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Anaemia and related nutrient deficiencies after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis.
BMJ Open. 2015 Jul 16; 5(7):e006964.BO

Abstract

OBJECTIVE

To obtain a pooled risk estimate on the long-term impact of anaemia and related nutritional deficiencies in patients receiving Roux-en-Y gastric bypass (RYGB) surgery.

DESIGN

Systematic review and meta-analysis.

DATA SOURCES

MEDLINE, EMBASE and Cochrane databases were searched to identify English reports published before 16 May 2014.

ELIGIBILITY CRITERIA

Articles with case numbers >100, follow-up period >12 months, and complete data from both before and after surgery were selected. Outcomes of interest were changes in baseline measurements of proportion of patients with anaemia, by haemoglobin, haematocrit, ferritin, iron, vitamin B12 and folate levels.

DATA COLLECTION AND ANALYSIS

Two reviewers independently reviewed data and selected six prospective and nine retrospective studies with a total of 5909 patients. A random effect model with inverse variance weighting was used to calculate summary estimates of outcomes at 6, 12, 24 and 36 months postoperatively.

RESULTS

Proportion of patients with anaemia was 12.2% at baseline, which, respectively, increased to 20.9% and 25.9% at 12 and 24 months follow-up, consistent with decreases in haemoglobin and haematocrit levels. Although the serum iron level did not change substantially after surgery, the frequency of patients with ferritin deficiency increased from 7.9% at baseline to 13.4% and 23.0% at 12 and 24 months, respectively, postoperation. Vitamin B12 deficiency increased from 2.3% at baseline to 6.5% at 12 months after surgery in those subjects receiving RYGB. There was no obvious increase in folate deficiency.

CONCLUSIONS

RYGB surgery is associated with an increased risk of anaemia and deficiencies of iron and vitamin B12, but not folate. Ferritin is more sensitive when serum iron level is within normal range.

Authors+Show Affiliations

Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Graduate Institute of Medical Genomics and Proteomics, National Taiwan University, Taipei, Taiwan.Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Institute of Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

26185175

Citation

Weng, Ting-Chia, et al. "Anaemia and Related Nutrient Deficiencies After Roux-en-Y Gastric Bypass Surgery: a Systematic Review and Meta-analysis." BMJ Open, vol. 5, no. 7, 2015, pp. e006964.
Weng TC, Chang CH, Dong YH, et al. Anaemia and related nutrient deficiencies after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. BMJ Open. 2015;5(7):e006964.
Weng, T. C., Chang, C. H., Dong, Y. H., Chang, Y. C., & Chuang, L. M. (2015). Anaemia and related nutrient deficiencies after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. BMJ Open, 5(7), e006964. https://doi.org/10.1136/bmjopen-2014-006964
Weng TC, et al. Anaemia and Related Nutrient Deficiencies After Roux-en-Y Gastric Bypass Surgery: a Systematic Review and Meta-analysis. BMJ Open. 2015 Jul 16;5(7):e006964. PubMed PMID: 26185175.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anaemia and related nutrient deficiencies after Roux-en-Y gastric bypass surgery: a systematic review and meta-analysis. AU - Weng,Ting-Chia, AU - Chang,Chia-Hsuin, AU - Dong,Yaa-Hui, AU - Chang,Yi-Cheng, AU - Chuang,Lee-Ming, Y1 - 2015/07/16/ PY - 2015/7/18/entrez PY - 2015/7/18/pubmed PY - 2016/3/29/medline KW - Anemia KW - Ferritin KW - Iron KW - Nutritional Anemia KW - Roux-en-Y Gastric Bypass SP - e006964 EP - e006964 JF - BMJ open JO - BMJ Open VL - 5 IS - 7 N2 - OBJECTIVE: To obtain a pooled risk estimate on the long-term impact of anaemia and related nutritional deficiencies in patients receiving Roux-en-Y gastric bypass (RYGB) surgery. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE, EMBASE and Cochrane databases were searched to identify English reports published before 16 May 2014. ELIGIBILITY CRITERIA: Articles with case numbers >100, follow-up period >12 months, and complete data from both before and after surgery were selected. Outcomes of interest were changes in baseline measurements of proportion of patients with anaemia, by haemoglobin, haematocrit, ferritin, iron, vitamin B12 and folate levels. DATA COLLECTION AND ANALYSIS: Two reviewers independently reviewed data and selected six prospective and nine retrospective studies with a total of 5909 patients. A random effect model with inverse variance weighting was used to calculate summary estimates of outcomes at 6, 12, 24 and 36 months postoperatively. RESULTS: Proportion of patients with anaemia was 12.2% at baseline, which, respectively, increased to 20.9% and 25.9% at 12 and 24 months follow-up, consistent with decreases in haemoglobin and haematocrit levels. Although the serum iron level did not change substantially after surgery, the frequency of patients with ferritin deficiency increased from 7.9% at baseline to 13.4% and 23.0% at 12 and 24 months, respectively, postoperation. Vitamin B12 deficiency increased from 2.3% at baseline to 6.5% at 12 months after surgery in those subjects receiving RYGB. There was no obvious increase in folate deficiency. CONCLUSIONS: RYGB surgery is associated with an increased risk of anaemia and deficiencies of iron and vitamin B12, but not folate. Ferritin is more sensitive when serum iron level is within normal range. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/26185175/Anaemia_and_related_nutrient_deficiencies_after_Roux_en_Y_gastric_bypass_surgery:_a_systematic_review_and_meta_analysis_ L2 - http://bmjopen.bmj.com/cgi/pmidlookup?view=long&pmid=26185175 DB - PRIME DP - Unbound Medicine ER -