Correlation between changes of nutritional parameter changes and alopecia in patients with obesity undergoing laparoscopic sleeve gastrectomy: a prospective cohort study

Background: With the rising prevalence of obesity, laparoscopic sleeve gastrectomy (LSG) is a key treatment for severe obesity and its complications. Postoperative hair loss, linked to nutritional deficiencies and rapid weight loss, may impact patients’ psychological health and weight loss outcomes. This study analyzed nutritional indicators (body composition, minerals, anthropometrics, serum proteins and hematinic parameters) in patients with obesity pre- and post-LSG. Patients were grouped by hair loss severity to compare differences and identify independent risk factors, aiming to optimize nutritional management and reduce hair loss risk. Materials and Methods: This single-center prospective cohort study included patients with obesity undergoing LSG at a tertiary hospital (August 2021–February 2022). Based on 3-month postoperative dermoscopic imaging, patients were divided into no/mild hair loss (N-M group) and moderate/severe hair loss (M-S group) groups. Preoperative, 1-month, and 3-month postoperative nutritional indicators were collected and compared. Logistic regression identified independent nutritional factors for hair loss. Results: A total of 67 patients, 24 were in the N-M group and 43 in the M-S group. Preoperatively, serum ferritin levels were significantly lower in the M-S group than in the N-M group (P<0.05). At 1 month postoperatively, the M-S group had significantly lower levels of hemoglobin, serum albumin, and calcium compared to the N-M group (P<0.05). Notably, in the M-S group, hemoglobin levels decreased, while other parameters increased compared to baseline. The changes in hemoglobin, serum albumin, and calcium at 1 month were significantly lower in the M-S group compared to the N-M group (P<0.05). Logistic regression analysis showed that the changes in serum albumin (OR = 0.687, P<0.05) and calcium (OR = 0.821, P<0.05) at 1 month postoperatively were independent factors for the occurrence of hair loss. Conclusion: Changes in serum albumin and calcium levels at 1 month after LSG are independent factors contributing to alopecia in patients post-bariatric surgery.