Assessment of baseline rates of functional and absolute iron deficiency in bariatric surgery candidates: a retrospective study |
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| Affiliation: | 1. Diabetes Complications Research Centre, UCD Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland;2. Weight Management Service, St. Columcille''s Hospital, Dublin, Ireland;3. Department of Surgery, St Vincent''s University Hospital, Dublin, Ireland;4. Surgery and Surgical Specialities, School of Medicine, University College Dublin, Dublin, Ireland;5. Applied Health Science, Indiana University Bloomington, School of Public Health, Bloomington, Indiana;1. Department of Gastroenterology, Health Research Institute (IDIS), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain;2. Department of Endocrinology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain;1. Departament de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain;2. Cardiovascular Risk and Nutrition Research Group (CARIN-ULEC), Institut Hospital del Mar d''Investigacions Mèdiques, Barcelona Biomedical Research Park, Barcelona, Spain;3. Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain;4. Centro de Investigaciones Biomédicas en Red de Obesidad y Nutrición, Madrid, Spain;5. Unit of Gastrointestinal Surgery, Hospital del Mar, Institut de Recerca Institut Hospital del Mar d''Investigacions Mèdiques, Barcelona, Spain;6. Consorci Sanitari de l’Alt Penedès i Garraf, Vilafranca del Penedès, Spain;1. University of Ottawa, Department of Medicine, Ottawa, Ontario, Canada;2. Queen’s University, Department of Public Health Sciences, Kingston, Ontario, Canada;3. Queen’s University, Department of Surgery, Kingston, Ontario, Canada;4. McMaster University, Hamilton, Ontario, Canada |
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| Abstract: | BackgroundPreoperative optimization of iron status is a priority in candidates for bariatric surgery. Inflammation is strongly associated with obesity, and as a consequence, functional iron deficiency (ID) is potentially an underreported issue in surgical candidates.ObjectivesIn light of updated practice guidelines, to retrospectively review preoperative iron status in an Irish cohort of bariatric surgery candidates, taking account of the relative incidence rate of functional ID.SettingA tertiary care obesity service with bariatric surgery referral in Ireland.MethodsBaseline nutritional biochemistry records were reviewed between February 2017 and February 2020 in a hospital, Dublin, Ireland. Absolute ID was defined as serum ferritin <30 μg/L; functional ID was defined as ferritin, 30 to 100 μg/L, in the presence of C-reactive protein >5 mg/L. Anemia was indexed with reference to hemoglobin and qualified by vitamin B12 and folate status to rule out anemia unrelated to primary ID.ResultsThe analysis included 120 patients, 68% female, 49.6 ± 9.3 years, and body mass index, 52.0 ± 9.6 kg/m2. The prevalence of absolute and functional ID was 11.7% and 30.8%, respectively (P = .0003). Anemia was associated with absolute ID and functional ID in 14.3% and 10.8% of patients (P = .29). Folate and vitamin B12 deficiency occurred in <5% of patients.ConclusionIn patients seeking bariatric surgery for severe obesity, the prevalence of baseline functional ID is substantial and can be associated with anemia. These findings raise queries with regard to how best to optimize preoperative iron status in the context of ongoing inflammation. |
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| Keywords: | Iron deficiency C-reactive protein Bariatric surgery |
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