park, Y.G., Kim, S.G.,… Kim, D.H. (2016). Relationship Between Bariatric Surgery And Bone Mineral Density: A Meta-Analysis. Obesity Surgery, 26(7), 1414-1421.
  • Komori, T. (2015). Animal Models For Osteoporosis. European Journal of Pharmacology, 15(759), 287-294.
  • Lauti, M., Kularatna, M., Hill, A.G., & MacCormick, A.D. (2016). Weight Regain Following Sleeve Gastrectomy-A Systematic Review. Obesity Surgery, 26(6),1326-1334.
  • Lespessailles, E., & Toumi, H. (2017). Vitamin D Alteration Associated With Obesity And Bariatric Surgery. Experimental Biology and Medicine, 242(10), 1086-1094.
  • Liu, C., Wu, D., Zhang, J.F., Xu, D., Xu, W.F.,… Chen, Y. (2016). Changes In Bone Metabolism In Morbidly Obese Patients After Bariatric Surgery: A Meta-Analysis. Obesity Surgery, 26(1), 91-97.
  • Lupoli, R., Lembo, E., Saldalamacchia, G., Avola, C.K., Angrisani, L., & Capaldo, B. (2017). Bariatric Surgery And Long-Term Nutritional Issues. World Journal of Diabetes, 8(11), 464-474.
  • Magro, D.O., Geloneze, B., Delfini, R., Pareja, B.C., Callejas, F., & Pareja, J.C. (2008). Long-term weight regain after gastric bypass: a 5-year prospective study. Obesity Surgery, 18(6), 648-651.
  • Malik, P.R.A., Doumouras, A.G., Malhan, R.S., Lee, Y., Boudreau, V.,… Barlow, K. (2020). Obesity, Cancer, and risk reduction with bariatric surgery. Surgical Clinics of North America, 101(2), 239-254.
  • Mehta, M., Istfan, N.W., & Apovian, C.M. (2020). Obesity: Overview Of Weight Management. Endocrine Practice, 27(6), 626-635. Mohapatra. S., Gangadharan, K., & Pitchumoni, C.S. (2020). Malnutrition In Obesity Before And After Bariatric Surgery. Disease-a-Month, 66(2), 100866. doi: 10.1016/j.disamonth.2019.06.008.
  • Newbury, L., Dolan, K., Hatzifotis, M., Low, N., & Fielding, G. (2003). Calcium and Vitamin D Depletion And Elevated Parathyroid Hormone Following Biliopancreatic Diversion. Obesity Surgery, 13(6), 893–895.
  • Nguyen, N.T., Blackstone, R.P., Morton, J.M., Ponce, J., & Rosenthal, R. (2020). The ASMBS Textbook Of Bariatric Surgery. Switzerland:Springer International Publishing.
  • Odom, J., Zalesin, K.C., Washington, T.L., Miller, W.W., Hakmeh, B.,… Zaremba, D.L. (2010). Behavioral Predictors Of Weight Regain After Bariatric Surgery. Obesity Surgery, 20(3), 349–356.
  • Saad, R., Habli, D., Sabbagh, R.E., & Chakhtoura, M. (2020). Bone Health Following Bariatric Surgery: An Update. Journal of Clinical Densitometry, 23(2), 165-181.
  • Santo, M.A., Riccioppo, D., Pajecki, D., Kawamoto, F., Cleva, R.,… Antonangelo, L. (2016). Weight Regain After Gastric Bypass: Influence Of Gut Hormones. Obesity Surgery, 26(5), 919-925.
