Department of Surgery, Rijnstate Hospital, Postal number 1190, 6800, TA, Arnhem, The Netherlands.
Department of Surgery, Radboud UMC, Nijmegen, The Netherlands.
Obes Surg. 2018 Jun;28(6):1738-1744. doi: 10.1007/s11695-017-3088-5.
Iron deficiency is one of the most common deficiencies that may occur after Roux-en-Y gastric bypass (RYGB). Little is known about the optimal treatment of post-RYGB iron deficiency.
The aim of this study is to evaluate the changes in iron absorption characteristics after RYGB for two oral iron formulations, one presented in tablet form and one as in the form of a solution.
Iron absorption in 24 obese women was studied before and 1 month after RYGB. Twelve patients were tested with a single dose of 600 mg ferrous fumarate in tablet form (195 mg of elementary iron, group 1), and 12 patients received a single dose of 1390 mg ferrous gluconate as a solution (160 mg of elementary iron, group 2). Serum iron levels were measured before (T) and every hour after ingestion of the supplement (T-T).
Before surgery, iron absorption was similar for the two supplements (P = 0.71). However, RYGB was associated with a decrease in fumarate iron absorption (P < 0.001) but did not affect gluconate iron absorption (P = 0.13). Postoperative absorption of fumarate iron was significantly lower than gluconate iron at T1 (P < 0.05), but the overall difference over 9 h did not reach statistical significance (P = 0.53).
RYGB adversely affects the absorption of ferrous fumarate tablets but not that of solubilized ferrous gluconate. A solubilized supplement is therefore preferred as the supplement of first choice after RYGB.
铁缺乏症是 Roux-en-Y 胃旁路（RYGB）术后最常见的缺乏症之一。对于 RYGB 后缺铁的最佳治疗方法知之甚少。
本研究旨在评估两种口服铁制剂在 RYGB 后铁吸收特性的变化，一种以片剂形式呈现，另一种以溶液形式呈现。
对 24 名肥胖女性进行铁吸收研究，在 RYGB 之前和之后 1 个月进行。12 名患者接受 600mg 富马酸亚铁片剂（195mg 元素铁，第 1 组）单次剂量测试，12 名患者接受 1390mg 葡萄糖酸亚铁溶液（160mg 元素铁，第 2 组）单次剂量测试。在服用补充剂之前（T）和之后每小时测量血清铁水平（T-T）。
手术前，两种补充剂的铁吸收相似（P=0.71）。然而，RYGB 与富马酸铁吸收减少有关（P<0.001），但不影响葡萄糖酸铁吸收（P=0.13）。术后富马酸铁的吸收在 T1 时明显低于葡萄糖酸铁（P<0.05），但在 9 小时内的总体差异未达到统计学意义（P=0.53）。
RYGB 对富马酸亚铁片剂的吸收产生不利影响，但对溶解的葡萄糖酸亚铁的吸收没有影响。因此，溶解的补充剂是 RYGB 后首选的补充剂。
