Skip to main content
Erschienen in: Obesity Surgery 11/2020

12.08.2020 | Review

Iron, Vitamin B12, Folate and Copper Deficiency After Bariatric Surgery and the Impact on Anaemia: a Systematic Review

verfasst von: Carrie-Anne Lewis, Susan de Jersey, Matthew Seymour, George Hopkins, Ingrid Hickman, Emma Osland

Erschienen in: Obesity Surgery | Ausgabe 11/2020

Einloggen, um Zugang zu erhalten

Abstract

Bariatric surgery may increase the risk of iron, vitamin B12, folate and copper deficiencies, which can cause anaemia. This review aims to critique the evidence on the prevalence of these nutritional deficiencies and the impact on anaemia in the first 12 months after surgery. PRISMA and MOOSE frameworks, the NHMRC evidence hierarchy and The Academy of Nutrition and Dietetics bias tool were used to systematically critique current literature. Seventeen studies reported on deficiency prevalence with the majority being of low quality. Important confounders to serum micronutrient levels were not adequately considered. Results on the prevalence of nutritional anaemias were also lacking. Further investigation into the prevalence of iron, vitamin B12, folate and copper deficiency and its impact on anaemia in bariatric surgery is needed.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
3.
Zurück zum Zitat Mechanick JI, Apovian C, Brethauer S, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures–2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists. Surg Obes Relat Dis. 2020;16(2):175–247.PubMedCrossRef Mechanick JI, Apovian C, Brethauer S, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures–2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists. Surg Obes Relat Dis. 2020;16(2):175–247.PubMedCrossRef
4.
Zurück zum Zitat Parrott J, Frank L, Rabena R, et al. American Society for Metabolic and Bariatric Surgery integrated health nutritional guidelines for the surgical weight loss patient 2016 update: micronutrients. Surg Obes Relat Dis. 2017;13(5):727–41.PubMedCrossRef Parrott J, Frank L, Rabena R, et al. American Society for Metabolic and Bariatric Surgery integrated health nutritional guidelines for the surgical weight loss patient 2016 update: micronutrients. Surg Obes Relat Dis. 2017;13(5):727–41.PubMedCrossRef
8.
Zurück zum Zitat Duncan A, Talwar D, McMillan C, et al. Quantitative data on the magnitude of the systemic inflammatory response and its effect on micronutrient status based on plasma measures. Am J Clin Nutr. 2012;95:64–71.PubMedCrossRef Duncan A, Talwar D, McMillan C, et al. Quantitative data on the magnitude of the systemic inflammatory response and its effect on micronutrient status based on plasma measures. Am J Clin Nutr. 2012;95:64–71.PubMedCrossRef
11.
Zurück zum Zitat World Health Organisation. Iron deficiency anaemia: assessment, prevention and control. A guide for programme managers. Geneva: World Health Organisation; 2001. World Health Organisation. Iron deficiency anaemia: assessment, prevention and control. A guide for programme managers. Geneva: World Health Organisation; 2001.
14.
Zurück zum Zitat Shamseer L, Moher D, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;349:g7647.CrossRef Shamseer L, Moher D, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. BMJ. 2015;349:g7647.CrossRef
15.
Zurück zum Zitat Stroup DF, Berlin JA, Morton SC. Meta-analysis of observational studies in epidemiology. J Am Med Assoc. 2000;283(15):2008–12.CrossRef Stroup DF, Berlin JA, Morton SC. Meta-analysis of observational studies in epidemiology. J Am Med Assoc. 2000;283(15):2008–12.CrossRef
17.
Zurück zum Zitat Von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495–9.CrossRef Von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495–9.CrossRef
18.
Zurück zum Zitat Handu D, Moloney L, Wolfram T, et al. Academy of Nutrition and Dietetics methodology for conducting systematic reviews for the Evidence Analysis Library. J Acad Nutr Diet. 2016;116(2):311–8.PubMedCrossRef Handu D, Moloney L, Wolfram T, et al. Academy of Nutrition and Dietetics methodology for conducting systematic reviews for the Evidence Analysis Library. J Acad Nutr Diet. 2016;116(2):311–8.PubMedCrossRef
19.
