SLEEVE GASTREKTOMİ OPERASYONU GEÇİREN BİREYLERDE POSTOPERATİF PROTEİN TÜKETİMİ VE GIDA TAKVİYESİ KULLANIMININ B12 VİTAMİN DEĞERLERİNE ETKİSİ

Öz

Kronik bir hastalık olan obezite, beraberinde getirdiği komplikasyonlarla birlikte yaşam şeklini olumsuz etkileyen, yüksek morbidite ve mortaliteye sebep olan bir halk sağlığı sorunudur. Bariatrik cerrahi, uzun dönemli kalıcı ağırlık kaybının sağlanmasında ve obezitenin komplikasyonlarının azaltılmasında son çare olarak etkili tedavi yöntemlerini içermektedir. Bariatrik cerrahi yöntemlerinden olan sleeve gastrektomi (SG), tüketilen gıda hacmini besin emilimini etkilemeden kısıtlayarak açlık hissinin azalmasını sağlamaktadır. Bu çalışma, sleeve gastrektomi operasyonu geçiren bireylerde ameliyat sonrası gıda takviyesi kullanım durumlarının belirlenmesi, protein tüketim miktarlarının saptanması ve B12 vitamin değerleri üzerine olan etkisini araştırmak amacıyla yapılmıştır. Ameliyat öncesi, ameliyat sonrası 3. ve 6. ay B12 vitamin değeri gıda takviyesi kullananlarda; 375,08±136,35 pg/mL, 364,80±58,75 ve 361,52±70,20 pg/mL iken gıda takviyesi kullanmayanlarda; 328,24±77,59 pg/mL, 281,28±52,48 pg/mL 269,24±46,19 pg/mL saptanmıştır. Sonuç olarak takviye kullanmayan hastalarda protein tüketimi arttıkça B12 vitamin seviyesinde ılımlı yükselme olduğu, fakat B12 vitamini referans aralığının alt sınırına yakın olduğu; gıda takviyesi kullananlarda ise vitamin B12 değerinin anlamlı düzeyde yüksek bulunduğı sonucuna varılmıştır (p<0,05).

Anahtar Kelimeler

• B12 vitamini
• Gıda Takviyesi
• Protein tüketimi
• Sleeve Gastrektomi

THE EFFECT OF PROTEIN CONSUMPTION AND FOOD SUPPLEMENTS IN USE ON VITAMIN B12 IN POSTOPERATIVE SLEEVE GASTRECTOMY SURGERY

Öz

Obesity, which is a chronic disease, is a public health problem that negatively affects the lifestyle with its complications and causes high morbidity and mortality. Bariatric surgery includes effective treatment methods as the last step in achieving long-term permanent weight loss and reducing the complications of obesity. Sleeve gastrectomy (SG), one of the bariatric surgery methods, reduces the feeling of hunger by restricting the amount of food consumed without affecting nutrient absorption. This study was carried out in order to determine the post-operative food supplement usage status, to determine the protein consumption amounts and to investigate the effect on vitamin B12 values in individuals who had undergone sleeve gastrectomy operation. Preoperative, postoperative 3- and 6- months vitamin B12 value in those using food supplements; 375,08±136,35 pg/mL, 364,80±58,75 and 361,52±70,20 pg/mL in those who did not use food supplements; It was found 328,24±77,59 pg/mL, 281,28±52,48 pg/mL 269,24±46,19 pg/mL. As a result, it was determined that as protein consumption increased in patients who did not use supplements, there was a moderate increase in vitamin B12 level, but it was close to the lower limit of the vitamin B12 reference range. It was concluded that vitamin B12 value was found to be significantly higher in those who used food supplements (p<0,05).

Anahtar Kelimeler

• vitamin B12
• Food Supplements
• Protein Consumption
• Sleeve Gastrectomy

Kaynakça

1. Abenova, U. (2021). Obezite modellemesi oluşturulmuş farelerde sistemik ve semen plazması oksidatif hasar parametreleri ilişkisi [Yüksek Lisans Tezi]. Maltepe Üniversitesi.
2. Aksoy A. (2000). Beslenme biyokimyası. Hatipoğlu Basım ve Yayım.
3. Alıç N., & Samur G. (2022). Bariatrik cerrahi sonrası malnütrisyonun değerlendirilmesi ve tedavisinde güncel yaklaşımlar. Gazi Sağlık Bilimleri Dergisi, 7(1), 112-124. https://doi.org/10.52881/gsbdergi.983017
4. Alphan, M. E. (2005). Sağlıklı beslenme sağlıklı lezzetler. Nobel Akademik Yayıncılık.
5. Atkinson, R. L. (2005). Etiologies of Obesity. In Goldstein, D. J. (Eds), The management of eating disorders and obesity (2nd ed., pp.105-118). Humana Press. https://doi.org/10.1385/1-59259-865-X:105
6. Bond, D. S., Evans, R. K., & DeMaria, E. J. (2004). A conceptual application of Health Behavior Theory in the design and implementation of a successful Surgical Weight Loss Program. Obesity Surgery, 14(6), 849-856. https://doi.org/10.1381/0960892041590917
7. Coupaye, M., Rivière, P., Breuil, M. C., Castel, B., Bogard, C., Dupré, T., Flamant, M., Msika, S., & Ledoux, S. (2014). Comparison of nutritional status during the first year after sleeve gastrectomy and Roux-en-Y gastric bypass. Obesity Surgery, 24(2), 276–283. https://doi.org/10.1007/s11695-013-1089-6.
8. Crawford, C., Gibbens, K., Lomelin, D., Krause, C., Simorov, A., & Oleynikov, D. (2017). Sleeve gastrectomy and anti-reflux procedures. Surgical Endoscopy, 31(3), 1012–1021. https://doi.org/10.1007/s00464-016-5092-6.

