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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Frontiers Media S.A.
2021-09-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fendo.2021.679066/full |
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| author | Jorunn Sandvik Jorunn Sandvik Jorunn Sandvik Kirsti Kverndokk Bjerkan Kirsti Kverndokk Bjerkan Hallvard Græslie Dag Arne Lihaug Hoff Dag Arne Lihaug Hoff Gjermund Johnsen Gjermund Johnsen Christian Klöckner Christian Klöckner Ronald Mårvik Ronald Mårvik Siren Nymo Siren Nymo Siren Nymo Åsne Ask Hyldmo Bård Eirik Kulseng Bård Eirik Kulseng |
| author_facet | Jorunn Sandvik Jorunn Sandvik Jorunn Sandvik Kirsti Kverndokk Bjerkan Kirsti Kverndokk Bjerkan Hallvard Græslie Dag Arne Lihaug Hoff Dag Arne Lihaug Hoff Gjermund Johnsen Gjermund Johnsen Christian Klöckner Christian Klöckner Ronald Mårvik Ronald Mårvik Siren Nymo Siren Nymo Siren Nymo Åsne Ask Hyldmo Bård Eirik Kulseng Bård Eirik Kulseng |
| author_sort | Jorunn Sandvik |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-22T09:47:58Z |
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| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-12-22T09:47:58Z |
| publishDate | 2021-09-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Endocrinology |
| spelling | doaj.art-893ab40b67f04647a2e3202fed3623ed2022-12-21T18:30:29ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922021-09-011210.3389/fendo.2021.679066679066Iron Deficiency and Anemia 10 Years After Roux-en-Y Gastric Bypass for Severe ObesityJorunn Sandvik0Jorunn Sandvik1Jorunn Sandvik2Kirsti Kverndokk Bjerkan3Kirsti Kverndokk Bjerkan4Hallvard Græslie5Dag Arne Lihaug Hoff6Dag Arne Lihaug Hoff7Gjermund Johnsen8Gjermund Johnsen9Christian Klöckner10Christian Klöckner11Ronald Mårvik12Ronald Mårvik13Siren Nymo14Siren Nymo15Siren Nymo16Åsne Ask Hyldmo17Bård Eirik Kulseng18Bård Eirik Kulseng19Department of Surgery, Møre and Romsdal Hospital trust, Ålesund, NorwayCentre for Obesity Research, Clinic of Surgery, St. Olav’s University Hospital, Trondheim, NorwayDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Surgery, Møre and Romsdal Hospital trust, Ålesund, NorwayFaculty of Social Science and History, Volda University College, Volda, NorwayClinic of Surgery, Namsos Hospital, Nord-Trøndelag Hospital Trust, Namsos, NorwayDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, NorwayCentre for Obesity Research, Clinic of Surgery, St. Olav’s University Hospital, Trondheim, NorwayNorwegian National Advisory Unit on Advanced Laparoscopic Surgery, Clinic of Surgery, St. Olav’s University Hospital, Trondheim, NorwayCentre for Obesity Research, Clinic of Surgery, St. Olav’s University Hospital, Trondheim, NorwayDepartment of Psychology, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayNorwegian National Advisory Unit on Advanced Laparoscopic Surgery, Clinic of Surgery, St. Olav’s University Hospital, Trondheim, NorwayCentre for Obesity Research, Clinic of Surgery, St. Olav’s University Hospital, Trondheim, NorwayDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayClinic of Surgery, Namsos Hospital, Nord-Trøndelag Hospital Trust, Namsos, NorwayCentre for Obesity Research, Clinic of Surgery, St. Olav’s University Hospital, Trondheim, NorwayCentre for Obesity Research, Clinic of Surgery, St. Olav’s University Hospital, Trondheim, NorwayDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, NorwayIron 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.https://www.frontiersin.org/articles/10.3389/fendo.2021.679066/fulliron deficiencyRYGB bypassbariatric surgeryiron deficiency and anemia after RYGBlong-term RYGBfatigue |
| spellingShingle | Jorunn Sandvik Jorunn Sandvik Jorunn Sandvik Kirsti Kverndokk Bjerkan Kirsti Kverndokk Bjerkan Hallvard Græslie Dag Arne Lihaug Hoff Dag Arne Lihaug Hoff Gjermund Johnsen Gjermund Johnsen Christian Klöckner Christian Klöckner Ronald Mårvik Ronald Mårvik Siren Nymo Siren Nymo Siren Nymo Åsne Ask Hyldmo Bård Eirik Kulseng Bård Eirik Kulseng Iron Deficiency and Anemia 10 Years After Roux-en-Y Gastric Bypass for Severe Obesity Frontiers in Endocrinology iron deficiency RYGB bypass bariatric surgery iron deficiency and anemia after RYGB long-term RYGB fatigue |
| 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 | iron deficiency RYGB bypass bariatric surgery iron deficiency and anemia after RYGB long-term RYGB fatigue |
| url | https://www.frontiersin.org/articles/10.3389/fendo.2021.679066/full |
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