Roberto de Cleva1, Lilian Cardia1, Daniel Riccioppo2, Miwa Kawamoto3, Newton Kanashiro3, Marco Aurelio Santo1. 1. 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. 2. 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. 3. University of São Paulo School of Medicine, São Paulo, Brazil.
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.
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 obesepatients, 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 obesepatients 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.
Authors: Annette von Drygalski; Deborah A Andris; Peter R Nuttleman; Scott Jackson; John Klein; James R Wallace Journal: Surg Obes Relat Dis Date: 2010-05-08 Impact factor: 4.734
Authors: Rayko Evstatiev; Philippe Marteau; Tariq Iqbal; Igor L Khalif; Jürgen Stein; Bernd Bokemeyer; Ivan V Chopey; Florian S Gutzwiller; Lise Riopel; Christoph Gasche Journal: Gastroenterology Date: 2011-06-12 Impact factor: 22.682
Authors: Ted D Adams; Richard E Gress; Sherman C Smith; R Chad Halverson; Steven C Simper; Wayne D Rosamond; Michael J Lamonte; Antoinette M Stroup; Steven C Hunt Journal: N Engl J Med Date: 2007-08-23 Impact factor: 91.245
Authors: A Schigt; V E A Gerdes; H A Cense; F J Berends; F M H van Dielen; I Janssen; A van der Laar; B A van Wagensveld; J A Romijn; M J Serlie Journal: Neth J Med Date: 2013-01 Impact factor: 1.422