Iron Deficiency Anemia and Its Effect on Comorbidities Post Roux-en-Y Gastric Bypass in Pakistani Population: A Single Center Cohort Study

Mushtaq Ahmad; Ghulam Siddiq; Tehreem Zahid; Sumaira Gulzar; Mahnoor Zahid

doi:doi:10.11648/j.ass.20221002.12

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Iron Deficiency Anemia and Its Effect on Comorbidities Post Roux-en-Y Gastric Bypass in Pakistani Population: A Single Center Cohort Study

Mushtaq Ahmad, Ghulam Siddiq, Tehreem Zahid, Sumaira Gulzar, Mahnoor Zahid

Published in Advances in Surgical Sciences (Volume 10, Issue 2)

Received: 12 August 2022 Accepted: 30 August 2022 Published: 16 September 2022

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Abstract

This single-center prospective cohort study was conducted from May 2015 to May 2020 at Shifa International Hospital, Islamabad, Pakistan. It included all patients above the age of 18 undergoing Roux en Y gastric bypass (RYGB) surgery for weight loss. All patients included had a body mass index above 40 kg/m² without co-morbidities and a body mass index between 30-35kg/m² with comorbidities. Iron studies, complete blood count, and lipid profile were done pre-operatively and post-operatively at 12, 24, and 36 months. There were 134 (67%) females and 66 (33%) males. A total of 110 (55%) people were iron deficient preoperatively. The mean age calculated for iron deficient participants was 42.25 while that for iron-sufficient was 46.13. Also, the mean preoperative BMI for iron deficient patients was 45.5 while for iron sufficient was 46.2. Overall, the mean hemoglobin before surgery was 13.5 which decreased to 12.9 at 12 months, 12.5 at 24 months, and 11.7 at 36 months postoperatively. There was an improvement in all comorbidities such as hypertension, type-2 diabetes, sleep apnea, quality of life, depression, osteoarthritis, gastroesophageal reflux disease, and dyslipidemia after RYGB surgery. Iron deficiency increases after RYGB, the deficiency is more profound in pre-menopausal women and people with baseline iron deficiency.

Published in	Advances in Surgical Sciences (Volume 10, Issue 2)
DOI	10.11648/j.ass.20221002.12
Page(s)	18-21
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Anemia, Bariatric Surgery, Iron Deficiency, Obesity, Roux en Y

References

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[2]	Ikramuddin S, Korner J, Lee W-J, Connett JE, Inabnet WB, Billington CJ, et al. Roux-en-Y gastric bypass vs intensive medical management for the control of type 2 diabetes, hypertension, and Hyperlipidemia. JAMA. 2013; 309 (21): 2240.
[3]	Gowanlock Z, Lezhanska A, Conroy M, Crowther M, Tiboni M, Mbuagbaw L, et al. Iron deficiency following bariatric surgery: A retrospective cohort study. Blood Advances. 2020; 4 (15): 3639–47.
[4]	Lowry B, Hardy K, Vergis A. Iron deficiency in bariatric surgery patients: A single-centre experience over 5 years. Canadian Journal of Surgery. 2020; 63 (4).
[5]	Alvarez-Leite JI. Nutrient deficiencies secondary to bariatric surgery. Curr Opin Clin Nutr Metab Care 2004; 7: 569-575.
[6]	Castanha CR, Ferraz AAB, Castanha AR, Queiroz G, Lacerda RML. Vilar L. Avaliação da qualidade de vida, perda de peso e comorbidades de pacientes submetidos à cirurgia bariátrica. Rev Col Bras Cir. 2018; 45 (3): e1864.
[7]	Kelles SMB, Machado CJ, Barreto SM. Ten-years of bariatric surgery in Brazil: in-hospital mortality rates for patients assisted by universal health system or a health maintenance organization. ABCD. Arq Bras Cir Dig. 2014; 27 (4): 261-7.
[8]	Brolin RE, Gorman JH, Gorman RC, et al. Prophylactic iron supplementation after Roux-en-Y gastric bypass: a prospective double-blind randomized study. Arch Surg 1998; 122: 740e744.
[9]	Teitelman M, Grotegut CA, Williams NN, Lewis JD. The impact of bariatric surgery on menstrual patterns. Obes Surg 2006; 16: 1457e1463.
[10]	Obinwanne KM, Fredrickson KA, Mathiason MA, Kallies KJ, Farnen JP, Kothari SN J Am Coll Surg. 2014 Feb; 218 (2): 246-52. Incidence, treatment, and outcomes of iron deficiency after laparoscopic Roux-en-Y gastric bypass: a 10-year analysis.
[11]	Munoz F, Botella-Romero S, Gomez-Ramirez A, et al. Iron deficiency and anemia in bariatric surgical patients: causes, diagnosis and proper management. Nutr Hosp. 2009; 24: 640–54.
[12]	Toh SY, Zarshenas N, Prevalence of nutrient deficiencies in bariatric patients Jorgensen J Nutrition. 2009 Nov-Dec; 25 (11-12): 1150-6.
[13]	Salgado W Jr, Modotti C, Nonino CB, Ceneviva R. Anemia and iron deficiency before and after bariatric surgery. Surg Obes Relat Dis. 2014; 10 (1): 49-54.
[14]	Alexandrou A, Armeni E, Kouskouni E, Tsoka E, Diamantis T, Lambrinoudaki, I. Cross-sectional long-term micronutrient deficiencies after sleeve gastrectomy versus Roux-en-Y gastric bypass: a pilot study. Surg Obes Relat Dis. 2014; 10 (2): 262-8.
[15]	Mizón C, Ruz M, Csendes A, Carrasco F, Rebolledo A, Codoceo J, Inostroza J, Papapietro K, Pizarro F, Olivares M. Persistent anemia after Roux-en-Y gastric bypass. Nutrition 2007; 23: 277-280.

