Prevalence of iron, folate, and vitamin B12 deficiency anemia after laparoscopic Roux-en-Y gastric bypass
Prevalence of iron, folate, and vitamin B12 deficiency anemia after laparoscopic Roux-en-Y gastric bypass
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DOI：
10.1007/s11695-007-9310-0
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发表时间：
2008-03-01
期刊：
影响因子：
2.9
通讯作者：
Herrera, Miguel F.
中科院分区：
文献类型：
--
作者：
Vargas-Ruiz, Angel G.;Hernandez-Rivera, Gabriela;Herrera, Miguel F.
背景腹腔镜Roux-en-Y胃旁路术（LRYGBP）是最常见的减肥手术之一，在这种手术中胃容量受到限制，小肠的吸收减少。本研究的目的是评估LRYGBP患者铁、叶酸和维生素B12缺乏性贫血的发生率。患者和方法纳入了2003年7月至2005年1月在我们门诊接受LRYGBP治疗的30例患者的临床记录，这些患者至少随访了24个月。所有患者都服用了复合维生素补充剂。分析术前、术后6个月、1、2、3年的全血细胞计数、血浆铁、总铁结合能力、转铁蛋白饱和度、血清叶酸和钴胺素水平。结果女性25例（83.4%），男性5例（16.6%），年龄21 ~ 56岁。术前2例（6.6%）出现缺铁性贫血。术后2年和3年缺铁的比例分别为40%和54.5%。2年时33.3%的人缺乏钴胺素，3年时27.2%的人缺乏钴胺素。随访2年时，46.6%的患者已经出现贫血，随访3年时为63.6%。没有观察到任何患者叶酸缺乏。结论我们的常规维生素补充方案不足以预防大多数患者的铁和维生素B12缺乏症。
Background One of the most common bariatric operations is the laparoscopic Roux-en-Y gastric bypass (LRYGBP) in which the gastric capacity is restricted and the absorption by the small intestine is reduced. The objective of this study was to evaluate the incidence of iron, folate, and vitamin B12 deficiency anemia in patients undergoing LRYGBP.Patients and methods Clinical records of 30 patients who underwent LRYGBP between July 2003 and January 2005 and had a minimum follow up of 24 months at our outpatient clinic were included. Multivitamin supplementation was prescribed to all patients. The complete blood cell count, plasma iron, total iron-binding capacity, transferrin saturation, serum folate, and cobalamin levels before surgery, 6 months, 1, 2, and 3 years after the surgery were analyzed.Results There were 25 women (83.4%) and five men (16.6%) with ages from 21 to 56 years. Before surgery, two patients (6.6%) presented ferropenic anemia. Iron deficiency was seen in 40 and 54.5% 2 and 3 years after surgery, respectively. Cobalamin deficiency was observed in 33.3% at 2 years and in 27.2% at 3 years. At 2-year follow-up, 46.6% of the patients had already developed anemia and 63.6% at 3 years. Folate deficiency was not observed in any patient.Conclusion Our routine scheme of vitamin supplementation is not sufficient to prevent iron and vitamin B12 deficiencies in most patients.