Zurück zum Zitat Merlin T, Weston A, Tooher R. Extending an evidence hierarchy to include topics other than treatment: revising the Australian ‘levels of evidence’. BMC Med Res Methodol. 2009;9(1):34.PubMedPubMedCentralCrossRef Merlin T, Weston A, Tooher R. Extending an evidence hierarchy to include topics other than treatment: revising the Australian ‘levels of evidence’. BMC Med Res Methodol. 2009;9(1):34.PubMedPubMedCentralCrossRef
20.
Zurück zum Zitat Toh SY, Zarshenas N, Jorgensen J. Prevalence of nutrient deficiencies in bariatric patients. Nutrition. 2009;25(11–12):1150–6.PubMedCrossRef Toh SY, Zarshenas N, Jorgensen J. Prevalence of nutrient deficiencies in bariatric patients. Nutrition. 2009;25(11–12):1150–6.PubMedCrossRef
21.
Zurück zum Zitat Ruiz-Tovar J, Llavero C, Zubiaga L, et al. Maintenance of multivitamin supplements after sleeve gastrectomy. Obes Surg. 2016:1–7. Ruiz-Tovar J, Llavero C, Zubiaga L, et al. Maintenance of multivitamin supplements after sleeve gastrectomy. Obes Surg. 2016:1–7.
22.
Zurück zum Zitat Våge V, Sande VA, Mellgren G, et al. Changes in obesity-related diseases and biochemical variables after laparoscopic sleeve gastrectomy: a two-year follow-up study. BMC Surg. 2014;14:8.PubMedPubMedCentralCrossRef Våge V, Sande VA, Mellgren G, et al. Changes in obesity-related diseases and biochemical variables after laparoscopic sleeve gastrectomy: a two-year follow-up study. BMC Surg. 2014;14:8.PubMedPubMedCentralCrossRef
23.
Zurück zum Zitat Moizé V, Andreu A, Flores L, et al. Long-term dietary intake and nutritional deficiencies following sleeve gastrectomy or Roux-en-Y gastric bypass in a Mediterranean population. J Acad Nutr Diet. 2013;113(3):400–10.PubMedCrossRef Moizé V, Andreu A, Flores L, et al. Long-term dietary intake and nutritional deficiencies following sleeve gastrectomy or Roux-en-Y gastric bypass in a Mediterranean population. J Acad Nutr Diet. 2013;113(3):400–10.PubMedCrossRef
27.
Zurück zum Zitat Hakeam HA, O'Regan PJ, Salem AM, et al. Impact of laparoscopic sleeve gastrectomy on iron indices: 1 year follow-up. Obes Surg. 2009;19(11):1491–6.PubMedCrossRef Hakeam HA, O'Regan PJ, Salem AM, et al. Impact of laparoscopic sleeve gastrectomy on iron indices: 1 year follow-up. Obes Surg. 2009;19(11):1491–6.PubMedCrossRef
29.
Zurück zum Zitat Capoccia D, Coccia F, Paradiso F, et al. Laparoscopic gastric sleeve and micronutrients supplementation: our experience. J Obes. 2012;2012:1–5.CrossRef Capoccia D, Coccia F, Paradiso F, et al. Laparoscopic gastric sleeve and micronutrients supplementation: our experience. J Obes. 2012;2012:1–5.CrossRef
30.
Zurück zum Zitat Zarshenas N, Lam TCW, Loi KW, et al. Investigating nutritional deficiencies pre and post sleeve gastrectomy. Obes Surg. 2015;25(1):S159.CrossRef Zarshenas N, Lam TCW, Loi KW, et al. Investigating nutritional deficiencies pre and post sleeve gastrectomy. Obes Surg. 2015;25(1):S159.CrossRef
35.