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APA Style

Mushtaq Ahmad, Ghulam Siddiq, Tehreem Zahid, Sumaira Gulzar, Mahnoor Zahid. (2022). Iron Deficiency Anemia and Its Effect on Comorbidities Post Roux-en-Y Gastric Bypass in Pakistani Population: A Single Center Cohort Study. Advances in Surgical Sciences, 10(2), 18-21. https://doi.org/10.11648/j.ass.20221002.12

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ACS Style

Mushtaq Ahmad; Ghulam Siddiq; Tehreem Zahid; Sumaira Gulzar; Mahnoor Zahid. Iron Deficiency Anemia and Its Effect on Comorbidities Post Roux-en-Y Gastric Bypass in Pakistani Population: A Single Center Cohort Study. Adv. Surg. Sci. 2022, 10(2), 18-21. doi: 10.11648/j.ass.20221002.12

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AMA Style

Mushtaq Ahmad, Ghulam Siddiq, Tehreem Zahid, Sumaira Gulzar, Mahnoor Zahid. Iron Deficiency Anemia and Its Effect on Comorbidities Post Roux-en-Y Gastric Bypass in Pakistani Population: A Single Center Cohort Study. Adv Surg Sci. 2022;10(2):18-21. doi: 10.11648/j.ass.20221002.12

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@article{10.11648/j.ass.20221002.12,
  author = {Mushtaq Ahmad and Ghulam Siddiq and Tehreem Zahid and Sumaira Gulzar and Mahnoor Zahid},
  title = {Iron Deficiency Anemia and Its Effect on Comorbidities Post Roux-en-Y Gastric Bypass in Pakistani Population: A Single Center Cohort Study},
  journal = {Advances in Surgical Sciences},
  volume = {10},
  number = {2},
  pages = {18-21},
  doi = {10.11648/j.ass.20221002.12},
  url = {https://doi.org/10.11648/j.ass.20221002.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20221002.12},
  abstract = {This single-center prospective cohort study was conducted from May 2015 to May 2020 at Shifa International Hospital, Islamabad, Pakistan. It included all patients above the age of 18 undergoing Roux en Y gastric bypass (RYGB) surgery for weight loss. All patients included had a body mass index above 40 kg/m2 without co-morbidities and a body mass index between 30-35kg/m2 with comorbidities. Iron studies, complete blood count, and lipid profile were done pre-operatively and post-operatively at 12, 24, and 36 months. There were 134 (67%) females and 66 (33%) males. A total of 110 (55%) people were iron deficient preoperatively. The mean age calculated for iron deficient participants was 42.25 while that for iron-sufficient was 46.13. Also, the mean preoperative BMI for iron deficient patients was 45.5 while for iron sufficient was 46.2. Overall, the mean hemoglobin before surgery was 13.5 which decreased to 12.9 at 12 months, 12.5 at 24 months, and 11.7 at 36 months postoperatively. There was an improvement in all comorbidities such as hypertension, type-2 diabetes, sleep apnea, quality of life, depression, osteoarthritis, gastroesophageal reflux disease, and dyslipidemia after RYGB surgery. Iron deficiency increases after RYGB, the deficiency is more profound in pre-menopausal women and people with baseline iron deficiency.},
 year = {2022}
}