  • Sarwer, D.B., Dilks, R.J., & West-Smith, L. (2011). Dietary Intake And Eating Behavior After Bariatric Surgery: Threats To Weight Loss Maintenance And Strategies For Success. Surgery for Obesity and Related Diseases, 7(5), 644-651.
  • Shah, M., Sharma, A., Wermers, R.A., Kennel, K.A., Kellogg, T.A., & Mundi, M.S. (2017). Hypocalcemia After Bariatric Surgery: Prevalence And Associated Risk Factors. Obesity Surgery, 27(11), 2905-2911.
  • Shapses, S.A., & Riedt, C.S. (2006). Bone, Body Weight, And Weight Reduction: What Are The Concerns?. Recent Advances in Nutritional Sciences, 136(6), 1453-1456.
  • Sharma, C., Kaur, A., Thind, S.S., Singh, B., & Raina, S. (2015). Advanced Glycation End-Products (Ages): An Emerging Concern For Processed Food Industries. Journal of Food Science and Technology, 52(12), 7561-7576.
  • Slater, G.H., Ren, C.J., Siegel, N., Williams, T., Barr, D.,… Wolfe, B. (2004). Serum Fat-Soluble Vitamin Deficiency And Abnormal Calcium Metabolism After Malabsorptive Bariatric Surgery. Journal of Gastrointestinal Surgery, 8(1), 48-55.
  • Sorensen, K., Herrington, H., & Kushner, R.F. (2014). Nutrition And Weight Regain In The Bariatric Surgical Patient. Kushner, R.F., & Still, C.D. (Ed.). Nutrition And Bariatric Surgery. (ss.265-281). New York: CRC Press: Taylor & Francis.
  • Steenackers, N., Van Der Schueren, B., Mertens, A., Lannoo, M., Grauwet, T., Augustijns, P., & Matthys, C. (2018). Iron Deficiency After Bariatric Surgery: What İs The Real Problem?. Proceedings of the Nutrition Society, 77(4), 445-455.
  • Wang, J., Ma, J., Yu, H., Zhang, P., Han, Z., & Bao, Y. (2019). Unacylated Ghrelin Is Correlated With The Decline Of Bone Mineral Density After Roux-En-Y Gastric Bypass In Obese Chinese With Type 2 Diabetes. Surgery for Obesity and Related Diseases, 15(9), 1473-1480.
  • Weng, T.C., Chang, C.H., Dong, Y.H., Chang, Y.C., & Chuang, L.M. (2015). Anaemia And Related Nutrient Deficiencies After Roux-En-Y Gastric Bypass Surgery: A Systematic Review And Meta-Analysis. BMJ Open, 16, 5(7). doi: 10.1136/bmjopen-2014-006964.
  • Wucher, H., Ciangura, C., Poitou, C., & Czernichow, S. (2008). Effects Of Weight Loss On Bone Status After Bariatric Surgery : Association Between Adipokines And Bone Markers. Obesity Surgery, 18(1), 58–65.
  • Yu, E.W. (2018). Bariatric Surgery: Weighing In On Bone Loss. Journal of Bone and Mineral Research, 33(6), 973-974.
  • T.C. Sağlık Bakanlığı. (2019). Türkiye beslenme ve sağlık araştırması (TBSA). https://hsgm.saglik.gov.tr/depo/birimler/saglikli-beslenme-hareketli-hayat db/Yayinlar/kitaplar/TBSA_RAPOR_KITAP_20.08.pdf.