Zurück zum Zitat Gobato RC, Chaves DFS, Chaim EA. Micronutrient and physiologic parameters before and 6 months after RYGB. Surg Obes Relat Dis. 2014;10(5):944–51.PubMedCrossRef Gobato RC, Chaves DFS, Chaim EA. Micronutrient and physiologic parameters before and 6 months after RYGB. Surg Obes Relat Dis. 2014;10(5):944–51.PubMedCrossRef
36.
Zurück zum Zitat Blume CA, Boni CC, Casagrande DS, et al. Nutritional profile of patients before and after Roux-en-Y gastric bypass: 3-year follow-up. Obes Surg. 2012;22(11):1676–85.PubMedCrossRef Blume CA, Boni CC, Casagrande DS, et al. Nutritional profile of patients before and after Roux-en-Y gastric bypass: 3-year follow-up. Obes Surg. 2012;22(11):1676–85.PubMedCrossRef
37.
Zurück zum Zitat Brolin RE, Gorman RC, Milgrim LM, et al. Multivitamin prophylaxis in prevention of post-gastric bypass vitamin and mineral deficiencies. Int J Obes. 1991;15(10):661–7.PubMed Brolin RE, Gorman RC, Milgrim LM, et al. Multivitamin prophylaxis in prevention of post-gastric bypass vitamin and mineral deficiencies. Int J Obes. 1991;15(10):661–7.PubMed
38.
Zurück zum Zitat Skroubis G, Sakellaropoulos G, Pouggouras K, et al. Comparison of nutritional deficiencies after Roux-en-Y gastric bypass and after biliopancreatic diversion with Roux-en-Y gastric bypass. Obes Surg. 2002;12(4):551–8.PubMedCrossRef Skroubis G, Sakellaropoulos G, Pouggouras K, et al. Comparison of nutritional deficiencies after Roux-en-Y gastric bypass and after biliopancreatic diversion with Roux-en-Y gastric bypass. Obes Surg. 2002;12(4):551–8.PubMedCrossRef
39.
Zurück zum Zitat Ruz M, Carrasco F, Rojas P, et al. Iron absorption and iron status are reduced after Roux-en-Y gastric bypass. Am J Clin Nutr. 2009;90(3):527–32.PubMedCrossRef Ruz M, Carrasco F, Rojas P, et al. Iron absorption and iron status are reduced after Roux-en-Y gastric bypass. Am J Clin Nutr. 2009;90(3):527–32.PubMedCrossRef
41.
Zurück zum Zitat Aron-Wisnewsky J, Verger E, Dao M, et al. Micronutrient and protein deficiencies after gastric bypass and sleeve gastrectomy: a one year follow-up. Obes Facts. 2015;8:38. Aron-Wisnewsky J, Verger E, Dao M, et al. Micronutrient and protein deficiencies after gastric bypass and sleeve gastrectomy: a one year follow-up. Obes Facts. 2015;8:38.
43.
Zurück zum Zitat Vargas-Ruiz AG, Hernández-Rivera G, Herrera MF. Prevalence of iron, folate, and vitamin B12 deficiency anemia after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2008;18(3):288–93.PubMedCrossRef Vargas-Ruiz AG, Hernández-Rivera G, Herrera MF. Prevalence of iron, folate, and vitamin B12 deficiency anemia after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2008;18(3):288–93.PubMedCrossRef
44.
Zurück zum Zitat Carvalho IR, Loscalzo IT, Borges de Freitas MF, et al. Incidence of vitamin B12 deficiency in patients submitted to Fobi-Capella Roux-en-Y bariatric surgery. Arq Bras Cir Dig. 2012;25(1):36.PubMedCrossRef Carvalho IR, Loscalzo IT, Borges de Freitas MF, et al. Incidence of vitamin B12 deficiency in patients submitted to Fobi-Capella Roux-en-Y bariatric surgery. Arq Bras Cir Dig. 2012;25(1):36.PubMedCrossRef
45.
