Ruz Manuel, Carrasco Fernando, Rojas Pamela, Codoceo Juana, Inostroza Jorge, Rebolledo Annabella, Basfi-fer Karen, Csendes Attila, Papapietro Karin, Pizarro Fernando, Olivares Manuel, Sian Lei, Westcott Jamie L, Hambidge K Michael, Krebs Nancy F
Department of Nutrition, University of Chile, Santiago, Chile.
Am J Clin Nutr. 2009 Sep;90(3):527-32. doi: 10.3945/ajcn.2009.27699. Epub 2009 Jul 22.
Iron deficiency and iron deficiency anemia are common in patients who undergo gastric bypass. The magnitude of change in iron absorption is not well known.
The objective was to evaluate the effects of Roux-en-Y gastric bypass (RYGBP) on iron status and iron absorption at different stages after surgery. We hypothesized that iron absorption would be markedly impaired immediately after surgery and would not improve after such a procedure.
Anthropometric, body-composition, dietary, hematologic, and iron-absorption measures were determined in 67 severe and morbidly obese women [mean age: 36.9 +/- 9.8 y; weight: 115.1 +/- 15.6 kg, body mass index (BMI: in kg/m(2)); 45.2 +/- 4.7] who underwent RYGBP. The Roux-en-Y loop length was 125-150 cm. Determinations were carried out before and 6, 12, and 18 mo after surgery. Fifty-one individuals completed all 4 evaluations.
The hemoglobin concentration decreased significantly throughout the study (repeated-measures analysis of variance). The percentage of anemic subjects changed from 1.5% at the beginning of the study to 38.8% at 18 mo. The proportion of patients with low serum ferritin increased from 7.5% to 37.3%. The prevalence of iron deficiency anemia was 23.9% at the end of the experimental period. Iron absorption from both a standard diet and from a standard dose of ferrous ascorbate decreased significantly after 6 mo of RYGBP to 32.7% and 40.3% of their initial values, respectively. No further significant modifications were noted.
Iron absorption is markedly reduced after RYGBP with no further modifications, at least until 18 mo after surgery.
缺铁和缺铁性贫血在接受胃旁路手术的患者中很常见。铁吸收的变化程度尚不清楚。
评估Roux-en-Y胃旁路术（RYGBP）对术后不同阶段铁状态和铁吸收的影响。我们假设术后铁吸收会立即受到显著损害，且术后不会改善。
对67名接受RYGBP的重度病态肥胖女性[平均年龄：36.9±9.8岁；体重：115.1±15.6 kg，体重指数（BMI：kg/m²）；45.2±4.7]进行人体测量、身体成分、饮食、血液学和铁吸收测量。Roux-en-Y袢长度为125 - 150 cm。在手术前以及术后6、12和18个月进行测定。51名个体完成了所有4次评估。
在整个研究过程中血红蛋白浓度显著下降（重复测量方差分析）。贫血受试者的百分比从研究开始时的1.5%变为18个月时的38.8%。血清铁蛋白低的患者比例从7.5%增加到37.3%。实验期结束时缺铁性贫血的患病率为23.9%。RYGBP术后6个月后，标准饮食和标准剂量的抗坏血酸亚铁的铁吸收分别显著下降至初始值的32.7%和40.3%。未观察到进一步的显著变化。
RYGBP术后铁吸收显著降低，至少在术后18个月内无进一步变化。