Bariatric Surgery and Long-Term Nutrition Problems

Yıl 2021, Cilt: 16 Sayı: 63, 133 - 149, 30.09.2021

Öz

Bariatric surgery is considered to be a highly effective treatment in obese individuals, as it reduces weight loss, obesity-related concomitant diseases and mortality, and improves the quality of life. All Bariatric procedures alter, to varying degrees, the anatomy and physiology of the gastrointestinal tract; These changes make patients more susceptible to deficiencies in macro and micronutrients that can lead to diseases such as anemia, osteoporosis, protein malnutrition. Most obese patients have some nutritional deficiencies before surgery. For this reason, patients should be subjected to a full nutritional assessment before the operation and these deficiencies that exist before the operation should be corrected. Nutritional complications associated with bariatric surgery can be prevented by lifelong nutrition monitoring by administering multivitamins and mineral supplements according to the patient's needs. In this study, literature about long-term complications occurring after bariatric surgery is compiled.

Kaynakça

  • Alvarez, V., Carrasco, F., Cuevas, A., Valenzuela, B., Muñoz, G.,…Ghiardo, D. (2016). Mechanisms Of Long-Term Weight Regain In Patients Undergoing Sleeve Gastrectomy. Nutrition, 32(3), 303-308.
  • Alwasaidi, T.A., Alahmadi, D.K., Alrufayi, B.M., Alaofi, R.K., & Almutairi, R.S. (2020). Determining The Prevalence And Causes Of Anaemia İn Patients After Bariatric Surgery İn A Saudi Hospital. Journal of Taibah University Medical Sciences, 15(2), 129-135.
  • Ayer, Ç., Özkan, D., & Tohtak, G.K. (2020). Bariatrik Cerrahi Sonrası Makro Ve Mikro Besin Ögesi Yetersizlikleri. Güncel Gastroenteroloji, 24(2), 99-102.
  • Ben-Porat, T., Weiss, R., Sherf-Dagan, S., Nabulsi, N., Maayani, A.,… Khalaileh, A. (2020). Nutritional Deficiencies In Patients With Severe Obesity Before Bariatric Surgery: What Should Be The Focus During The Preoperative Assessment?. Journal of the Academy of Nutrition and Dietetics, 120(5), 874-884.
  • Carrasco, F., Basfi-Fer, K., Rojas, P., Csendes, A., Papapietro, K.,… Codoceo, J. (2018). Calcium Absorption May Be Affected After Either Sleeve Gastrectomy Or Roux-En-Y Gastric Bypass İn Premenopausal Women: A 2-Y Prospective Study. The American Journal of Clinical Nutrition, 108(1), 24-32.
  • Chakhtoura, M.T., Nakhoul, N.N., Shawwa, K., Mantzoros, C., & Fuleihan, G. (2016). Hypovitaminosis D In Bariatric Surgery: A Systematic Review Of Observational Studies. Metabolism: Clinical and Experimental, 65(4), 574-585.
  • Chen, Y., Yang, J., Nie, X., Song, Z., & Gu, Y. (2018). Effects Of Bariatric Surgery On Change Of Brown Adipocyte Tissue And Energy Metabolism In Obese Mice. Obesity Surgery, 28(3), 820-830. Corbeels, K., Verlinden, L., Lannoo, M., Simoens, C., Matthys, C., Verstuyf, A.,… Meulemans, A. (2018). Thin Bones: Vitamin D And Calcium Handling After Bariatric Surgery. Bone Reports, 8, 57-63.
  • DiGiorgi, M. (2012). Factors Associated With Long Term Weight Regain After Bariatric Surgery. Doktora Tezi, Columbia University Behavioral Nutrition, New York.
  • Faintuch, J., Matsuda, M., Cruz, M.E.L.F., Silva, M.M., Teivelis, M.P.,… Garrido, A.B. (2004). Severe Protein-Calorie Malnutrition After Bariatric Procedures. Obesity Surgery, 14(2), 175-181.
  • Gallo, S. & Cheskin, L.J. (2020). Treatment Of Obesity: Beyond The Diet. Gastroenterology Clinics of North America,.50(1), 113-125.
  • Galyean, S., Sawant, D., & Shin, A.C. (2020). Personalized Nutrition For Management Of Micronutrient Deficiency—Literature Review İn Non-Bariatric Populations And Possible Utility İn Bariatric Cohort. Obesity Surgery, 30(9), 3570-3582.
