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Iron Deficiency and Anemia 10 Years After Roux-en-Y Gastric Bypass for Severe Obesity

Iron deficiency with or without anemia is a well-known long-term complication after Roux-en-Y, gastric bypass (RYGB) as the procedure alters the gastrointestinal absorption of iron. Iron is essential for hemoglobin synthesis and a number of cellular processes in muscles, neurons, and other organs. F...

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Autores principales: Sandvik, Jorunn, Bjerkan, Kirsti Kverndokk, Græslie, Hallvard, Hoff, Dag Arne Lihaug, Johnsen, Gjermund, Klöckner, Christian, Mårvik, Ronald, Nymo, Siren, Hyldmo, Åsne Ask, Kulseng, Bård Eirik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493084/
https://www.ncbi.nlm.nih.gov/pubmed/34630319
http://dx.doi.org/10.3389/fendo.2021.679066
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author Sandvik, Jorunn
Bjerkan, Kirsti Kverndokk
Græslie, Hallvard
Hoff, Dag Arne Lihaug
Johnsen, Gjermund
Klöckner, Christian
Mårvik, Ronald
Nymo, Siren
Hyldmo, Åsne Ask
Kulseng, Bård Eirik
author_facet Sandvik, Jorunn
Bjerkan, Kirsti Kverndokk
Græslie, Hallvard
Hoff, Dag Arne Lihaug
Johnsen, Gjermund
Klöckner, Christian
Mårvik, Ronald
Nymo, Siren
Hyldmo, Åsne Ask
Kulseng, Bård Eirik
author_sort Sandvik, Jorunn
collection PubMed
description Iron deficiency with or without anemia is a well-known long-term complication after Roux-en-Y, gastric bypass (RYGB) as the procedure alters the gastrointestinal absorption of iron. Iron is essential for hemoglobin synthesis and a number of cellular processes in muscles, neurons, and other organs. Ferritin is the best marker of iron status, and in a patient without inflammation, iron deficiency occurs when ferritin levels are below 15 µg/L, while iron insufficiency occurs when ferritin levels are below 50 µg/L. Lifelong regular blood tests are recommended after RYGB, but the clinical relevance of iron deficiency and iron insufficiency might be misjudged as long as the hemoglobin levels are normal. The aim of this study was to explore the frequency of iron deficiency and iron deficiency anemia one decade or more after RYGB, the use of per oral iron supplements, and the frequency of intravenous iron treatment. Nine hundred and thirty patients who underwent RYGB for severe obesity at three public hospitals in Norway in the period 2003–2009 were invited to a follow-up visit 10–15 years later. Results from blood tests and survey data on the use of oral iron supplements and intravenous iron treatment were analyzed. Ferritin and hemoglobin levels more than 10 years after RYGB were available on 530 patients [423 (79.8%) women]. Median (IQR) ferritin was 33 (16–63) µg/L, and mean (SD) hemoglobin was 13.4 (1.3) g/dl. Iron deficiency (ferritin ≤ 15 µg/L) was seen in 125 (23.6%) patients; in addition, iron insufficiency (ferritin 16–50 µg/L) occurred in 233 (44%) patients. Mean (SD) hemoglobin levels were 12.5 (1.4) g/dl in patients with iron deficiency, 13.5 (1.2) g/dl in patients with iron insufficiency, 13.8 (1.3) g/dl in the 111 (21%) patients with ferritin 51–100 µg/L, and 13.8 (1.2) g/dl in the 55 (10%) patients with ferritin >100 µg/L. Two hundred and seventy-five (56%) patients reported taking oral iron supplements, and 138 (27.5%) had received intravenous iron treatment after the RYGB procedure. Iron deficiency or iron insufficiency occurred in two-thirds of the patients 10 years after RYGB, although more than half of them reported taking oral iron supplements.