9. Çolak G. A., & Sağlam D (2021). Laparoskopik sleeve gastrektomi operasyonunun kısa dönemde besin alımı, biyokimyasal kan parametreleri ve antropometrik ölçümlere etkisinin değerlendirilmesi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 12(2), 291-295. https://doi.org/10.31067/acusaglik.847119
10. DeMaria, E. J., Pate, V., Warthen, M., & Winegar, D. A. (2010). Baseline data from American society for metabolic and bariatric surgery-designated bariatric surgery centers of excellence using the bariatric outcomes longitudinal database. Surgery for Obesity and Related Diseases, 6, 347-355. https://doi.org/10.1016/j.soard.2009.11.015
11. Dias, M. C., Ribeiro, A. G., Scabim, V. M., Faintuch, J., Zilberstein, B., & Gama-Rodrigues, J. J. (2006). Dietary intake of female bariatric patients after anti-obesity gastroplasty. Clinics (Sao Paulo, Brazil), 61(2), 93–98. https://doi.org/10.1590/s1807-59322006000200002.
12. Erdem, N. Z., & Kahraman, K. (2015). Bariatrik hastaların diyetlerinin izlenmesi. İçinde: E. Merdol (Ed.), Temel Beslenme ve Diyetetik (1st ed., pp.355-382). Güneş Tıp Kitabevi.
13. Ernst, B., Thurnheer, M., Schmid, S. M., & Schultes, B. (2009). Evidence for the necessity to systematically assess micronutrient status prior to bariatric surgery. Obesity surgery, 19(1), 66–73. https://doi.org/10.1007/s11695-008-9545-4.
14. İpek, E. (2019). Türkiye’de obezitenin sosyoekonomik belirleyicileri. Uluslararası İktisadi ve İdari İncelemeler Dergisi, 25, 57-70. https://doi.org/10.18092/ulikidince.536601
15. Langan, R. C., & Goodbred, A. J. (2017). Vitamin B12 Deficiency: Recognition and management. American Family Physician, 96(6), 384–389. https://www.aafp.org/pubs/afp/issues/2017/0915/p384.html?v=796834e7a283
16. Martens, J. H., Barg, H., Warren, M. J. & Jahn, D. (2002). Microbial production of vitamin B12. Applied Microbiology and Biotechnology, 58, 275-285. htpps://doi.org/10.1007/s00253-001-0902-7
17. Mechanick, J. I., Kushner, R. F., Sugerman, H. J., Gonzalez-Campoy, J. M., Collazo-Clavell, M. L., Guven, S., Spitz, A. F., Apovian, C. M., Livingston, E. H., Brolin, R., Sarwer, D. B., Anderson, W. A., & Dixon, J. (2008). American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient. Surgery for Obesity and Related Diseases, 4(5), S109-S184. https://doi.org/10.1016/j.soard.2008.08.009
18. Mechanick, J. I., Apovian, C., Brethauer, S., Garvey, W. T., Joffe, A. M., Kim, J., ... & Still, C. D. (2020). Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures–2019 update: Cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists. Surgery for Obesity and Related Diseases, 16(2), 175-247. https://doi.org/10.1016/j.soard.2019.10.025
19. Menenakos, E., Stamou, K. M., Albanopoulos, K., Papailiou, J., Theodorou, D., & Leandros, E. (2010). Laparoscopic sleeve gastrectomy performed with intent to treat morbid obesity: A prospective single-center study of 261 patients with a median follow-up of 1 year. Obesity surgery, 20(3), 276–282. https://doi.org/10.1007/s11695-009-9918-3.
20. Mihmanli, M., Isil, R. G., Bozkurt, E., Demir, U., Kaya, C., Bostanci, O., Isil, C. T., Sayin, P., Oba, S., Ozturk, F. Y., & Altuntas, Y. (2016). Postoperative effects of laparoscopic sleeve gastrectomy in morbid obese patients with type 2 diabetes. SpringerPlus, 5, 497. https://doi.org/10.1186/s40064-016-2167-8.
21. Moizé, V., Deulofeu, R., Torres, F., de Osaba, J. M., & Vidal, J. (2011). Nutritional intake and prevalence of nutritional deficiencies prior to surgery in a Spanish morbidly obese population. Obesity Surgery, 21(9), 1382–1388. https://doi.org/10.1007/s11695-011-0360-y
