Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, O&N2, Herestraat 49, Box 521, 3000, Leuven, Belgium,
Obes Surg. 2014 Jan;24(1):56-61. doi: 10.1007/s11695-013-1042-8.
Roux-en-Y gastric bypass (RYGB) may reduce the absorption of iron, but the extent to which this absorption is impeded is largely unknown. First, we determined the prevalence of iron deficiency following RYGB and explored the risk factors for its development. Second, we examined to what extent oral iron supplements are absorbed after RYGB.
Monocentric retrospective study in 164 patients (123 females, 41 males; mean age 43 years) who underwent RYGB between January 2006 and November 2010 was done. Pre- and postoperative data on gender, age, BMI, serum levels of iron, ferritin, hemoglobin, vitamin B12, 25-hydroxy vitamin D, and use of proton pump inhibitors and H2 antagonists were collected. Generalized linear mixed models were used for the analysis of the data. In 23 patients who developed iron deficiency after surgery, an oral challenge test with 100 mg FeSO4 · 7H2O was performed.
Following RYGB, 52 (42.3 %) female patients and 9 male (22.0 %) patients developed iron deficiency (serum ferritin concentration ≤ 20 μg/L). The prevalence of iron deficiency was significantly higher in females than males (p = 0.0170). Young age (p = 0.0120), poor preoperative iron status (p = 0.0004), vitamin B12 deficiency (p = 0.0009), and increasing time after surgery (p < 0.0001) were also associated with iron deficiency. In the oral iron challenge test, only one patient out of 23 showed sufficient iron absorption.
Iron deficiency is extremely frequent after RYGB and is linked with different risk factors. Iron supplementation seems essential, but the effect of oral tablets may be limited as absorption of oral iron supplements is insufficient post-RYGB.
Roux-en-Y 胃旁路术（RYGB）可能会降低铁的吸收，但这种吸收受到多大程度的阻碍尚不清楚。首先，我们确定了 RYGB 后缺铁的发生率，并探讨了其发展的危险因素。其次，我们研究了 RYGB 后口服铁补充剂的吸收程度。
我们对 2006 年 1 月至 2010 年 11 月期间接受 RYGB 的 164 名患者（123 名女性，41 名男性；平均年龄 43 岁）进行了单中心回顾性研究。收集了手术前后的性别、年龄、BMI、铁、铁蛋白、血红蛋白、维生素 B12、25-羟维生素 D 水平以及质子泵抑制剂和 H2 拮抗剂的使用情况。使用广义线性混合模型进行数据分析。在术后发生缺铁的 23 名患者中，进行了 100mg FeSO4·7H2O 的口服挑战试验。
RYGB 后，52 名（42.3%）女性和 9 名（22.0%）男性患者出现缺铁（血清铁蛋白浓度≤20μg/L）。女性缺铁的发生率明显高于男性（p=0.0170）。年龄较小（p=0.0120）、术前铁状态较差（p=0.0004）、维生素 B12 缺乏（p=0.0009）以及术后时间延长（p<0.0001）也与缺铁有关。在口服铁挑战试验中，23 名患者中仅有 1 名显示出足够的铁吸收。
RYGB 后缺铁极为常见，与不同的危险因素有关。补铁似乎是必要的，但由于 RYGB 后口服铁补充剂的吸收不足，口服片剂的效果可能有限。