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TY - JOUR
T1 - Iron Deficiency Anemia and Its Effect on Comorbidities Post Roux-en-Y Gastric Bypass in Pakistani Population: A Single Center Cohort Study
AU - Mushtaq Ahmad
AU - Ghulam Siddiq
AU - Tehreem Zahid
AU - Sumaira Gulzar
AU - Mahnoor Zahid
Y1 - 2022/09/16
PY - 2022
N1 - https://doi.org/10.11648/j.ass.20221002.12
DO - 10.11648/j.ass.20221002.12
T2 - Advances in Surgical Sciences
JF - Advances in Surgical Sciences
JO - Advances in Surgical Sciences
SP - 18
EP - 21
PB - Science Publishing Group
SN - 2376-6182
UR - https://doi.org/10.11648/j.ass.20221002.12
AB - This single-center prospective cohort study was conducted from May 2015 to May 2020 at Shifa International Hospital, Islamabad, Pakistan. It included all patients above the age of 18 undergoing Roux en Y gastric bypass (RYGB) surgery for weight loss. All patients included had a body mass index above 40 kg/m2 without co-morbidities and a body mass index between 30-35kg/m2 with comorbidities. Iron studies, complete blood count, and lipid profile were done pre-operatively and post-operatively at 12, 24, and 36 months. There were 134 (67%) females and 66 (33%) males. A total of 110 (55%) people were iron deficient preoperatively. The mean age calculated for iron deficient participants was 42.25 while that for iron-sufficient was 46.13. Also, the mean preoperative BMI for iron deficient patients was 45.5 while for iron sufficient was 46.2. Overall, the mean hemoglobin before surgery was 13.5 which decreased to 12.9 at 12 months, 12.5 at 24 months, and 11.7 at 36 months postoperatively. There was an improvement in all comorbidities such as hypertension, type-2 diabetes, sleep apnea, quality of life, depression, osteoarthritis, gastroesophageal reflux disease, and dyslipidemia after RYGB surgery. Iron deficiency increases after RYGB, the deficiency is more profound in pre-menopausal women and people with baseline iron deficiency.
VL - 10
IS - 2
ER -

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Author Information

Mushtaq Ahmad

Department of Bariatric Surgery, Shifa International Hospital, Islamabad, Pakistan
Ghulam Siddiq

Department of Bariatric Surgery, Shifa International Hospital, Islamabad, Pakistan
Tehreem Zahid

Shifa Clinical Research Center, Shifa International Hospital, Islamabad, Pakistan
Sumaira Gulzar

Shifa Clinical Research Center, Shifa International Hospital, Islamabad, Pakistan
Mahnoor Zahid

Benazir Bhutto Hospital, Rawalpindi, Pakistan

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APA Style

Mushtaq Ahmad, Ghulam Siddiq, Tehreem Zahid, Sumaira Gulzar, Mahnoor Zahid. (2022). Iron Deficiency Anemia and Its Effect on Comorbidities Post Roux-en-Y Gastric Bypass in Pakistani Population: A Single Center Cohort Study. Advances in Surgical Sciences, 10(2), 18-21. https://doi.org/10.11648/j.ass.20221002.12

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ACS Style

Mushtaq Ahmad; Ghulam Siddiq; Tehreem Zahid; Sumaira Gulzar; Mahnoor Zahid. Iron Deficiency Anemia and Its Effect on Comorbidities Post Roux-en-Y Gastric Bypass in Pakistani Population: A Single Center Cohort Study. Adv. Surg. Sci. 2022, 10(2), 18-21. doi: 10.11648/j.ass.20221002.12

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AMA Style

Mushtaq Ahmad, Ghulam Siddiq, Tehreem Zahid, Sumaira Gulzar, Mahnoor Zahid. Iron Deficiency Anemia and Its Effect on Comorbidities Post Roux-en-Y Gastric Bypass in Pakistani Population: A Single Center Cohort Study. Adv Surg Sci. 2022;10(2):18-21. doi: 10.11648/j.ass.20221002.12

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@article{10.11648/j.ass.20221002.12,
  author = {Mushtaq Ahmad and Ghulam Siddiq and Tehreem Zahid and Sumaira Gulzar and Mahnoor Zahid},
  title = {Iron Deficiency Anemia and Its Effect on Comorbidities Post Roux-en-Y Gastric Bypass in Pakistani Population: A Single Center Cohort Study},
  journal = {Advances in Surgical Sciences},
  volume = {10},
  number = {2},
  pages = {18-21},
  doi = {10.11648/j.ass.20221002.12},
  url = {https://doi.org/10.11648/j.ass.20221002.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ass.20221002.12},
  abstract = {This single-center prospective cohort study was conducted from May 2015 to May 2020 at Shifa International Hospital, Islamabad, Pakistan. It included all patients above the age of 18 undergoing Roux en Y gastric bypass (RYGB) surgery for weight loss. All patients included had a body mass index above 40 kg/m2 without co-morbidities and a body mass index between 30-35kg/m2 with comorbidities. Iron studies, complete blood count, and lipid profile were done pre-operatively and post-operatively at 12, 24, and 36 months. There were 134 (67%) females and 66 (33%) males. A total of 110 (55%) people were iron deficient preoperatively. The mean age calculated for iron deficient participants was 42.25 while that for iron-sufficient was 46.13. Also, the mean preoperative BMI for iron deficient patients was 45.5 while for iron sufficient was 46.2. Overall, the mean hemoglobin before surgery was 13.5 which decreased to 12.9 at 12 months, 12.5 at 24 months, and 11.7 at 36 months postoperatively. There was an improvement in all comorbidities such as hypertension, type-2 diabetes, sleep apnea, quality of life, depression, osteoarthritis, gastroesophageal reflux disease, and dyslipidemia after RYGB surgery. Iron deficiency increases after RYGB, the deficiency is more profound in pre-menopausal women and people with baseline iron deficiency.},
 year = {2022}
}

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