Primary Care/Department of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Section for Endocrinology and Diabetology, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Nutr Metab Cardiovasc Dis. 2023 May;33(5):998-1006. doi: 10.1016/j.numecd.2023.02.008. Epub 2023 Feb 16.
After bariatric surgery, micronutrient deficiencies may lead to anaemia. To prevent post-operative deficiencies, patients are recommended lifelong micronutrient supplementation. Studies investigating the effectiveness of supplementation to prevent anaemia after bariatric surgery are scarce. This study aimed to investigate the relationship between nutritional deficiencies and anaemia in patients who report use of supplementation two years after bariatric surgery versus patients who do not.
Obese (BMI≥35 kg/m) individuals (n = 971) were recruited at Sahlgrenska University Hospital in Gothenburg, Sweden between 2015 and 2017. The interventions were Roux-en-Y gastric bypass (RYGB), n = 382, sleeve gastrectomy (SG), n = 201, or medical treatment (MT), n = 388. Blood samples and self-reported data on supplements were collected at baseline and two years post treatment. Anaemia was defined as haemoglobin <120 g/L for females and <130 g/L for males. Standard statistical methods, including a logistic regression model and a machine learning algorithm, were used to analyse data. The frequency of anaemia increased from baseline in patients treated with RYGB (3·0% vs 10·5%; p < 0·05). Neither iron-dependent biochemistry nor frequency of anaemia differed between participants who reported use of iron supplements and those who did not at the two-year follow-up. Low preoperative level of haemoglobin and high postoperative percent excessive BMI loss increased the predicted probability of anaemia two years after surgery.
The results from this study indicate that iron deficiency or anaemia may not be prevented by substitutional treatment per current guidelines after bariatric surgery and highlights there is reason to ensure adequate preoperative micronutrient levels.
March 03, 2015; NCT03152617.
减重手术后，微量营养素缺乏可能导致贫血。为预防术后缺乏，建议患者终生补充微量营养素。研究表明，补充微量营养素对预防减重手术后贫血的有效性存在差异。本研究旨在调查在接受减重手术后两年内报告使用补充剂的患者与未使用补充剂的患者之间营养缺乏与贫血的关系。
2015 年至 2017 年，在瑞典哥德堡的萨尔格伦斯卡大学医院招募了肥胖（BMI≥35 kg/m）个体（n=971）。干预措施包括 Roux-en-Y 胃旁路术（RYGB），n=382；袖状胃切除术（SG），n=201；或药物治疗（MT），n=388。在基线和治疗后两年收集血液样本和补充剂自我报告数据。贫血定义为女性血红蛋白<120 g/L，男性血红蛋白<130 g/L。采用标准统计方法，包括逻辑回归模型和机器学习算法分析数据。与基线相比，RYGB 治疗患者的贫血发生率增加（3.0% vs. 10.5%；p<0.05）。在两年随访时，报告使用铁补充剂和未使用铁补充剂的参与者之间，铁依赖性生化指标和贫血的发生频率无差异。术前血红蛋白水平低和术后体重指数过量百分比高会增加术后两年贫血的预测概率。
本研究结果表明，根据当前指南，铁缺乏或贫血在减重手术后可能无法通过替代治疗来预防，这表明有理由确保术前有足够的微量营养素水平。
2015 年 3 月 3 日；NCT03152617。
