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Obesity Week 2013

Females have 50% chance of iron deficiency after bypass

The incidence of iron deficiency was increased among women compared to men (57% vs. 20%)

Female patients should be advised that there is a 50% chance they will become iron deficient following laparoscopic Roux-en-Y gastric bypass (LRYGB), according to researchers from Gundersen Health System. They also noted that given the incidence of iron deficiency after LRYGB reported in their study patients should have iron status monitored carefully by all providers and be appropriately referred for treatment.

The study entitled, ‘Incidence, treatment, and outcomes of iron deficiency after laparoscopic roux-en-y gastric bypass: a 10-year analysis’, sought to determine the incidence of iron deficiency and the need for intravenous iron administration after LRYGB at their community-based integrated multi-specialty health system and teaching hospital.  

They reviewed the medical records of patients who underwent LRYGB from September 2001 to December 2011, and the inclusion criteria consisted of at least one ferritin value after surgery. Patients were stratified by level of iron deficiency. Patients with at least one ferritin value <50ng/mL were considered iron deficient.

The results revealed that there were 959 patients (84.9% were female); 492 (51.3%) patients were iron deficient. Of these, 40.9% were severely iron deficient, with a ferritin value <30ng/mL. Two hundred eighteen patients (22.7%) met criteria for iron-deficiency anaemia, and 92.2% of patients with iron-deficiency anaemia were severely iron deficient.  

Patients who were iron deficient in the postoperative period were younger (41.7 vs. 46.0 years; p=0.001). The incidence of iron deficiency was increased among women compared to men (57% vs. 20%; p=0.001) and women who were premenopausal compared to those who were postmenopausal (71% vs. 35%; p=0.001).

Intravenous iron was required by 6.7%. After Intravenous iron therapy, 53% had improvement in both haemoglobin and ferritin values, and 39% had improvement in ferritin values only.

Mean ferritin levels at one, two, and three to five years postoperatively were 45.8, 36.8, and 22.1ng/mL in the iron deficient group vs. 159.4, 155.9, and 129.0ng/mL, in patients who were never iron deficient, respectively (p=0.001).  

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