Diabetes Complications Research Centre, UCD Conway Institute, School of Medicine, University College Dublin, Dublin, Ireland.
Weight Management Service, St. Columcille's Hospital, Dublin, Ireland.
Surg Obes Relat Dis. 2021 Dec;17(12):2009-2014. doi: 10.1016/j.soard.2021.09.005. Epub 2021 Sep 10.
Preoperative optimization of iron status is a priority in candidates for bariatric surgery. Inflammation is strongly associated with obesity, and as a consequence, functional iron deficiency (ID) is potentially an underreported issue in surgical candidates.
In light of updated practice guidelines, to retrospectively review preoperative iron status in an Irish cohort of bariatric surgery candidates, taking account of the relative incidence rate of functional ID.
A tertiary care obesity service with bariatric surgery referral in Ireland.
Baseline nutritional biochemistry records were reviewed between February 2017 and February 2020 in a hospital, Dublin, Ireland. Absolute ID was defined as serum ferritin <30 μg/L; functional ID was defined as ferritin, 30 to 100 μg/L, in the presence of C-reactive protein >5 mg/L. Anemia was indexed with reference to hemoglobin and qualified by vitamin B12 and folate status to rule out anemia unrelated to primary ID.
The analysis included 120 patients, 68% female, 49.6 ± 9.3 years, and body mass index, 52.0 ± 9.6 kg/m. The prevalence of absolute and functional ID was 11.7% and 30.8%, respectively (P = .0003). Anemia was associated with absolute ID and functional ID in 14.3% and 10.8% of patients (P = .29). Folate and vitamin B12 deficiency occurred in <5% of patients.
In patients seeking bariatric surgery for severe obesity, the prevalence of baseline functional ID is substantial and can be associated with anemia. These findings raise queries with regard to how best to optimize preoperative iron status in the context of ongoing inflammation.
术前铁状态的优化是肥胖症患者接受减重手术的首要任务。炎症与肥胖密切相关，因此，功能性缺铁（ID）可能是手术候选者中一个被低估的问题。
根据最新的实践指南，回顾爱尔兰肥胖症患者接受减重手术候选者的术前铁状态，考虑到功能性 ID 的相对发病率。
爱尔兰一家具有减重手术转诊服务的三级保健肥胖症服务机构。
在都柏林的一家医院，回顾了 2017 年 2 月至 2020 年 2 月期间的基本营养生化记录。绝对 ID 定义为血清铁蛋白 <30μg/L；功能性 ID 定义为铁蛋白 30-100μg/L，同时 C 反应蛋白 >5mg/L。贫血根据血红蛋白索引，并根据维生素 B12 和叶酸状态进行定性，以排除与原发性 ID 无关的贫血。
分析纳入了 120 例患者，其中 68%为女性，年龄 49.6±9.3 岁，体重指数 52.0±9.6kg/m。绝对 ID 和功能性 ID 的患病率分别为 11.7%和 30.8%（P=0.0003）。贫血与绝对 ID 和功能性 ID 相关，分别占 14.3%和 10.8%的患者（P=0.29）。叶酸和维生素 B12 缺乏发生在<5%的患者中。
在因严重肥胖寻求减重手术的患者中，基线功能性 ID 的患病率相当高，并且可能与贫血相关。这些发现提出了有关如何在持续炎症的背景下优化术前铁状态的问题。
