Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, China.
Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, China.
Obes Surg. 2023 Mar;33(3):897-910. doi: 10.1007/s11695-023-06465-x. Epub 2023 Jan 26.
This study reviews the prevalence of iron deficiency (ID) in bariatric surgery candidates and the long-term outcomes of the prevalence of ID after bariatric surgery.
A systematic literature search and meta-analysis were performed in PubMed for articles published by August 31, 2022, including these search terms: bariatric surgery, metabolic surgery, weight loss surgery, obesity surgery, sleeve gastrectomy, gastric banding, gastric bypass, duodenal switch, duodenojejunal bypass, iron, iron deficiency, sideropenia, and hypoferritinemia. Fifty-seven studies examining a total of 26,328 patients with morbidly obese were included in this meta-analysis finally.
The results showed a prevalence of 17% of ID in bariatric surgery candidates and a prevalence of 14%, 17%, 26%, 34%, 23%, 38%, and 23% of ID at 1-, 2-, 3-, 4-, 5-, 8-, and 10-year follow-up after bariatric surgery, respectively. Additionally, the results showed a prevalence of 15%, 19%, 35%, 38%, 29%, 30%, and 23% of ID at 1-, 2-, 3-, 4-, 5-, 8-, and 10-year follow-up after Roux-en-Y gastric bypass, respectively; a prevalence of 12%, 12%, 15%, 31%, and 17% of ID at 1-, 2-, 3-, 4-, and 5-year follow-up after sleeve gastrectomy, respectively; and a prevalence of 19% of ID at 1-year follow-up after anastomosis gastric bypass.
As a result, preoperative evaluation and correction of ID may lead to better outcomes for bariatric surgery candidates. ID is also common in patients after bariatric procedures, especially RYGB. Long-term, even lifelong, medical and nutritional monitoring and tailored interventions are critical.
本研究回顾了肥胖症手术患者中缺铁（ID）的流行情况以及肥胖症手术后 ID 流行的长期结果。
在 PubMed 上进行了系统的文献检索和荟萃分析，检索了截至 2022 年 8 月 31 日发表的文章，包括这些检索词：减重手术、代谢手术、减肥手术、肥胖症手术、胃袖状切除术、胃带术、胃旁路手术、十二指肠转位术、空肠回肠旁路术、铁、缺铁、小细胞低色素性贫血和低铁蛋白血症。最终，这项荟萃分析纳入了 57 项共 26328 例病态肥胖患者的研究。
结果显示，肥胖症手术患者 ID 的患病率为 17%，在接受减重手术后 1、2、3、4、5、8 和 10 年的随访中，ID 的患病率分别为 14%、17%、26%、34%、23%、38%和 23%。此外，研究结果还显示，在 Roux-en-Y 胃旁路手术后 1、2、3、4、5、8 和 10 年的随访中，ID 的患病率分别为 15%、19%、35%、38%、29%、30%和 23%；在胃袖状切除术术后 1、2、3、4 和 5 年的随访中，ID 的患病率分别为 12%、12%、15%、31%和 17%；在吻合胃旁路术后 1 年的随访中，ID 的患病率为 19%。
因此，术前评估和纠正 ID 可能会导致肥胖症手术患者的结局更好。ID 在接受减重手术的患者中也很常见，尤其是 RYGB。长期甚至终生的医学和营养监测以及针对性干预至关重要。
