Incidence and prevalence of copper deficiency following roux-en-y gastric bypass surgery

Int J Obes (Lond). 2012 Mar;36(3):328-35. doi: 10.1038/ijo.2011.159. Epub 2011 Aug 30.


Introduction and objectives: The frequency of copper deficiency and clinical manifestations following roux-en-y gastric bypass (RYGB) surgery is not yet clear. Objectives were to determine the prevalence and incidence of copper deficiency in patients who have undergone RYGB.

Design and methods: We sought to determine the number of RYGB patients undergoing medical and nutritional follow-up visits at the Emory Bariatric Center who experienced copper deficiency and associated hematological and neurological complaints (n=136). Separately, in patients followed longitudinally before and during 6 and 24 months following RYGB surgery, we obtained measures of copper status (n=16). Systemic blood cell counts and measures of copper, zinc and ceruloplasmin were determined using standardized assays in reference laboratories including atomic absorption spectrometry and immunoassays.

Results: Thirteen patients were identified to have copper deficiency suggesting a prevalence of copper deficiency of 9.6%, and the majority of these had concomitant complications including anemia, leukopenia and various neuro-muscular abnormalities. In the longitudinal study, plasma copper concentrations and ceruloplasmin activity decreased over 6 and 24 months following surgery, respectively (P<0.05), but plasma zinc concentrations did not change. A simultaneous decrease in white blood cells was observed (P<0.05). The incidence of copper deficiency in these subjects was determined to be 18.8%.

Conclusions: The prevalence and incidence of copper deficiency following RYGB surgery was determined to be 9.6% and 18.8%, respectively, with many patients experiencing mild-to-moderate symptoms. Given that copper deficiency can lead to serious and irreversible complications if untreated, frequent monitoring of the copper status of RYGB patients is warranted.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anemia / epidemiology*
  • Anemia / etiology
  • Copper / blood
  • Copper / deficiency*
  • Female
  • Follow-Up Studies
  • Gastric Bypass / adverse effects*
  • Humans
  • Incidence
  • Leukopenia / epidemiology*
  • Leukopenia / etiology
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Neuromuscular Diseases / epidemiology*
  • Neuromuscular Diseases / etiology
  • Obesity, Morbid / complications
  • Obesity, Morbid / epidemiology*
  • Obesity, Morbid / surgery
  • Patient Selection
  • Prevalence
  • United States / epidemiology
  • Young Adult


  • Copper