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Prevalence of anemia and related deficiencies 10 years after gastric bypass: a retrospective study
Örebro universitet, Institutionen för hälsovetenskap och medicin. Division of Internal Medicine, Department of Endocrinology, Örebro University Hospital, Örebro, Sweden .
Division of Surgery, Örebro University Hospital, Region Örebro län, Örebro, Sweden.ORCID-id: 0000-0002-3644-3319
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden .
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden .
Visa övriga samt affilieringar
2015 (Engelska)Ingår i: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 25, nr 6, s. 1019-1023Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Bariatric surgery has gained wide acceptance as treatment for severe obesity and is associated with decreased overall mortality. The aims of this study were to evaluate the prevalence of anemia long term after Roux-en-Y gastric bypass (RYGB) and to search for factors predicting anemia.

All 745 patients who underwent RYGB between 1993 and 2003 at either A-rebro or Uppsala University Hospital and who were living in Sweden were invited to participate by providing a fasting blood sample and completing a questionnaire about their health status. Full blood count, serum iron, transferrin, vitamin B-12, and folic acid were determined.

Follow-up was completed in 431 patients (58 %) with mean age 51.3 +/- 10 years. Of all patients, 27 % had anemia postoperatively and related deficiencies; iron, folic acid, and vitamin B-12 were seen in 20, 12, and 2 %, respectively. There was no correlation between anemia and sex, follow-up time, 25-OH vitamin D level, and preoperative or postoperative BMI. An inverse correlation was found between anemia and regular medical checkups concerning gastric bypass surgery.

Twenty-seven percent of patients had anemia more than 10 years after RYGB. Anemia does not seem to progress with time and was less common in patients with regular medical checkups. Thus, improved long-term follow-up is needed.

Ort, förlag, år, upplaga, sidor
Springer, 2015. Vol. 25, nr 6, s. 1019-1023
Nyckelord [en]
Gastric bypass, Anemia, Iron deficiency, Long-termfollow-up
Nationell ämneskategori
Kirurgi
Forskningsämne
Kirurgi
Identifikatorer
URN: urn:nbn:se:oru:diva-44899DOI: 10.1007/s11695-014-1500-yISI: 000354216500010PubMedID: 25394588Scopus ID: 2-s2.0-84939978711OAI: oai:DiVA.org:oru-44899DiVA, id: diva2:821473
Anmärkning

Funding Agencies:

Örebro County Council

Uppsala-Örebro Regional Research Council RFR-32261

Tillgänglig från: 2015-06-15 Skapad: 2015-06-15 Senast uppdaterad: 2018-04-16Bibliografiskt granskad
Ingår i avhandling
1. Vitamin D and its role in obesity and other associated conditions
Öppna denna publikation i ny flik eller fönster >>Vitamin D and its role in obesity and other associated conditions
2018 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Vitamin D has received much attention in recent years due to the re-emergence of vitamin D deficiency as a global health issue along with increasing evidence indicating that 1,25-dihydroxivitamin D, the hormonally active form of vita-min D, not only acts in calcium and bone metabolism but also generates ex-traskeletal biological responses.

In this thesis, the role of vitamin D in obesity and other associated condi-tions has been studied.

In paper 1, the prevalence of vitamin D deficiency and secondary hyperpara-thyroidism over the long term after Roux-en-Y gastric bypass (RYGB) were evaluated. We found a substantial prevalence of vitamin D deficiency and secondary hyperparathyroidism after RYGB, whereas calcium levels remained within normal range. An expected improvement in vitamin D status after weight loss could have been countered by the malabsorption induced by surgery.

In paper 2, the prevalence of anemia and related deficiencies over the long term after RYGB were studied. We found that 27% of the patients had anemia postoperatively, 20% had iron deficiency, 12% had folate deficiency and 2% had vitamin B12 deficiency. Anemia was mainly due to iron deficiency, and its frequency did not seem to progress with time after surgery.

In paper 3, the effects of vitamin D supplementation on body composition and cardiorespiratory fitness in overweight men with vitamin D deficiency at baseline were investigated. No statistically significant difference between the placebo and the intervention group regarding changes in percentage body fat, maximum oxygen uptake, BMI and maximum load was found.

In paper 4, the prevalence and determinants of 3-epi-25(OH)D3 were exam-ined. 3-epi-25(OH)D3 was detected in 7.7% of the study population and the mean concentration was 8.4 nmol/L. The quantification of 3-epi-25(OH)D3 would not significantly influence the clinical interpretation of vitamin D levels.

In conclusion, new knowledge about vitamin D is continuously emerging but there is a discrepancy between cross-sectional studies associating low vitamin D levels to obesity and other related metabolic complications and the lack of effects of vitamin D supplementation in clinical trials. Large RCTs with longer duration in obese subjects with baseline vitamin D deficiency are warranted.

Ort, förlag, år, upplaga, sidor
Örebro: Örebro University, 2018. s. 67
Serie
Örebro Studies in Medicine, ISSN 1652-4063 ; 177
Nyckelord
Vitamin D, obesity, Roux-en-Y gastric bypass, secondary hyperpara-thyroidism, anemia, iron deficiency, body composition, cardiorespiratory fitness, Vitamin D C3 epimer
Nationell ämneskategori
Allmänmedicin
Identifikatorer
urn:nbn:se:oru:diva-64979 (URN)978-91-7529-238-0 (ISBN)
Disputation
2018-04-20, Örebro universitet, Campus USÖ, hörsal C3, Södra Grev Rosengatan 32, Örebro, 13:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2018-02-12 Skapad: 2018-02-12 Senast uppdaterad: 2019-02-06Bibliografiskt granskad

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Karefylakis, ChristosRask, Eva

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