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spelling pubmed-84930842021-10-07 Iron Deficiency and Anemia 10 Years After Roux-en-Y Gastric Bypass for Severe Obesity Sandvik, Jorunn Bjerkan, Kirsti Kverndokk Græslie, Hallvard Hoff, Dag Arne Lihaug Johnsen, Gjermund Klöckner, Christian Mårvik, Ronald Nymo, Siren Hyldmo, Åsne Ask Kulseng, Bård Eirik Front Endocrinol (Lausanne) Endocrinology Iron deficiency with or without anemia is a well-known long-term complication after Roux-en-Y, gastric bypass (RYGB) as the procedure alters the gastrointestinal absorption of iron. Iron is essential for hemoglobin synthesis and a number of cellular processes in muscles, neurons, and other organs. Ferritin is the best marker of iron status, and in a patient without inflammation, iron deficiency occurs when ferritin levels are below 15 µg/L, while iron insufficiency occurs when ferritin levels are below 50 µg/L. Lifelong regular blood tests are recommended after RYGB, but the clinical relevance of iron deficiency and iron insufficiency might be misjudged as long as the hemoglobin levels are normal. The aim of this study was to explore the frequency of iron deficiency and iron deficiency anemia one decade or more after RYGB, the use of per oral iron supplements, and the frequency of intravenous iron treatment. Nine hundred and thirty patients who underwent RYGB for severe obesity at three public hospitals in Norway in the period 2003–2009 were invited to a follow-up visit 10–15 years later. Results from blood tests and survey data on the use of oral iron supplements and intravenous iron treatment were analyzed. Ferritin and hemoglobin levels more than 10 years after RYGB were available on 530 patients [423 (79.8%) women]. Median (IQR) ferritin was 33 (16–63) µg/L, and mean (SD) hemoglobin was 13.4 (1.3) g/dl. Iron deficiency (ferritin ≤ 15 µg/L) was seen in 125 (23.6%) patients; in addition, iron insufficiency (ferritin 16–50 µg/L) occurred in 233 (44%) patients. Mean (SD) hemoglobin levels were 12.5 (1.4) g/dl in patients with iron deficiency, 13.5 (1.2) g/dl in patients with iron insufficiency, 13.8 (1.3) g/dl in the 111 (21%) patients with ferritin 51–100 µg/L, and 13.8 (1.2) g/dl in the 55 (10%) patients with ferritin >100 µg/L. Two hundred and seventy-five (56%) patients reported taking oral iron supplements, and 138 (27.5%) had received intravenous iron treatment after the RYGB procedure. Iron deficiency or iron insufficiency occurred in two-thirds of the patients 10 years after RYGB, although more than half of them reported taking oral iron supplements. Frontiers Media S.A. 2021-09-22 /pmc/articles/PMC8493084/ /pubmed/34630319 http://dx.doi.org/10.3389/fendo.2021.679066 Text en Copyright © 2021 Sandvik, Bjerkan, Græslie, Hoff, Johnsen, Klöckner, Mårvik, Nymo, Hyldmo and Kulseng https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Sandvik, Jorunn
Bjerkan, Kirsti Kverndokk
Græslie, Hallvard
Hoff, Dag Arne Lihaug
Johnsen, Gjermund
Klöckner, Christian
Mårvik, Ronald
Nymo, Siren
Hyldmo, Åsne Ask
Kulseng, Bård Eirik
Iron Deficiency and Anemia 10 Years After Roux-en-Y Gastric Bypass for Severe Obesity
title Iron Deficiency and Anemia 10 Years After Roux-en-Y Gastric Bypass for Severe Obesity
title_full Iron Deficiency and Anemia 10 Years After Roux-en-Y Gastric Bypass for Severe Obesity
title_fullStr Iron Deficiency and Anemia 10 Years After Roux-en-Y Gastric Bypass for Severe Obesity
title_full_unstemmed Iron Deficiency and Anemia 10 Years After Roux-en-Y Gastric Bypass for Severe Obesity
title_short Iron Deficiency and Anemia 10 Years After Roux-en-Y Gastric Bypass for Severe Obesity
title_sort iron deficiency and anemia 10 years after roux-en-y gastric bypass for severe obesity
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493084/
https://www.ncbi.nlm.nih.gov/pubmed/34630319
http://dx.doi.org/10.3389/fendo.2021.679066
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