22. Obeid, R., Heil, S. G., Verhoeven, M. M., Van den Heuvel, E. G., De Groot, L. C., & Eussen, S. J. (2019). Vitamin B12 intake from animal foods, biomarkers, and health aspects. Frontiers in Nutrition, 6, 93. https://doi.org/10.3389/fnut.2019.00093
23. Obeidat, F. W., Shanti, H. A., Mismar, A. A., Elmuhtaseb, M. S., & Al-Qudah, M. S. (2014). Volume of resected stomach as a predictor of excess weight loss after sleeve gastrectomy. Obesity Surgery, 24(11), 1904–1908. https://doi.org/10.1007/s11695-014-1330-y
24. O’Leary, F., & Samman, S. (2010). Vitamin B12 in health and disease. Nutrients, 2(3), 299-316. https://doi.org/10.3390/nu2030299
25. Özütürker, S. (2019). Erzincan’da yaşayan yaşlı bireylerin obezite değerleri. Erzincan Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 12(2), 393-403.
26. Parrott, J., Frank, L., Rabena, R., Craggs-Dino, L., Isom, K. A., & Greiman, L. (2017). American Society for Metabolic and Bariatric Surgery Integrated Health Nutritional Guidelines for the surgical weight loss patient 2016 update: Micronutrients. Surgery for Obesity and Related Diseases, 13(5), 727–741. https://doi.org/10.1016/j.soard.2016.12.018.
27. Saber, A. A., Elgamal, M. H., & McLeod, M. K. (2008). Bariatric surgery: The past, present, and future. Obesity Surgery, 18(1), 121–128. https://doi.org/10.1007/s11695-007-9308-7
28. Sarwer, D. B., Wadden, T. A., Moore, R. H., Baker, A. W., Gibbons, L. M., Raper, S. E., & Williams, N. N. (2008). Preoperative eating behavior, postoperative dietary adherence, and weight loss after gastric bypass surgery. Surgery for Obesity and Related Diseases, 4(5), 640–646. https://doi.org/10.1016/j.soard.2008.04.013
29. Schauer, P. R., Eldar, S. M., Heneghan, H. M., & Brethauer, S. A. (2012). Metabolic surgery and control of type 2 diabetes. Translational Endocrinology & Metabolism, 3(2), 49-61.
30. Schweiger, C., Elazary, R., & Keidar, A. (2010). Effect of different bariatric operations on food tolerance and quality of eating. Obesity Surgery, 20(10), 1393- 1399. https://doi.org/10.1007/s11695-010-0233-9
31. Shah, M., Simha, V., & Garg, A. (2006). Long-term impact of bariatric surgery on body weight, comorbidities, and nutritional status. The Journal of Clinical Endocrinology and Metabolism, 91(11), 4223–4231. https://doi.org/10.1210/jc.2006-0557.
32. Tam, A. A., & Çakır, B. (2012). Birinci basamakta obeziteye yaklaşım. Ankara Medical Journal, 12(1), 37-41. https://dergipark.org.tr/en/download/article-file/19739.
33. Tucker, K. L., Rich, S., Rosenberg, I., Jacques, P., Dallal, G., Wilson, P. W., & Selhub, J. (2000). Plasma vitamin B-12 concentrations relate to intake source in the Framingham Offspring study. The American Journal of Clinical Nutrition, 71, 514–522. https://doi.org/10.1093/ajcn/71.2.514
34. T.C. Sağlık Bakanlığı. (2016). Türkiye Beslenme Rehberi TÜBER 2015. Alban Tanıtım. https://okulsagligi.meb.gov.tr/meb_iys_dosyalar/2017_01/27102535_tyrkiye_beslenme_rehberi.pdf
35. Varela, J. E., Wilson, S. E., & Nguyen, N. T. (2006). Outcomes of bariatric surgery in the elderly. The American Surgeon, 72(10), 865–869. https://doi.org/10.1177/000313480607201005.
36. Wardé-Kamar, J., Rogers, M., Flancbaum, L., & Laferrère, B. (2004). Calorie intake and meal patterns up to 4 years after Roux-en-Y gastric bypass surgery. Obesity Surgery, 14(8), 1070–1079. https://doi.org/10.1381/0960892041975668.
37. Watanabe F. (2007). Vitamin B12 sources and bioavailability. Experimental Biology and Medicine, 232, 1266-1274. https://doi.org/10.3181/0703-MR-67.