Part of the Morbid Obesity – Bio-Psycho-Social study based at Sykehuset Innlandet, Norway. PhD candidate Solveig Meyer Mikalsen
There is a globally increasing prevalence of obesity which predisposes to comorbidities like type 2 diabetes, hypertension, dyslipidemia and coronary heart disease. As weight loss is associated with improvement in metabolic function an increasing number of patients are referred to bariatric surgery. About 80% of patients undergoing bariatric surgery are women, many in their childbearing age.
Serum magnesium (Mg) is reported to be reduced in individuals with obesity , diabetes, and hypertension and has been suggested as a marker and possible pathogenic factor in the development of metabolic syndrome .
We studied changes in serum Mg concentrations in obese patients who underwent lifestyle interventions followed by Roux-en-Y gastric bypass (RYGB) during a period of 14 months and found that a modest weight loss of approximately 10 kg after > 8 weeks of lifestyle interventions increased serum Mg by about 5%. After surgery serum Mg remained stable in nondiabetic patients, while it continued to increase in diabetic patients.
As even small increments in serum Mg are reported to lower the risk of cardiovascular and ischemic heart disease, our results are interesting in a public health perspective.
Weight loss is associated with improved fertility rates but bariatric surgery is also regarded as a risk factor for adverse pregnancy outcomes , particularly due to disturbances in micronutrient status . Exposure to toxic elements during fetal life and infancy may have serious long-term health consequences for the child, and cause damage to the central nervous system, lungs and kidneys.
We studied changes in whole blood Hg, Pb and Cd concentrations before and 12 months after RYGB in a group of patients with a BMI≥35, where the majority were women of reproductive age. We found that weight loss induced by bariatric surgery increased median whole blood Pb significantly, whereas it reduced Hg and Cd concentrations as measured one year after surgery. Weight loss is known to increase fertility, and as the majority of bariatric surgery patients are women of reproductive age, increase in whole blood Pb concentrations is of concern. Further studies should be performed in this field.
Improved Magnesium Levels in Morbidly Obese Diabetic and Non-diabetic Patients After Modest Weight Loss.