Impact of laparoscopic sleeve gastrectomy on iron indices: 1 year follow-up.
BACKGROUND
Laparoscopic sleeve gastrectomy (LSG) has been recently introduced as a stand-alone, restrictive bariatric surgery. Theoretically, LSG attenuates micronutrients deficiencies and associated complications that typically observed following malabsorptive procedures. The aim of this study was to assess iron indices and the 1-year incidence of iron deficiency in patients undergoing LSG.


METHODS
This was a prospective, cohort study; patients who underwent LSG from June 2007 to April 2008 at our institution were screened for inclusion. Preoperative hemoglobin and iron indices including serum iron, transferrin saturation, ferritin, and soluble transferrin receptor were compared to their levels at 6 and 12 months after surgery. Similarly, vitamin B12 and red blood cell (RBC) folate were analyzed as secondary end points. Weight parameters and C-reactive protein (CRP) levels were compared before surgery and 1 year postoperatively.


RESULTS
A total of 61 patients were included in the study. One year after surgery, there was a significant decrease in the mean body mass index from 47.5 +/- 9.6 to 30.5 +/- 6.5 (P < 0.001). The incidence of iron deficiency was 4.9% at both follow-up time points. Anemia was evident in 4.9% of patients 1 year postoperatively. Significant decrease in the means of the natural logarithm of vitamin B12 and RBC folate were observed as early as 6 months after surgery (P = 0.014; P < 0.005, respectively). The decrease in mean CRP level 12 months postoperatively was statistically significant compared to its preoperative value (P < 0.0001).


CONCLUSIONS
LSG is an effective procedure for the treatment of morbid obesity and its associated inflammatory state. One year after surgery, development of iron deficiency was insignificant.
Hakeam
Hakeam A
HA
Pharmacy Services Division, King Faisal Specialist Hospital & Research Centre, PO Box 3354 MBC#11, Riyadh 11211, Saudi Arabia. hakeam@kfshrc.edu.sa
O'Regan
Patrick J
PJ
Salem
Abdulrahman M
AM
Bamehriz
Fahad Y
FY
Eldali
Abdelmoneim M
AM
D018798:Anemia, Iron-Deficiency / Q000097:blood / Q000453:epidemiology* / Q000209:etiology; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D015331:Cohort Studies; D003677:Deficiency Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology; D004912:Erythrocytes / Q000737:chemistry; D005260:Female; D005293:Ferritins / Q000097:blood; D005492:Folic Acid / Q000097:blood; D005743:Gastrectomy / Q000009:adverse effects; D006801:Humans; D007501:Iron / Q000097:blood*; D000090463:Iron Deficiencies; D010535:Laparoscopy; D008297:Male; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications / Q000601:surgery*; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology; D011446:Prospective Studies; D011990:Receptors, Transferrin; D014168:Transferrin / Q000378:metabolism; D014805:Vitamin B 12 / Q000097:blood; D015431:Weight Loss / Q000502:physiology
D011990:Receptors, Transferrin; D014168:Transferrin; D002097:C-Reactive Protein; D005293:Ferritins; D005492:Folic Acid; D007501:Iron; D014805:Vitamin B 12