Monaco-Ferreira Daniela Vicinansa, Leandro-Merhi Vânia Aparecida
Dietitian, Master of Health Sciences, Puc-Campinas, SP, Brazil.
Professor, Doctor of the Graduate Program in Health Sciences, Puc-Campinas, SP, Brazil.
Obes Surg. 2017 Aug;27(8):1993-1999. doi: 10.1007/s11695-017-2582-0.
The aim of this study is to investigate changes in iron metabolism and verify whether biochemical parameters are related to the use of oral iron supplement 10 years after Roux-en-Y gastric bypass.
This longitudinal retrospective study included 151 patients submitted to Roux-en-Y gastric bypass. The collected data included use of an oral iron supplement, hemoglobin, hematocrit, serum iron, and ferritin. The chi-squared or Fisher's exact test was used to analyze the association between use of iron supplement and nutritional deficiency. The generalized estimating equations (GEEs) analyzed the nutritional deficiencies over time.
Of the study patients with iron-deficiency anemia (n = 15) in the 12-month follow-up, 73.33% (n = 11) were taking an iron supplement, and 26.67% (n = 4) were not (p = 0.0010). The effect of time was significant for hemoglobin, ferritin, iron overload (p < 0.0001), and hematocrit (p = 0.0007). Of the patients who remained in the study until the 120-month follow-up, 37.5 and 45.0% were diagnosed with iron-deficiency anemia, defined as ferritin <15 μg/L and ferritin <30 μg/L, respectively.
Iron-deficiency anemia increased over time even in patients taking oral iron supplements.
本研究旨在调查Roux-en-Y胃旁路术后10年铁代谢的变化，并验证生化参数是否与口服铁补充剂的使用有关。
这项纵向回顾性研究纳入了151例行Roux-en-Y胃旁路术的患者。收集的数据包括口服铁补充剂的使用情况、血红蛋白、血细胞比容、血清铁和铁蛋白。采用卡方检验或Fisher精确检验分析铁补充剂使用与营养缺乏之间的关联。广义估计方程（GEEs）分析随时间变化的营养缺乏情况。
在12个月随访中有缺铁性贫血的研究患者（n = 15）中，73.33%（n = 11）正在服用铁补充剂，26.67%（n = 4）未服用（p = 0.0010）。时间对血红蛋白、铁蛋白、铁过载（p < 0.0001）和血细胞比容（p = 0.0007）的影响具有显著性。在研究中持续到120个月随访的患者中，分别有37.5%和45.0%被诊断为缺铁性贫血，定义为铁蛋白<15 μg/L和铁蛋白<30 μg/L。
即使在服用口服铁补充剂的患者中，缺铁性贫血也随时间增加。
