Anemia and iron deficiency before and after bariatric surgery |
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| Affiliation: | 1. Department of Surgery and Anatomy, Clinical Hospital of the Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil;2. Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil;3. Nutritional Division of the Department of Internal Medicine, Clinical Hospital of the Medical School of Ribeirão Preto, University of São Paulo, São Paulo, Brazil;1. Department of Physiology, Faculty of Medicine, Tanta University, Egypt;2. Department of Biochemistry, Faculty of Medicine, Tanta University, Egypt;1. Department of General and Visceral Surgery, Klinikum Vest, Knappschaftskrankenhaus Recklinghausen, Recklinghausen, Germany;2. Department of Nutrition and Food Sciences, Nutritional Physiology, University of Bonn, Bonn, Germany;3. Department of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany;4. Faculty of Food, Nutrition and Hospitality Sciences, Hochschule Niederrhein, University of Applied Sciences, Mönchengladbach, Germany;1. Division of Upper Gastrointestinal Surgery, Department of Surgery, Korea University College of Medicine, Seoul, Korea;2. Institute for Evidence-based Medicine, The Korean Branch of Australasian Cochrane Center, Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea;3. Bariatric and Metabolic Institute, Section of Minimally Invasive Surgery, Cleveland Clinic Florida, Weston, Florida;1. Minimally Invasive Bariatric Surgery and Advanced Laparoscopy Fellowship, La Crosse, WI;2. Department of Research, Gundersen Medical Foundation, La Crosse, WI;3. Department of Hematology, Gundersen Health System, La Crosse, WI;4. Department of General and Vascular Surgery, Gundersen Health System, La Crosse, WI;1. Department of Diet and Nutrition, Hadassah Hebrew University Medical Center, Jerusalem, Israel;2. Department of Surgery, Hadassah Hebrew University Medical Center, Jerusalem, Israel;3. Department of Human Metabolism and Nutrition, Hadassah Hebrew University Medical Center, Jerusalem, Israel |
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| Abstract: | BackgroundIron deficiency and anemia are changes often associated with obesity. Bariatric surgery is responsible for increasing the iron loss and reducing its absorption. The objective of this study was to evaluate anemia and iron deficiency before and after bariatric surgery and to relate them to possible predisposing factors.MethodsA retrospective study was conducted on obese patients submitted to open Roux-en-Y gastric bypass, in which clinical and laboratory data were obtained up to 48 months postoperatively. Patients were divided into groups according to the presence or absence of anemia and to the presence or absence of iron deficiency (even without anemia), and all data were compared between these groups.ResultsPreoperatively, 21.5% of patients had anemia and 20% had iron deficiency. The number of patients with anemia did not vary through the 4 years of the study, but ferritin levels significantly decreased with time (P<.01). Younger patients and patients with greater weight loss had a higher incidence of anemia. Female gender was a variable associated with a greater incidence of iron deficiency.ConclusionsAnemia and iron deficiency are frequent in obese patients and must be treated before surgery. Medical and nutritional surveillance is important in the postoperative period of bariatric surgery. Management of each condition must be directed at correcting the 2 major sources of iron deficiency and anemia: food intolerance (mostly meat intolerance) and losses (frequently due to menstruation). These are the factors more related to iron deficient anemia. |
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| Keywords: | Obesity Bariatric surgery Anemia Iron deficiency |
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