  • Guillet, C., Masgrau, A., Mishellany-Dutour, A., Blot, A., Caille, A.,… Lyon, N. (2020). Bariatric Surgery Affects Obesity-Related Protein Requirements. Clinical Nutrition ESPEN, 40, 392-400.
  • Hathorn, K., Wang, T.J., Wong, D., Redd, W.D., McCarty, T.R.,… Wynter, J. (2020). Mo 1974 Weight Regain Following Bariatrıc Surgery: A Comparison Of Weight Loss Outcomes Among Patients Seen In Medical Vs. Endobariatric Specialty Clinics. Gastroenterology, 158(6), 997-998.
  • Hayter, J. & Thomas, A. (2021). Investigation And Management Of Anaemia. United Kingdom: Medicine-Elsevier Ltd.
  • Heber, D., Greenway, F.L., Kaplan, L.M., Livingston, E., Salvador, J.,… Still, C. (2010). Endocrine And Nutritional Management Of The Post-Bariatric Surgery Patient: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, 95(11), 4823-4843.
  • Kim, J., Nimeri, A., Khorgami, Z., Chaar, M.E., Lima, A.G., & Vosburg, R.W. (2021). Metabolic Bone Changes After Bariatric Surgery: 2020 Update, American Society For Metabolic And Bariatric Surgery Clinical Issues Committee Position Statement. Surgery for Obesity and Related Diseases, 17(1), 1-8.
  • King, W.C., Hinerman, A.S. & Courcoulas, A.P. (2020). Weight Regain After Bariatric Surgery: A Systematic Literature Review And Comparison Across Studies Using A Large Reference Sample. Surgery for Obesity and Related Diseases, 16(8), 1133-1144.
  • Ko, B.J., Myung, S.K., Cho, K.H., Park, Y.G., Kim, S.G.,… Kim, D.H. (2016). Relationship Between Bariatric Surgery And Bone Mineral Density: A Meta-Analysis. Obesity Surgery, 26(7), 1414-1421.
  • Komori, T. (2015). Animal Models For Osteoporosis. European Journal of Pharmacology, 15(759), 287-294.
  • Lauti, M., Kularatna, M., Hill, A.G., & MacCormick, A.D. (2016). Weight Regain Following Sleeve Gastrectomy-A Systematic Review. Obesity Surgery, 26(6),1326-1334.
  • Lespessailles, E., & Toumi, H. (2017). Vitamin D Alteration Associated With Obesity And Bariatric Surgery. Experimental Biology and Medicine, 242(10), 1086-1094.
  • Liu, C., Wu, D., Zhang, J.F., Xu, D., Xu, W.F.,… Chen, Y. (2016). Changes In Bone Metabolism In Morbidly Obese Patients After Bariatric Surgery: A Meta-Analysis. Obesity Surgery, 26(1), 91-97.
  • Lupoli, R., Lembo, E., Saldalamacchia, G., Avola, C.K., Angrisani, L., & Capaldo, B. (2017). Bariatric Surgery And Long-Term Nutritional Issues. World Journal of Diabetes, 8(11), 464-474.
  • Magro, D.O., Geloneze, B., Delfini, R., Pareja, B.C., Callejas, F., & Pareja, J.C. (2008). Long-term weight regain after gastric bypass: a 5-year prospective study. Obesity Surgery, 18(6), 648-651.
  • Malik, P.R.A., Doumouras, A.G., Malhan, R.S., Lee, Y., Boudreau, V.,… Barlow, K. (2020). Obesity, Cancer, and risk reduction with bariatric surgery. Surgical Clinics of North America, 101(2), 239-254.
  • Mehta, M., Istfan, N.W., & Apovian, C.M. (2020). Obesity: Overview Of Weight Management. Endocrine Practice, 27(6), 626-635. Mohapatra. S., Gangadharan, K., & Pitchumoni, C.S. (2020). Malnutrition In Obesity Before And After Bariatric Surgery. Disease-a-Month, 66(2), 100866. doi: 10.1016/j.disamonth.2019.06.008.
  • Newbury, L., Dolan, K., Hatzifotis, M., Low, N., & Fielding, G. (2003). Calcium and Vitamin D Depletion And Elevated Parathyroid Hormone Following Biliopancreatic Diversion. Obesity Surgery, 13(6), 893–895.
  • Nguyen, N.T., Blackstone, R.P., Morton, J.M., Ponce, J., & Rosenthal, R. (2020). The ASMBS Textbook Of Bariatric Surgery. Switzerland:Springer International Publishing.
