Investigating the Prevalence of Copper and Zinc Abnormalities in Patients Pre and Post bariatric Surgery-an Australian Experience

Introduction: Bariatric surgery predisposes patients to nutritional deficiencies. There are limited studies on zinc and copper abnormalities in this cohort.

Purpose: The aim of this study was to identify the prevalence of these abnormalities in a cohort of Australian bariatric patients. Inflammatory markers, adherence to multivitamin supplementation (MVS) and the presence of gastrointestinal (GI) symptoms were also investigated.

Material and methods: Data was collected on all patients who attended a single clinic in Sydney, Australia, from August 2020 to August 2021.

Results: The study cohort consisted of 231 patients (76.2% female; mean pre-operative body mass index of 43.4 ± 7.1 kg/m²), most of whom underwent sleeve gastrectomy (78.8%). Data were collected preoperatively and then at ≤ 6 months, 1 and > 2 years postoperatively. Prior to surgery, low levels of zinc (2.1%) and copper (0.7%) were rare, but elevated copper levels were common (16.7%) and potentially related to an elevated C-reactive protein (CRP) (47.7%). Following surgery at > 2 years, the mean total weight loss (TWL) was 33.5 ± 12.4. CRP levels improved over time. Post operatively, low zinc (2.7-3.6%) and copper (1.5%) levels were rare. Patients with low levels in zinc and copper were a higher-risk group and generally exhibited GI symptoms, despite taking MVS.

Conclusion: In the initial post-operative stages and with good adherence to MVS containing copper and zinc, abnormalities may not be a concern. Patients with GI symptoms appear to be at higher risk of abnormalities; increasing awareness, thorough screening, and more comprehensive supplementation are recommended.