Abstract Information

P-74

Bariatric surgery for morbid obesity in patient with spinal cord injury – a longitudinal follow up

Wong S, Tiberti S, Belci M
National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury, , UK

Introductions / background: We previously reported that bariatric surgery could help morbid obese patients with spinal cord injury1 (SCI) but long-term follow up data is lacking.

Design/ Methods: This study reports a two year outcome of a patient who underwent bariatric surgery. A 46 year old female sustained an incomplete paraplegia (T10, AIS B) reported a weight gain from 126.5kg to 134.3kg after SCI. A laparoscopic Roux-en-Y gastric bypass (RYGB) was successfully performed in May 2013. Patient was discharged with a prescription of a general multivitamin / mineral preparation, vitamin D supplements and thiamine supplements.

Results: Patient has lost 42.3kg since she had her RYGB. There were important clinical improvements in body mass index (kg/m2) (49.2 to 33.2); mid-upper arm circumference (cm) (32.9 to 36.4); triceps-skinfold thickness (mm) (41.6 to 37.6); mid-arm muscle circumference (cm) (32.9 to 24.6); total cholesterol (mmol/L) (4.4 to 4.2); HDL-cholesterol (mmol/L) (1.4 to 1.5); LDL-cholesterol (mmol/L) (1.7 to 2.2); triglycerides (mmol/L) (1.7 to 1.2); 25 hydroxy-vitamin D (ummol/L) (30.8 to 55.4); folate (ng/mL) (6.4 to 14.6); ferritin (ng/mL) (229 to 62); vitamin B12 (pg/mL) (701 to 343).

Conclusion: Although RYGB could help morbid obese SCI patients to lose weight. It may not be sufficient to stimulate / maintain muscle mass in long term. Despite regular oral multivitamin and mineral supplementation, ferritin and B12 seems to deplete overtime, indicating long-term monitoring is essential. Further studies are warranted to examine the efficacy of nutrition-pharmacotherapy and / or physical activity intervention could preserve muscle mass in this vulnerable group of patients.

References
1. Wong S et al. Eur J Clin Nutr 2013, 67: 998-999.


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