  • Odom, J., Zalesin, K.C., Washington, T.L., Miller, W.W., Hakmeh, B.,… Zaremba, D.L. (2010). Behavioral Predictors Of Weight Regain After Bariatric Surgery. Obesity Surgery, 20(3), 349–356.
  • Saad, R., Habli, D., Sabbagh, R.E., & Chakhtoura, M. (2020). Bone Health Following Bariatric Surgery: An Update. Journal of Clinical Densitometry, 23(2), 165-181.
  • Santo, M.A., Riccioppo, D., Pajecki, D., Kawamoto, F., Cleva, R.,… Antonangelo, L. (2016). Weight Regain After Gastric Bypass: Influence Of Gut Hormones. Obesity Surgery, 26(5), 919-925.
  • Sarwer, D.B., Dilks, R.J., & West-Smith, L. (2011). Dietary Intake And Eating Behavior After Bariatric Surgery: Threats To Weight Loss Maintenance And Strategies For Success. Surgery for Obesity and Related Diseases, 7(5), 644-651.
  • Shah, M., Sharma, A., Wermers, R.A., Kennel, K.A., Kellogg, T.A., & Mundi, M.S. (2017). Hypocalcemia After Bariatric Surgery: Prevalence And Associated Risk Factors. Obesity Surgery, 27(11), 2905-2911.
  • Shapses, S.A., & Riedt, C.S. (2006). Bone, Body Weight, And Weight Reduction: What Are The Concerns?. Recent Advances in Nutritional Sciences, 136(6), 1453-1456.
  • Sharma, C., Kaur, A., Thind, S.S., Singh, B., & Raina, S. (2015). Advanced Glycation End-Products (Ages): An Emerging Concern For Processed Food Industries. Journal of Food Science and Technology, 52(12), 7561-7576.
  • Slater, G.H., Ren, C.J., Siegel, N., Williams, T., Barr, D.,… Wolfe, B. (2004). Serum Fat-Soluble Vitamin Deficiency And Abnormal Calcium Metabolism After Malabsorptive Bariatric Surgery. Journal of Gastrointestinal Surgery, 8(1), 48-55.
  • Sorensen, K., Herrington, H., & Kushner, R.F. (2014). Nutrition And Weight Regain In The Bariatric Surgical Patient. Kushner, R.F., & Still, C.D. (Ed.). Nutrition And Bariatric Surgery. (ss.265-281). New York: CRC Press: Taylor & Francis.
  • Steenackers, N., Van Der Schueren, B., Mertens, A., Lannoo, M., Grauwet, T., Augustijns, P., & Matthys, C. (2018). Iron Deficiency After Bariatric Surgery: What İs The Real Problem?. Proceedings of the Nutrition Society, 77(4), 445-455.
  • Wang, J., Ma, J., Yu, H., Zhang, P., Han, Z., & Bao, Y. (2019). Unacylated Ghrelin Is Correlated With The Decline Of Bone Mineral Density After Roux-En-Y Gastric Bypass In Obese Chinese With Type 2 Diabetes. Surgery for Obesity and Related Diseases, 15(9), 1473-1480.
  • Weng, T.C., Chang, C.H., Dong, Y.H., Chang, Y.C., & Chuang, L.M. (2015). Anaemia And Related Nutrient Deficiencies After Roux-En-Y Gastric Bypass Surgery: A Systematic Review And Meta-Analysis. BMJ Open, 16, 5(7). doi: 10.1136/bmjopen-2014-006964.
  • Wucher, H., Ciangura, C., Poitou, C., & Czernichow, S. (2008). Effects Of Weight Loss On Bone Status After Bariatric Surgery : Association Between Adipokines And Bone Markers. Obesity Surgery, 18(1), 58–65.
  • Yu, E.W. (2018). Bariatric Surgery: Weighing In On Bone Loss. Journal of Bone and Mineral Research, 33(6), 973-974.
  • T.C. Sağlık Bakanlığı. (2019). Türkiye beslenme ve sağlık araştırması (TBSA). https://hsgm.saglik.gov.tr/depo/birimler/saglikli-beslenme-hareketli-hayat db/Yayinlar/kitaplar/TBSA_RAPOR_KITAP_20.08.pdf.
Toplam 43 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Burak Erim 0000-0003-1927-4549

Erdi Ergene 0000-0001-7555-5148

Canan Hecer 0000-0003-1156-9510

Yayımlanma Tarihi 30 Eylül 2021
Gönderilme Tarihi 7 Aralık 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 16 Sayı: 63

Kaynak Göster

APA Erim, B., Ergene, E., & Hecer, C. (2021). Bariyatrik Cerrahi ve Uzun Dönem Beslenme Sorunları. Anadolu Bil Meslek Yüksekokulu Dergisi, 16(63), 133-149.


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