Zurück zum Zitat Brolin RE, Gorman JH, Gorman RC, et al. Are vitamin B12 and folate deficiency clinically important after Roux-en-Y gastric bypass? J Gastrointest Surg. 1998;2(5):436–42.PubMedCrossRef Brolin RE, Gorman JH, Gorman RC, et al. Are vitamin B12 and folate deficiency clinically important after Roux-en-Y gastric bypass? J Gastrointest Surg. 1998;2(5):436–42.PubMedCrossRef
46.
Zurück zum Zitat Silvestre V, Ruano M, Domínguez Y, et al. Morbid obesity and gastric bypass surgery: biochemical profile. Obes Surg. 2004;14(9):1227–32.PubMedCrossRef Silvestre V, Ruano M, Domínguez Y, et al. Morbid obesity and gastric bypass surgery: biochemical profile. Obes Surg. 2004;14(9):1227–32.PubMedCrossRef
48.
Zurück zum Zitat Salgado W, Modotti C, Nonino CB, et al. Anemia and iron deficiency before and after bariatric surgery. Surg Obes Relat Dis. 2014;10(1):49–54.PubMedCrossRef Salgado W, Modotti C, Nonino CB, et al. Anemia and iron deficiency before and after bariatric surgery. Surg Obes Relat Dis. 2014;10(1):49–54.PubMedCrossRef
56.
Zurück zum Zitat Gasteyger C, Suter M, Calmes JM, et al. Changes in body composition, metabolic profile and nutritional status 24 months after gastric banding. Obes Surg. 2006;16(3):243–50.PubMedCrossRef Gasteyger C, Suter M, Calmes JM, et al. Changes in body composition, metabolic profile and nutritional status 24 months after gastric banding. Obes Surg. 2006;16(3):243–50.PubMedCrossRef
58.
Zurück zum Zitat Aasheim ET, Björkman S, Søvik TT, et al. Vitamin status after bariatric surgery: a randomized study of gastric bypass and duodenal switch. Am J Clin Nutr. 2009;90(1):15–22.PubMedCrossRef Aasheim ET, Björkman S, Søvik TT, et al. Vitamin status after bariatric surgery: a randomized study of gastric bypass and duodenal switch. Am J Clin Nutr. 2009;90(1):15–22.PubMedCrossRef
61.
Zurück zum Zitat Saif T, Strain GW, Dakin G, et al. Evaluation of nutrient status after laparoscopic sleeve gastrectomy 1, 3, and 5 years after surgery. Surg Obes Relat Dis. 2012;8(5):542–7.PubMedPubMedCentralCrossRef Saif T, Strain GW, Dakin G, et al. Evaluation of nutrient status after laparoscopic sleeve gastrectomy 1, 3, and 5 years after surgery. Surg Obes Relat Dis. 2012;8(5):542–7.PubMedPubMedCentralCrossRef
63.
Zurück zum Zitat Schollenberger A, Damms-Machado A, Kaiser D, et al. Impact of laparoscopic sleeve gastrectomy on micronutrient status. Aktuelle Ernahrungsmedizin. 2016;41(1):15–20.CrossRef Schollenberger A, Damms-Machado A, Kaiser D, et al. Impact of laparoscopic sleeve gastrectomy on micronutrient status. Aktuelle Ernahrungsmedizin. 2016;41(1):15–20.CrossRef
64.
Zurück zum Zitat Coupaye M, Puchaux K, Bogard C, et al. Nutritional consequences of adjustable gastric banding and gastric bypass: a 1-year prospective study. Obes Surg. 2009;19(1):56–65.PubMedCrossRef Coupaye M, Puchaux K, Bogard C, et al. Nutritional consequences of adjustable gastric banding and gastric bypass: a 1-year prospective study. Obes Surg. 2009;19(1):56–65.PubMedCrossRef
66.
Zurück zum Zitat Provenzale D, Reinhold R, Golner B, et al. Evidence for diminished B12 absorption after gastric bypass: oral supplementation does not prevent low plasma B12 levels in bypass patients. J Am Coll Nutr. 1992;11(1):29–35.PubMedCrossRef Provenzale D, Reinhold R, Golner B, et al. Evidence for diminished B12 absorption after gastric bypass: oral supplementation does not prevent low plasma B12 levels in bypass patients. J Am Coll Nutr. 1992;11(1):29–35.PubMedCrossRef
68.
