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Prevalence and Incidence of Iron Deficiency in Patients Undergoing Bariatric Surgery: A Teaching Hospital Experience in Thailand

Polruang N, PharmD, BCNSP¹ , ², Rungprai D, B Pharm, BCP, FACP³, Tejavanija S, MD, MSc, ABPNS⁴, Linananda S, MD, BSc⁵, Santimaleeworagun W, B Pharm, PhD, BCIDP³

Affiliation : ¹ Department of Pharmacy, Bangbo Hospital, Samut Prakan, Thailand ² The College of Pharmacotherapy of Thailand, The Pharmacy Council, Nonthaburi, Thailand ³ Department of Pharmacy, Faculty of Pharmacy, Silpakorn University, Nakhon Pathom, Thailand ⁴ Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand ⁵ Department of Surgery, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand

Background: Bariatric surgery currently plays an important role in the treatment of obesity. However, iron deficiency and iron deficiency anemia are long-term complications after bariatric surgery. There have been no studies of prevalence and incidence of iron deficiency and iron deficiency anemia after bariatric surgery among Thai population.
Objective: To evaluate the incidence and prevalence of iron deficiency and iron deficiency anemia in Thai post-bariatric surgery patients.
Materials and Methods: The present study was a retrospective study. The data were collected from the medical records of 78 patients that underwent bariatric surgery, 12 for laparoscopic sleeve gastrectomy (LSG) and 66 for laparoscopic Roux-en-Y gastric bypass (LRYGB), at Phramongkutklao Hospital between January 2008 and December 2016. Demographic and laboratory data were obtained prior to surgery and at 3, 6, 12, and 24 months after the surgery.
Results: The prevalence and incidence of iron deficiency 24 months after LRYGB were 25.8% and 18.7%, respectively. The prevalence and incidence of iron deficiency anemia 24 months after LRYGB were 19.7% and 16.0%, respectively. Increasing time after surgery was also associated with significant abnormal iron profiles (p<0.001); whereas, there were no signs of iron deficiency and iron deficiency anemia among patients who underwent LSG.
Conclusion: At 24-month follow-up, the prevalence and incidence of iron deficiency and iron deficiency anemia have significantly increased among the patients who underwent LRYGB. Therefore, serum iron, hemoglobin, and hematocrit should be monitored to prevent and initiate the treatment of iron deficiency anemia.
Received 9 Sep 2019 | Revised 14 Nov 2019 | Accepted 21 Nov 2019

Keywords : Sleeve gastrectomy, Roux-en-Y gastric bypass, Iron deficiency, Anemia


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