Prevalence of Anemia and Related Deficiencies 10 Years After Gastric Bypass—a Retrospective Study

Karefylakis, Christos; Näslund, Ingmar; Edholm, David; Sundbom, Magnus; Karlsson, F. Anders; Rask, Eva

doi:10.1007/s11695-014-1500-y

Cited by 41 publications

(26 citation statements)

References 16 publications

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“…In this study, postoperative iron panels were not reported, but increasing degrees of anaemia were associated with a statistically significant greater incidence of the degree of microcytosis ( P < 0.0001). The reported prevalence of iron deficiency reported by others in up to 5 years after metabolic surgery is 20% to 50% (Table ) . These results demonstrate an alarming development of iron deficiency and anaemia with longer follow‐up.…”

Section: Postoperative Iron Nutritionmentioning

confidence: 63%

Metabolic surgery and iron homeostasis

et al. 2018

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Iron deficiency and anaemia after metabolic surgery, potentially modifiable nutritional complications, are becoming an increasing cause for concern as prevalence increases with time and there is limited evidence supporting the effectiveness of the current guidelines for prophylactic oral iron supplementation and treatment for deficiency.Abnormalities in iron nutrition predisposing to deficiency are common in severely obese patients, and the low-grade systemic inflammation, also common to these patients, reduces the effectiveness of oral iron supplementation. The surgical procedures result in alterations of foregut anatomy and physiology, which limit iron absorptive capacity and daily food intake. These alterations and the limited effects of oral iron supplementation explain the high prevalence of postoperative iron deficiency and anaemia. This review outlines current mechanisms concerning the pathogenesis of disordered iron nutrition in patients with severe obesity, current gaps in knowledge, and opportunities for quality improvement.

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Section: Postoperative Iron Nutritionmentioning

confidence: 63%

Metabolic surgery and iron homeostasis

et al. 2018

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“…Iron-deficiency anemia and vitamin B 12 deficiency after gastric bypass are well described. 23,24 Vitamin B 12 deficiency was not unexpected after sleeve gastrectomy, and it presumably relates to a reduction in intrinsic factor production after the procedure. These results, as well as the decreased vitamin A levels after gastric-bypass surgery, highlight the importance of long-term follow-up to evaluate nutritional measures, as well as the importance of ensuring that appropriate supplementation is provided to minimize the development of clinically significant nutritional deficiencies in adolescents after bariatric surgery.…”

Section: Discussionmentioning

confidence: 98%

Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents

et al. 2016

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BACKGROUND Bariatric surgery is increasingly considered for the treatment of adolescents with severe obesity, but few prospective adolescent-specific studies examining the efficacy and safety of weight-loss surgery are available to support clinical decision making. METHODS We prospectively enrolled 242 adolescents undergoing weight-loss surgery at five U.S. centers. Patients undergoing Roux-en-Y gastric bypass (161 participants) or sleeve gastrectomy (67) were included in the analysis. Changes in body weight, coexisting conditions, cardiometabolic risk factors, and weight-related quality of life and postoperative complications were evaluated through 3 years after the procedure. RESULTS The mean (±SD) baseline age of the participants was 17±1.6 years, and the mean body-mass index (the weight in kilograms divided by the square of the height in meters) was 53; 75% of the participants were female, and 72% were white. At 3 years after the procedure, the mean weight had decreased by 27% (95% confidence interval [CI], 25 to 29) in the total cohort, by 28% (95% CI, 25 to 30) among participants who underwent gastric bypass, and by 26% (95% CI, 22 to 30) among those who underwent sleeve gastrectomy. By 3 years after the procedure, remission of type 2 diabetes occurred in 95% (95% CI, 85 to 100) of participants who had had the condition at baseline, remission of abnormal kidney function occurred in 86% (95% CI, 72 to 100), remission of prediabetes in 76% (95% CI, 56 to 97), remission of elevated blood pressure in 74% (95% CI, 64 to 84), and remission of dyslipidemia in 66% (95% CI, 57 to 74). Weight-related quality of life also improved significantly. However, at 3 years after the bariatric procedure, hypoferritinemia was found in 57% (95% CI, 50 to 65) of the participants, and 13% (95% CI, 9 to 18) of the participants had undergone one or more additional intraabdominal procedures. CONCLUSIONS In this multicenter, prospective study of bariatric surgery in adolescents, we found significant improvements in weight, cardiometabolic health, and weight-related quality of life at 3 years after the procedure. Risks associated with surgery included specific micro-nutrient deficiencies and the need for additional abdominal procedures. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and others; Teen-LABS ClinicalTrials.gov number, NCT00474318.)

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“…In cases of post-surgery conception, specific nutritional deficiencies can affect visual acuity (vitamin A) and the development of the nervous system (vitamin B12) and neural tube (folates) [87,88]. …”

Section: Focus On Conditions Associated With Nutrient Deficienciesmentioning

confidence: 99%

Maternal Diet and Nutrient Requirements in Pregnancy and Breastfeeding. An Italian Consensus Document

Marangoni¹,

et al. 2016

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The importance of lifestyle and dietary habits during pregnancy and breastfeeding, for health of mothers and their offspring, is widely supported by the most recent scientific literature. The consumption of a varied and balanced diet from the preconceptional period is essential to ensure both maternal well-being and pregnancy outcomes. However, the risk of inadequate intakes of specific micronutrients in pregnancy and lactation is high even in the most industrialized countries. This particularly applies to docosahexaenoic acid (DHA), iron, iodine, calcium, folic acid, and vitamin D, also in the Italian population. Moreover, the risk of not reaching the adequate nutrient supply is increased for selected groups of women of childbearing age: those following exclusion diets, underweight or overweight/obese, smokers, adolescents, mothers who have had multiple or close pregnancies, and those with previous unfavorable pregnancy outcomes.

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Prevalence of Anemia and Related Deficiencies 10 Years After Gastric Bypass—a Retrospective Study

Abstract: Twenty-seven percent of patients had anemia more than 10 years after RYGB. Anemia does not seem to progress with time and was less common in patients with regular medical checkups. Thus, improved long-term follow-up is needed.

Cited by 41 publications

References 16 publications

Metabolic surgery and iron homeostasis

Metabolic surgery and iron homeostasis

Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents

Maternal Diet and Nutrient Requirements in Pregnancy and Breastfeeding. An Italian Consensus Document

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