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Anemia Before and After Roux-en-Y Gastric Bypass: Prevalence and Evolution on Long-Term Follow-up.

Abstract

PURPOSE

Anemia due to iron deficiency or inflammatory state is often associated with obesity. Bariatric surgery is responsible for increasing iron deficiency, but weight loss decreases the inflammatory state associated with obesity. The objective of our study was to investigate the prevalence and causes of anemia before and after bariatric surgery for severe obesity in a 5-year follow-up.

MATERIALS AND METHODS

Retrospective study, with electronic record analysis of obese patients, submitted to Roux-en-Y gastric bypass. Laboratory data were collected before and up to 60 months after surgery. Diagnosis and classification of anemia were done according to hemoglobin levels, serum ferritin, and transferrin saturation.

RESULTS

Preoperatively, 8.8% of patients had anemia (93.2%, mild), and 43.8% of the patients had anemia due to chronic disease. After 24 months, there was a progressive increase of iron-deficiency anemia (72.4%) and decrease in anemia due to chronic disease (15.5%) and mixed (12.1%), with maintenance of this profile during long-term follow-up.

CONCLUSION

Anemia is very frequent in severely obese patients and must be investigated both before and after bariatric surgery. The cause of anemia must be determined in order to use the best treatment available. We observed a reduction in the prevalence of chronic disease anemia during long-term follow-up probably due to the improvement in the systemic inflammatory state.

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  • Authors+Show Affiliations

    ,

    Department of Digestive Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, Rua Oscar Freire 2250 - CJ 314, São Paulo, SP, 05409-011, Brazil.

    ,

    Department of Digestive Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, Rua Oscar Freire 2250 - CJ 314, São Paulo, SP, 05409-011, Brazil.

    ,

    Department of Digestive Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, Rua Oscar Freire 2250 - CJ 314, São Paulo, SP, 05409-011, Brazil. danriccioppo@me.com.

    ,

    University of São Paulo School of Medicine, São Paulo, Brazil.

    ,

    University of São Paulo School of Medicine, São Paulo, Brazil.

    Department of Digestive Surgery, Hospital das Clínicas, University of São Paulo School of Medicine, Rua Oscar Freire 2250 - CJ 314, São Paulo, SP, 05409-011, Brazil.

    Source

    Obesity surgery : 2019 May 14 pg

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31087235

    Citation

    de Cleva, Roberto, et al. "Anemia Before and After Roux-en-Y Gastric Bypass: Prevalence and Evolution On Long-Term Follow-up." Obesity Surgery, 2019.
    de Cleva R, Cardia L, Riccioppo D, et al. Anemia Before and After Roux-en-Y Gastric Bypass: Prevalence and Evolution on Long-Term Follow-up. Obes Surg. 2019.
    de Cleva, R., Cardia, L., Riccioppo, D., Kawamoto, M., Kanashiro, N., & Santo, M. A. (2019). Anemia Before and After Roux-en-Y Gastric Bypass: Prevalence and Evolution on Long-Term Follow-up. Obesity Surgery, doi:10.1007/s11695-019-03920-6.
    de Cleva R, et al. Anemia Before and After Roux-en-Y Gastric Bypass: Prevalence and Evolution On Long-Term Follow-up. Obes Surg. 2019 May 14; PubMed PMID: 31087235.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Anemia Before and After Roux-en-Y Gastric Bypass: Prevalence and Evolution on Long-Term Follow-up. AU - de Cleva,Roberto, AU - Cardia,Lilian, AU - Riccioppo,Daniel, AU - Kawamoto,Miwa, AU - Kanashiro,Newton, AU - Santo,Marco Aurelio, Y1 - 2019/05/14/ PY - 2019/5/16/entrez KW - Anemia KW - Bariatric surgery KW - Chronic disease KW - Obesity JF - Obesity surgery JO - Obes Surg N2 - PURPOSE: Anemia due to iron deficiency or inflammatory state is often associated with obesity. Bariatric surgery is responsible for increasing iron deficiency, but weight loss decreases the inflammatory state associated with obesity. The objective of our study was to investigate the prevalence and causes of anemia before and after bariatric surgery for severe obesity in a 5-year follow-up. MATERIALS AND METHODS: Retrospective study, with electronic record analysis of obese patients, submitted to Roux-en-Y gastric bypass. Laboratory data were collected before and up to 60 months after surgery. Diagnosis and classification of anemia were done according to hemoglobin levels, serum ferritin, and transferrin saturation. RESULTS: Preoperatively, 8.8% of patients had anemia (93.2%, mild), and 43.8% of the patients had anemia due to chronic disease. After 24 months, there was a progressive increase of iron-deficiency anemia (72.4%) and decrease in anemia due to chronic disease (15.5%) and mixed (12.1%), with maintenance of this profile during long-term follow-up. CONCLUSION: Anemia is very frequent in severely obese patients and must be investigated both before and after bariatric surgery. The cause of anemia must be determined in order to use the best treatment available. We observed a reduction in the prevalence of chronic disease anemia during long-term follow-up probably due to the improvement in the systemic inflammatory state. SN - 1708-0428 UR - https://www.unboundmedicine.com/medline/citation/31087235/Anemia_Before_and_After_Roux-en-Y_Gastric_Bypass:_Prevalence_and_Evolution_on_Long-Term_Follow-up L2 - https://dx.doi.org/10.1007/s11695-019-03920-6 DB - PRIME DP - Unbound Medicine ER -