Morbid obesity is associated with a decreased life expectancy and a myriad of serious medical problems. The Roux-en-Y gastric bypass (RYGBP) is the most effective procedure for the treatment of these patients, but it can be responsible of early and late complications. The aim of this prospective study was to evaluate the rate of visceral protein malnutrition (VPM) in morbid obese (MO) patients two years after laparoscopic RYGBP. Albumin (Alb), prealbumin (Prealb), transferrin (Transf), retinol binding globulin (RBG), C3-complement factor (C3) plasma levels, and lymphocyte count (Lymph) were measured before and 2 years after RYGBP. Data were evaluated using paired Student t-test. Data were available for 46 patients (9 men and 37 women). Mean age: 38.5±11 years; mean follow-up time: 24± 9 months.
Results: No differences were observed in Prealb, RBG, Transf or Lymph count. Before surgery, 1 patient (2.2%) had C3 values under normal levels, and after surgery 4 patients (8.7%) had C3 values under normal levels.
Conclusions: 1- There were no changes in main visceral protein plasma levels: Alb, Prealb, Transf, and RBG in MO patients after 2 years of RYGBP. 2- A significant decrease of C3 values was observed in these patients, without changes in lymphocyte count. In spite of this decrease, C3 levels remained in most patients between the normal range. 3- RYGBP seems to be an effective procedure to treat morbid obesity which does not cause VPM, but immunity should be assessed.