title: Heme- and nonheme-iron absorption and iron status 12 mo after sleeve gastrectomy and Roux-en-Y gastric bypass in morbidly obese women.
abstract: BACKGROUND
  The effect of bariatric surgery on iron absorption is only partially known.
  
  
  OBJECTIVE
  The objective was to study the effects of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGBP) on heme- and nonheme-iron absorption and iron status.
  
  
  METHODS
  Fifty-eight menstruating women were enrolled in this prospective study [mean (±SD) age: 35.9 ± 9.1 y; weight: 101.7 ± 13.5 kg; BMI (in kg/m²): 39.9 ± 4.4]. Anthropometric, body-composition, dietary, and hematologic indexes and heme- and nonheme-iron absorption-using a standardized meal containing 3 mg Fe-were determined before and 12 mo after surgery. Forty-three subjects completed the 12-mo follow-up. Iron supplements were strictly controlled.
  
  
  RESULTS
  Heme-iron absorption was 23.9% before and 6.2% 12 mo after surgery (P < 0.0001). Nonheme-iron absorption decreased from 11.1% to 4.7% (P < 0.0001). No differences were observed by type of surgery. Iron intakes from all sources of supplements were 27.9 ± 6.2 mg/d in the SG group and 63.2 ± 21.1 mg/d in the RYGBP group (P < 0.001). Serum ferritin and total-body iron decreased more after RYGBP than after SG.
  
  
  CONCLUSIONS
  Iron (heme and nonheme) absorption is markedly reduced after SG and RYGBP. The magnitude of the decrease in heme-iron absorption is greater than that of nonheme iron. The amounts suggested as iron supplements may need to be increased to effectively prevent iron-status impairment.
authors.affiliation: Department of Nutrition, Faculty of Medicine, University of Chile, Santiago, Chile. mruz@med.uchile.cl
authors.forename: Manuel
authors.initials: M
authors.lastname: Ruz
authors.forename: Fernando
authors.initials: F
authors.lastname: Carrasco
authors.forename: Pamela
authors.initials: P
authors.lastname: Rojas
authors.forename: Juana
authors.initials: J
authors.lastname: Codoceo
authors.forename: Jorge
authors.initials: J
authors.lastname: Inostroza
authors.forename: Karen
authors.initials: K
authors.lastname: Basfi-Fer
authors.forename: Alejandra
authors.initials: A
authors.lastname: Valencia
authors.forename: Attila
authors.initials: A
authors.lastname: Csendes
authors.forename: Karin
authors.initials: K
authors.lastname: Papapietro
authors.forename: Fernando
authors.initials: F
authors.lastname: Pizarro
authors.forename: Manuel
authors.initials: M
authors.lastname: Olivares
authors.forename: Jamie L
authors.initials: JL
authors.lastname: Westcott
authors.forename: K Michael
authors.initials: KM
authors.lastname: Hambidge
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Krebs
mesh_terms: D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000150:complications / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control; D015992:Body Mass Index; D002677:Chile; D019587:Dietary Supplements; D004909:Erythrocyte Indices; D004912:Erythrocytes / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000009:adverse effects*; D015390:Gastric Bypass / Q000009:adverse effects*; D006418:Heme / Q000378:metabolism*; D006785:Hospitals, University; D006801:Humans; D007408:Intestinal Absorption; D007504:Iron Radioisotopes; D019266:Iron, Dietary / Q000008:administration & dosage / Q000378:metabolism* / Q000627:therapeutic use; D009752:Nutritional Status; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D010349:Patient Compliance; D010352:Patient Dropouts; D017697:Premenopause
chemical_list: D007504:Iron Radioisotopes; D019266:Iron, Dietary; D006418:Heme