To investigate the mid-term metabolic outcomes and changes in nutritional status of adolescents with severe obesity undergoing laparoscopic sleeve gastrectomy (LSG). Methods A retrospective analysis was conducted on the clinical data of 93 adolescent patients who underwent LSG at Shanghai Sixth People’s Hospital between July 2017 and July 2022. Weight changes, glycemic metabolism indicators (HbA1c and HOMA-IR), and the dynamics of iron deficiency, anemia, and vitamin D deficiency were collected and compared from preoperation to up to 3 years postoperatively. Mixed-effects models were used to analyze longitudinal data trends. Results A total of 93 patients were included for baseline analysis, with follow-up data available for 64, 49, and 33 patients at 1, 2, and 3 years postoperatively, respectively. Significant weight loss was achieved, with a mean percentage of excess weight loss (%EWL) of 99.7% at 2 years post-surgery. Glycemic metabolism improved, with mean HbA1c decreasing from 6.2% at baseline to 5.0% at 2 years, and HOMA-IR from 11.6 to 3.6 (both P<0.001). However, the prevalence of iron deficiency showed a significant upward trend (trend P=0.002), increasing from 6.5% at baseline to 33.3% at 3 years. More importantly, the prevalence of anemia also showed a significant upward trend (trend P=0.015), reaching 24.2% at 3 years. In contrast, the high preoperative prevalence of vitamin D deficiency (91.4%) showed a continuous and significant downward trend postoperatively (trend P<0.001). Conclusion For adolescents with severe obesity, LSG provides significant and durable weight loss and metabolic improvement. However, the risk of postoperative iron deficiency and even clinical anemia is significantly increased, highlighting the importance of long-term, systematic, multidisciplinary nutritional monitoring and management for these patients.
Key words
adolescent /
obesity /
sleeve gastrectomy /
weight loss /
metabolic improvement /
nutritional risk
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