Avinoah E, Peiser J, Ovnat A, Charuzi I
Dept. of Surgery C, Soroka Medical Center, Beer Sheba.
Harefuah. 1992 Jun 1;122(11):689-92, 752.
200 patients after Roux-en-Y gastric bypass were nutritionally followed for an average of 6.7 years. They were randomly selected out of 450 patients operated on during 1980-1985. They had lost a mean of 56 +/- 22% of their excess weight and had remained stable in weight for the preceding 5 years with limited nutritional caloric restriction. Iron saturation, hemoglobin and mean corpuscular volume declined gradually and significantly (p less than 0.0001, p less than 0.0001 and p less than 0.001, respectively). However, mean serum concentration of vitamin B12, which also had decreased significantly during the preceding 5 years (p less than 0.0004), increased during recent years, but still was lower than before the bypass. Albumin and transferrin levels remained normal. There was no correlation between weight change and serum concentration of iron or vitamin B12. We conclude that 6.7 years after surgery, while there is no caloric or protein deficiency, there has been gradual development of iron deficiency, but not correlated with weight loss.
对200例行Roux-en-Y胃旁路手术的患者进行了平均6.7年的营养随访。他们是从1980年至1985年接受手术的450例患者中随机选取的。他们已减掉平均56±22%的超重体重,并且在过去5年中通过有限的营养热量限制体重保持稳定。铁饱和度、血红蛋白和平均红细胞体积逐渐且显著下降(分别为p<0.0001、p<0.0001和p<0.001)。然而,维生素B12的平均血清浓度在过去5年中也显著下降(p<0.0004),近年来有所上升,但仍低于旁路手术前。白蛋白和转铁蛋白水平保持正常。体重变化与铁或维生素B12的血清浓度之间无相关性。我们得出结论,手术后6.7年,虽然不存在热量或蛋白质缺乏,但缺铁情况已逐渐发展,且与体重减轻无关。