Changes in Hematology and Calcium Metabolism After Gastric Bypass Surgery: a 2-Year Follow-Up Study
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Changes in Hematology and Calcium Metabolism After Gastric Bypass Surgery : a 2-Year Follow-Up Study. / Worm, Dorte; Madsbad, Sten; Kristiansen, Viggo B; Naver, Lars; Hansen, Dorte Lindqvist.
I: Obesity Surgery, Bind 25, Nr. 9, 09.2015, s. 1647-52.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Changes in Hematology and Calcium Metabolism After Gastric Bypass Surgery
T2 - a 2-Year Follow-Up Study
AU - Worm, Dorte
AU - Madsbad, Sten
AU - Kristiansen, Viggo B
AU - Naver, Lars
AU - Hansen, Dorte Lindqvist
PY - 2015/9
Y1 - 2015/9
N2 - BACKGROUND: Concerns regarding nutritional deficiencies have recently emerged after Roux-en-Y gastric bypass (RYGB).METHODS: A total of 835 subjects underwent RYGB, age 43.3 years, body mass index (BMI) 47.2 kg/m(2). Hematological and calcium metabolic variables were measured before, 6, 12, and 24 months after surgery. Daily supplement of 800 mg calcium, 800 U vitamin D, a multivitamin, and a vitamin B12 injection (1 mg) every third month was recommended. In subjects with low ferritin and decreasing hemoglobin levels, oral, or intravenous iron was administered.RESULTS: Hemoglobin concentration decreased from before surgery to month 24 for both men (9.3 ± 0.05 vs. 8.3 ± 0.08 mmol/L, p < 0.001) and women (8.4 ± 0.03 vs. 7.7 ± 0.06 mmol/L, p < 0.001). At 24 months, anemia was present in 25.8 % of women and 22.1 % of men. Predictors of anemia in both sexes were baseline hemoglobin (p < 0.001), excessive weight loss in men, and younger age in women (p < 0.001). Plasma ferritin levels decreased in both sexes (p < 0.01), whereas concentrations of folic acid and vitamin B12 increased from before surgery to 24 months after surgery (p < 0.001). Vitamin D increased from baseline to month 24 in both sexes (p < 0.01). In women, PTH increased from baseline to month 24 (p < 0.05) with no changes in calcium or magnesium.CONCLUSIONS: Supplementation of calcium and vitamin D was sufficient. Iron substitution did not prevent anemia, which especially affected premenopausal women. More attention should be given to iron substitution after RYGB.
AB - BACKGROUND: Concerns regarding nutritional deficiencies have recently emerged after Roux-en-Y gastric bypass (RYGB).METHODS: A total of 835 subjects underwent RYGB, age 43.3 years, body mass index (BMI) 47.2 kg/m(2). Hematological and calcium metabolic variables were measured before, 6, 12, and 24 months after surgery. Daily supplement of 800 mg calcium, 800 U vitamin D, a multivitamin, and a vitamin B12 injection (1 mg) every third month was recommended. In subjects with low ferritin and decreasing hemoglobin levels, oral, or intravenous iron was administered.RESULTS: Hemoglobin concentration decreased from before surgery to month 24 for both men (9.3 ± 0.05 vs. 8.3 ± 0.08 mmol/L, p < 0.001) and women (8.4 ± 0.03 vs. 7.7 ± 0.06 mmol/L, p < 0.001). At 24 months, anemia was present in 25.8 % of women and 22.1 % of men. Predictors of anemia in both sexes were baseline hemoglobin (p < 0.001), excessive weight loss in men, and younger age in women (p < 0.001). Plasma ferritin levels decreased in both sexes (p < 0.01), whereas concentrations of folic acid and vitamin B12 increased from before surgery to 24 months after surgery (p < 0.001). Vitamin D increased from baseline to month 24 in both sexes (p < 0.01). In women, PTH increased from baseline to month 24 (p < 0.05) with no changes in calcium or magnesium.CONCLUSIONS: Supplementation of calcium and vitamin D was sufficient. Iron substitution did not prevent anemia, which especially affected premenopausal women. More attention should be given to iron substitution after RYGB.
KW - Adult
KW - Anemia
KW - Calcium
KW - Dietary Supplements
KW - Female
KW - Follow-Up Studies
KW - Gastric Bypass
KW - Humans
KW - Male
KW - Malnutrition
KW - Middle Aged
KW - Obesity, Morbid
U2 - 10.1007/s11695-014-1568-4
DO - 10.1007/s11695-014-1568-4
M3 - Journal article
C2 - 25585613
VL - 25
SP - 1647
EP - 1652
JO - Obesity Surgery
JF - Obesity Surgery
SN - 0960-8923
IS - 9
ER -
ID: 162446121