Anemia after bariatric surgery cannot be explained by iron deficiency alone: results of a large cohort study

Drygalski, Annette von; Andris, Deborah A.; Nuttleman, Peter R.; Jackson, Scott; Klein, John P.; Wallace, James R.

doi:10.1016/j.soard.2010.04.008

Cited by 70 publications

(56 citation statements)

References 24 publications

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“…Other nutritional origins of anemia must be excluded by examining levels of folic acid, vitamin B12, zinc, copper, and vitamins A and E [22]. Eradication of H. pylori infection has been shown to improve responsiveness to iron supplementation and thus should be considered among the possible causes of postsurgical anemia [18].…”

Section: Evaluation Of Anemia and Cytopenias After Rygbmentioning

confidence: 99%

“…Obesity is also characterized by chronic inflammation, which is aggravated by rapid weight loss during the early postoperative period following RYGB. It was postulated that the associated elevation of a variety of proinflammatory cytokines increases the likelihood of anemia of inflammation and can also induce myelodysplastic-like features in the marrow that persist in the longterm after RYGB [22]. Hepcidin is upregulated by interleukin-6, and these factors act with other inflammatory cytokines and proteins, such as TNF- α , von Willebrand factor, C-reactive protein, and fibrinogen, which are all elevated in the early post-RYGB period [21].…”

Section: Obesity Mediated Inflammatory Anemia After Gastric Bypassmentioning

confidence: 99%

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Hematological Disorders following Gastric Bypass Surgery: Emerging Concepts of the Interplay between Nutritional Deficiency and Inflammation

Chen

Krishnamurthy

Mohamed

et al. 2013

BioMed Research International

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Obesity and the associated metabolic syndrome are among the most common and detrimental metabolic diseases of the modern era, affecting over 50% of the adult population in the United States. Surgeries designed to promote weight loss, known as bariatric surgery, typically involve a gastric bypass procedure and have shown high success rates for treating morbid obesity. However, following gastric bypass surgery, many patients develop chronic anemia, most commonly due to iron deficiency. Deficiencies of vitamins B1, B12, folate, A, K, D, and E and copper have also been reported after surgery. Copper deficiency can cause hematological abnormalities with or without neurological complications. Despite oral supplementation and normal serum concentrations of iron, copper, folate, and vitamin B12, some patients present with persistent anemia after surgery. The evaluation of hematologic disorders after gastric bypass surgery must take into account issues unique to the postsurgery setting that influence the development of anemia and other cytopenias. In this paper, the clinical characteristics and differential diagnosis of the hematological disorders associated with gastric bypass surgery are reviewed, and the underlying molecular mechanisms are discussed.

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Section: Evaluation Of Anemia and Cytopenias After Rygbmentioning

confidence: 99%

Section: Obesity Mediated Inflammatory Anemia After Gastric Bypassmentioning

confidence: 99%

Hematological Disorders following Gastric Bypass Surgery: Emerging Concepts of the Interplay between Nutritional Deficiency and Inflammation

Chen

Krishnamurthy

Mohamed

et al. 2013

BioMed Research International

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“…It is important to note that iron intake and TSI determined the increase of ferritin values 6 months after RYGB surgery when the analysis of both groups confirmed the influence of iron intake as the main marker of iron stores post-surgery in premenopausal women. The reduction of ferritin during the postoperative period increased the risk of anemia (13,23).…”

Section: Discussionmentioning

confidence: 99%

“…Iron deficiency can also be aggravated by menstrual blood loss in reproductive-aged women (4,(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

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Micronutrient supplementation in gastric bypass surgery: prospective study on inﬂammation and iron metabolism in premenopausal women

et al. 2017

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Marin FA, Verlengia R, Crisp AH, Sousa Novais PF, Rasera-Junior I, de Oliveira MR. Micronutrient supplementation in gastric bypass surgery: prospective study on infl ammation and iron metabolism in premenopausal women. Nutr Hosp 2017;34:369-375 DOI: http://dx.doi.org/10.20960/nh.1162 Paulo -FAPESP (Process no. 2012/18719-9) and Conselho Nacional de Desenvolvimento Científi co e Tecnológico -CNPq (Processs no. 142828/2011-4 Financial support: Fundação de Amparo à Pesquisa do Estado de São AbstractBackground: Low-grade chronic infl ammation in morbid obesity is associated with impaired iron metabolism. Bariatric surgery is effective in weight loss; however, it can induce specifi c nutritional defi ciencies, such as iron, especially in premenopausal women. Alternatively, after surgery, there is an improvement in systemic infl ammation, raising questions concerning the dosages of micronutrient supplementation. Objectives: This study aimed to assess the effect of two micronutrient supplementation schemes before and 6 months after a Roux-en-Y gastric bypass (RYGB) surgery on infl ammation and iron metabolism in premenopausal women.

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Prevalence of Self-reported Symptoms After Gastric Bypass Surgery for Obesity

et al. 2016

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Most patients reported improved well-being after RYGB surgery, but the prevalence of symptoms was high and nearly one-third of patients were hospitalized, 4- to 5-fold more than among the comparison group. Predictors of symptoms included young age, female sex, smoking, and experiencing symptoms before RYGB surgery. Development of weight loss procedures with fewer subsequent symptoms should be a high priority.

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Anemia after bariatric surgery cannot be explained by iron deficiency alone: results of a large cohort study

Cited by 70 publications

References 24 publications

Hematological Disorders following Gastric Bypass Surgery: Emerging Concepts of the Interplay between Nutritional Deficiency and Inflammation

Hematological Disorders following Gastric Bypass Surgery: Emerging Concepts of the Interplay between Nutritional Deficiency and Inflammation

Micronutrient supplementation in gastric bypass surgery: prospective study on inﬂammation and iron metabolism in premenopausal women

Prevalence of Self-reported Symptoms After Gastric Bypass Surgery for Obesity

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