Prevalence of Anemia in Subjects Randomized into Roux-en-Y Gastric Bypass or Sleeve Gastrectomy

Kheniser, Karim; Kashyap, Sangeeta R.; Schauer, Philip R.; Lam, Eddie T. C.; Kullman, Emily S.

doi:10.1007/s11695-017-2573-1

Cited by 23 publications

(39 citation statements)

References 8 publications

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“…In a meta‐analysis of studies of the prevalence of anaemia and nutritional deficiencies following RYGB vs SG, no procedural differences in rates of anaemia and iron deficiency were observed . In a study of 100 diabetics randomized to RYGB vs SG (STAMPEDE study), anaemia was in fact more prevalent at 2, 3, and 4 years after SG . These findings suggest that the preserved duodenum and proximal jejunum in SG do not appear to reduce the risk for postoperative iron deficiency or anaemia.…”

Section: Postoperative Iron Nutritionmentioning

confidence: 95%

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: 95%

Metabolic surgery and iron homeostasis

et al. 2018

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“…Our initial search identified a total of 5234 potentially relevant citations. Following screening, a total of 49 studies with 12,880 patients were eligible for inclusion 4,6,21–67 . Of these, five were randomized controlled trials, 33 were retrospective cohort studies, 10 were prospective cohort studies, and one was a nested case–control study.…”

Section: Resultsmentioning

confidence: 99%

“…Six studies compared outcomes in patients who received iron supplementation with those who did not 29,31,36,40,43,63 . Of these, five found that patients who took iron supplementation were less likely to develop ID and IDA compared with those who did not 29,31,36,40,63 .…”

Section: Resultsmentioning

confidence: 99%

Iron supplementation following bariatric surgery: A systematic review of current strategies

et al. 2021

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Summary Iron deficiency (ID) and iron deficiency anemia (IDA) are common following bariatric surgery; however, there are limited standardized treatment recommendations for their management. The purpose of this study was to review the current strategies for iron supplementation following bariatric surgery and assess their relative efficacy in managing ID and IDA. MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched to January 2021. Primary outcomes of interest were prevention or improvement in ID or IDA with iron supplementation. Forty‐nine studies with 12,880 patients were included. Most patients underwent Roux‐en‐Y gastric bypass (61.9%). Iron supplementation was most commonly administered orally for prevention of ID/IDA and was effective in 52% of studies. Both IV and oral iron were given for treatment of ID/IDA. Fifty percent (3/6) of the oral and 100% (3/3) of the IV supplementation strategies were effective at treating ID. Iron supplementation strategies employed following bariatric surgery are highly variable, and many do not provide sufficient iron to prevent the development of ID and IDA, potentially due to poor patient adherence. Further high‐quality prospective trials, particularly comparing intravenous and oral iron, are warranted in order to determine the ideal dosage, route, and duration of iron supplementation.

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“…Hence, premenopausal women are highly diagnosed with anemia postoperatively. Another study suggested that women are at a higher risk of eating less than men, although with limited evidence, which may add other risk for iron deficiency anemia[ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the net effects observed as a result of the adaptation of bariatric surgery may synergistically affect the hemoglobin level. These complicated factors include reduction of inflammation, adaptation of micronutrient absorption, limited meat intake, attenuated energy intake, and menstruation[ 12 , 13 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Risk of anemia in morbidly obese patients after bariatric surgery in Taiwan

Wang

Hsieh²,

Chen

2020

WJD

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BACKGROUND Bariatric surgery is one of most effective long-term treatments for morbid obesity. However, post-bariatric surgery anemia is identified as a common adverse effect and remains a challenge nowadays. AIM To estimate the risk of post-bariatric surgery anemia and to stratify the association between age, gender, and types of surgery. METHODS This study is a population-based cohort study. We conducted this nationwide study using claims data from National Health Insurance Research Database in Taiwan. There were 4373 morbidly obese patients in this study cohort. RESULTS Among patients who were diagnosed with morbid obesity, 2864 received bariatric surgery. All obesity-associated comorbidities decreased in the surgical group. Increasing risk of post-bariatric surgery anemia among obese patients was found by Cox proportional hazards regression [adjusted hazard ratio (HR): 2.36]. Also, we found significantly increasing cumulative incidence rate of anemia among patients receiving bariatric surgery by log-rank test. After adjusting for age and gender, the increasing incidence of post-bariatric surgery anemia was found among women (adjusted HR: 2.48), patients in the 20–29-year-old group (adjusted HR: 3.83), and patients in the 30-64-year-old group (adjusted HR: 2.37). Moreover, malabsorptive and restrictive procedures had significantly higher adjusted HRs, 3.18 and 1.55, respectively. CONCLUSION Bariatric surgery give rise to anemia risk among obese patients, specifically in women, young- and middle-aged patients, and patients undergoing malabsorptive procedures in our population-based cohort study in Taiwan.

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Prevalence of Anemia in Subjects Randomized into Roux-en-Y Gastric Bypass or Sleeve Gastrectomy

Abstract: The etiology of anemia appears to be iron-related and precipitated by the female sex. Scant iron supplementation is likely causative. However, anemia of chronic inflammation cannot be discounted as being somewhat causal. Subsequently, the aggregate may have had a synergistic influence.

Cited by 23 publications

References 8 publications

Metabolic surgery and iron homeostasis

Metabolic surgery and iron homeostasis

Iron supplementation following bariatric surgery: A systematic review of current strategies

Risk of anemia in morbidly obese patients after bariatric surgery in Taiwan

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