代谢手术即减重手术，是目前治疗病态肥胖的方法。作者对目前接受代谢手术者术前、术后最常见的10种营养元素，包括维生素B₁₂、维生素B₁、叶酸、铁、锌、维生素A、维生素D、钙、铜和蛋白质状况的研究进行综述。接受手术者维生素B₁₂、维生素D、铁和钙的缺乏最为常见；术前、术后定期对营养元素的监测是必要的，对患者的饮食和营养指导应该持续终身。

[1] ANGRISANI L,SANTONICOLA A,LOVINO P,et al.Bariatric surgery worldwide 2013[J].Obes Surg,2015,25(10):1822-1832.
[2] WANG M C,GUO X H,ZHANG Y W,et al.Laparoscopic Roux-en-Y gastric bypass versus sleeve gastrectomy for obese patients with Type 2 diabetes:a meta-analysis of randomized controlled trials[J].Am Surg,2015,81(2):166-171.
[3] CHANG S H,STOLL C R,SONG J,et al.The effectiveness and risks of bariatric surgery:an updated systematic review and meta-analysis,2003-2012[J].JAMA Surg,2014,149(3):275-287.
[4] ARTEAGA G I,MARTIN M A,MARTIN P J,et al.Usefulness of clinical signs and diagnostic tests for suspected leaks in bariatric surgery[J].Obes Surg,2015,25(9):1680-1684
[5] SPIEKER H,DIETRICH A.Bleeding complications in bariatric surgery:prophylaxis and therapy[J].Chirurg,2015,86(9):833-840.
[6] FUJIOKA K,DIBAISE J K,MARTINDALE R G.Nutrition and metabolic complications after bariatric surgery and their treatment[J].JPEN,2011,35(5 Suppl):52S-59S.
[7] MAJUMDER S,SORIANO J,LOUIE C A,et al.Vitamin B12 deficiency in patients undergoing bariatric surgery:preventive strategies and key recommendations[J].Surg Obes Relat Dis,2013,9(6):1013-1019.
[8] SHILEN V,LAKHANI A,HIRAL N,et al.Small intestinal bacterial overgrowth and thiamine deficiency after Roux-en-Y gastric bypass surgery in obese patients[J].Nutrition Research Volume,2008,5:293-298.
[9] HUNT A,HARRINGTON D,ROBINSON S.Vitamin B₁₂ deficiency[J].BMJ,2014,349:g5226.
[10] LANGAN R C,ZAWISTOSKI K J.Update on vitamin B12 deficiency[J].Am Fam Physician,2011,83(12):1425-1430.
[11] AILLS L,BLANKENSHIP J,BUFFINGTON C,et al.ASMBS allied health nutritional guidelines for the surgical weight loss patient[J].Surg Obes Relat Dis,2008,4(5 Suppl):S73-108.
[12] KUMAR S A.Prevention and treatment of peripheral neuropathy after bariatric surgery[J].Curr Treat Options Neurol,2010,12(1):29-36.
[13] PEREIRA S M,COSTA P R,ASSIS A M,et al.Obesity and vitamin D deficiency:a systematic review and meta-analysis[J].Obes Rev,2015,16(4):341-349.
[14] WORTSMAN J,MATSUOKA L Y,CHEN T C,et al.Decreased bioavailability of vitamin D in obesity[J].Am J Clin Nutr,2000,72:690-693.
[15] RADMILA L,SILVERMAN J B,JENNIFER G,et al.Pharmacotherapy prevention and management of nutritional deficiencies post Roux-en-Y gastric bypass[J].Obes Surg,2013,23:992-1000.
[16] van der BEEK E S,VALERIE M M,INGO E,et al.Nutritional deficiencies in gastric bypass patients;Incidence,time of occurrence and implications for post-operative surveillance[J].Obes Surg,2015,25(5):818-823.
[17] JAUREFUI L.Iron deficiency and bariatric surgery[J].Nutrients,2013,5(5):1595-1608.
[18] VANESSA P,ROMAIN C,GERALDINE P,et al.Iron deficiency:From diagnosis to treatment[J].Digestive and Liver Disease,2013,45(10):803-809.
[19] BORDALO L A,TEIXIERA T F,BRESSAN J,et al.Bariatric surgery:how and why to supplement[J].Rev Assoc Med Bras,2011,57(1):113-120.
[20] HASLAM N,PROBERT C S.An audit of the investigation and treatment of folic acid deficiency[J].J R Soc Med,1998,91(2):72-73.
[21] KERNS J C,ARUNDEL C,CHAWLA L S.Thiamin deficiency in people with obesity[J].Adv Nutr,2015,6(2):147-153.
[22] THORNALLEY P J,BABAEI J R,AI A H,et al.High prevalence of low plasma thiamine concentration in diabetes linked to a marker of vascular disease[J].Diabetologia,2007,50:2164-2170.
[23] SHAH H N,BAL B S,FINELLI F C,et al.Constipation in patients with thiamine deficiency after Roux-en-Y gastric bypass surgery[J].Digestion,2013,88:119-124.
[24] WALKER J,KEPNER A.Wernicke's encephalopathy presenting as acute psychosis after gastric bypass[J].J Emerg Med,2012,43(5):811-814.
[25] SHANKAR P,BOYLAN M,SRIRAM K.Micronutrient deficiencies after bariatric surgery[J].Nutrition,2010,26(11-12):1031-1037.
[26] CHAVES G V,PEREIRA S E,SABOYA C J,et al.Nutritional Status of vitamin A in morbid obesity before and after Roux-en-Y gastric bypass[J].Obes Surg,2007,17(7):970-976.
[27] CLEMENTS R H,KATASANI V G,PALEPU R,et al.Incidence of vitamin deficiency after laparoscopic Roux-en-Y gastric bypass in a university hospital setting[J].Am Surg,2006,72(12):1196-1202.
[28] SALLE A,DEMARSY D,POIRIER A L,et al.Zinc deficiency:a frequent and underestimated complication after bariatric surgery[J].Obes Surg,2010,20(12):1660-1670.
[29] CASTILLO D C,WEISSTAUB G.Zinc supplementation and growth of the fetus and low birth weight infant[J].J Nutr,2003,133:1494-1497.
[30] GRIFFITH D P,LIFF D A,ZIEGLER T R,et al.Acquired copper deficiency:a potentially serious and preventable complication following gastric bypass surgery[J].Obesity,2009,17(4):827-831.
[31] HEBER D,GREENWAY F L,KAPLAN L M,et al.Endocrine and nutritional management of the post-bariatric surgery patient:an endocrine society clinical practice guideline[J].J Clin Endocrinol Metab,2010,95(11):4823-4843.
[32] 郑成竹,丁丹.中国代谢外科简史与展望[J/CD].中华肥胖与代谢病电子杂志,2015,1(2):57-58.