Metabolic surgery and iron homeostasis

Benotti, Peter N.; Wood, G. Craig; Still, Christopher D.; Gerhard, Glenn S.; Rolston, David D.K.; Bistrian, Bruce R.

doi:10.1111/obr.12811

Cited by 15 publications

(10 citation statements)

References 78 publications

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“…Iron status is commonly disrupted among obese individuals [22], and, according to the evidence, depletes after bariatric surgery [23]. A high incidence of anemia appears post-operatively due to physiological changes, disruptions in absorption, insufficient intake of iron-rich food, as well as intolerance to meat consumption [24]. Different types of alimentary anemia are being diagnosed according to hemoglobin levels, RBC count and volume, and the cause of decrease in hemoglobin [25].…”

Section: Discussionmentioning

confidence: 99%

Nutritional Outcomes One Year after One Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy

et al. 2022

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One Anastomosis Gastric Bypass (OAGB) and Sleeve Gastrectomy (SG) are the most common bariatric procedures performed worldwide. SG is a restrictive procedure whereas OAGB involves malabsorption as well, supposing a risk of deficiency development post OAGB. The aim of the study was to compare nutritional deficiencies and metabolic markers one year after the procedures, while adhering to the current protocols. Retrospective analysis was performed for data on 60 adults undergoing primary OAGB, compared to 60 undergoing primary SG. Mean pre-surgery BMI for SG was 42.7 kg/m2 and 43.3 kg/m2 for OAGB. A multidisciplinary team followed up with the patients at least 3 times during the first year. Mean weight loss was 39.0 kg for SG and 44.1 kg for OAGB. The OAGB group presented a significantly sharper decline in T.Chol and a trend for sharper LDL decrease; a higher increase in folate and a trend for a greater decrease in albumin and hemoglobin were observed in OAGB. For vitamin B12, D, iron and ferritin, no difference was observed between the treatment groups, although there were some in-group differences. Nutritional recommendations and adopted supplement plans minimize the risk of deficiencies and result in improvement in metabolic biomarkers one year after OAGB, which was comparable to SG.

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Section: Discussionmentioning

confidence: 99%

Nutritional Outcomes One Year after One Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy

et al. 2022

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“…Iron deficiency is a common occurrence after MBS but its relationship with hair loss after MBS is controversial [ 35 – 41 ]. In this review, serum ferritin levels were significantly associated with hair loss following MBS, but serum iron levels were not.…”

Section: Discussionmentioning

confidence: 99%

Hair Loss After Metabolic and Bariatric Surgery: a Systematic Review and Meta-analysis

et al. 2021

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Background Hair loss is a common complication after metabolic and bariatric surgery (MBS). There is a lack of published systematic review in the scientific literature on this topic. The aim of this study was to perform a systematic review and meta-analysis on hair loss after MBS in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines. Methods PubMed, CINAHL, EMBASE, Web of Science, SCOPUS, and four Chinese databases were searched. Data were pooled using Review Manager 5.3 and Stata 12.0, and subgroups were performed if necessary and feasible. Results A total of 18 studies (n = 2538) were included. The pooled results showed that the incidence of hair loss after MBS was 57% (95% CI 42–71%). It decreased with longer follow-up times. Hair loss was significantly more common in younger (mean difference (MD), − 2.45; 95% CI, − 4.26 to − 0.64; p = 0.008) women (OR, 3.87; 95% CI, 0.59 to 17.59; p = 0.08). Serum zinc (standardized mean difference (SMD), − 1.13; 95% CI, − 2.27 to 0.01, p = 0.05), folic acid (SMD = − 0.88, 95% CI − 1.29 to − 0.46, p < 0.0001), and ferritin levels (SMD, − 0.22; 95% CI, − 0.38 to − 0.05; p = 0.01), but not serum iron and vitamin B12, were associated with hair loss following MBS. Conclusions Hair loss is common after MBS especially in younger women, and those with low serum levels of zinc, folic acid, and ferritin. Prospective studies on larger cohorts are needed.

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“…Iron absorption rates were independent of iron status. Benotti et al have recently addressed the disturbance in iron metabolism during metabolic surgery in obese subjects [ 72 ]. The International Diabetes Federation (IDF) position statement on bariatric surgery has been recommended for treating and preventing T2D in obese people [ 73 , 74 , 75 ].…”

Section: Iron Deficiency and Anemia In Obesitymentioning

confidence: 99%

Iron Deficiency in Obesity and after Bariatric Surgery

et al. 2021

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Iron deficiency (ID) is particularly frequent in obese patients due to increased circulating levels of acute-phase reactant hepcidin and adiposity-associated inflammation. Inflammation in obese subjects is closely related to ID. It induces reduced iron absorption correlated to the inhibition of duodenal ferroportin expression, parallel to the increased concentrations of hepcidin. Obese subjects often get decreased inflammatory response after bariatric surgery, accompanied by decreased serum hepcidin and therefore improved iron absorption. Bariatric surgery can induce the mitigation or resolution of obesity-associated complications, such as hypertension, insulin resistance, diabetes mellitus, and hyperlipidemia, adjusting many parameters in the metabolism. However, gastric bypass surgery and sleeve gastrectomy can induce malabsorption and may accentuate ID. The present review explores the burden and characteristics of ID and anemia in obese patients after bariatric surgery, accounting for gastric bypass technique (Roux-en-Y gastric bypass—RYGB) and sleeve gastrectomy (SG). After bariatric surgery, obese subjects’ iron status should be monitored, and they should be motivated to use adequate and recommended iron supplementation.

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Metabolic surgery and iron homeostasis

Cited by 15 publications

References 78 publications

Nutritional Outcomes One Year after One Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy

Nutritional Outcomes One Year after One Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy

Hair Loss After Metabolic and Bariatric Surgery: a Systematic Review and Meta-analysis

Iron Deficiency in Obesity and after Bariatric Surgery

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