Zurück zum Zitat Belfiore A, Cataldi M, Minichini L, et al. Short-term changes in body composition and response to micronutrient supplementation after laparoscopic sleeve gastrectomy. Obes Surg. 2015;25(12):2344–51.PubMedCrossRef Belfiore A, Cataldi M, Minichini L, et al. Short-term changes in body composition and response to micronutrient supplementation after laparoscopic sleeve gastrectomy. Obes Surg. 2015;25(12):2344–51.PubMedCrossRef
69.
Zurück zum Zitat Donadelli SP, Junqueira-Franco MVM, De Mattos Donadelli CA, et al. Daily vitamin supplementation and hypovitaminosis after obesity surgery. Nutrition. 2012;28(4):391–6.PubMedCrossRef Donadelli SP, Junqueira-Franco MVM, De Mattos Donadelli CA, et al. Daily vitamin supplementation and hypovitaminosis after obesity surgery. Nutrition. 2012;28(4):391–6.PubMedCrossRef
74.
Zurück zum Zitat Dogan K, Homan J, Schijns W, et al. Long-term nutritional status after Roux-en-Y gastric bypass in patients with no-show on regular follow-up. Obes Surg. 2014;24(7):990. Dogan K, Homan J, Schijns W, et al. Long-term nutritional status after Roux-en-Y gastric bypass in patients with no-show on regular follow-up. Obes Surg. 2014;24(7):990.
82.
Zurück zum Zitat Perin J, Prokopowicz G, Furtado M, et al. A randomized trial of a novel chewable multivitamin and mineral supplement following Roux-en-Y gastric bypass. Obes Surg. 2018;28(8):2406–20.PubMedCrossRef Perin J, Prokopowicz G, Furtado M, et al. A randomized trial of a novel chewable multivitamin and mineral supplement following Roux-en-Y gastric bypass. Obes Surg. 2018;28(8):2406–20.PubMedCrossRef
84.
Zurück zum Zitat Crea F, Morrow DA. C-reactive protein in cardiovascular disease. 2019. In: UpToDate [Internet]. Crea F, Morrow DA. C-reactive protein in cardiovascular disease. 2019. In: UpToDate [Internet].
85.
Zurück zum Zitat Kovesdy CP, Kopple JD, Kalantar-Zadeh K. Inflammation in renal insufficiency. 2020. In: UpToDate [Internet]. Kovesdy CP, Kopple JD, Kalantar-Zadeh K. Inflammation in renal insufficiency. 2020. In: UpToDate [Internet].
86.
Zurück zum Zitat Roberts NB, Taylor A, Sodi R. Vitamin and trace elements. In: Tietz textbook of clinical chemistry and molecular diagnostics [Internet], 6; 2018. p. 639-718. Roberts NB, Taylor A, Sodi R. Vitamin and trace elements. In: Tietz textbook of clinical chemistry and molecular diagnostics [Internet], 6; 2018. p. 639-718.
87.
Zurück zum Zitat Kjser MA, Emous M, Dijkstra FA, et al. How accurate can we estimate the length of the limbs in gastric bypass surgery? An ex vivo experiment. Annals of Obesity & Disorders. 2016;1(3):1016. Kjser MA, Emous M, Dijkstra FA, et al. How accurate can we estimate the length of the limbs in gastric bypass surgery? An ex vivo experiment. Annals of Obesity & Disorders. 2016;1(3):1016.
89.
Zurück zum Zitat Brethauer SA, Kim J, El Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg. 2015;25(4):587–606.PubMedCrossRef Brethauer SA, Kim J, El Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg. 2015;25(4):587–606.PubMedCrossRef
Metadaten
Titel
Iron, Vitamin B12, Folate and Copper Deficiency After Bariatric Surgery and the Impact on Anaemia: a Systematic Review
verfasst von
Carrie-Anne Lewis
Susan de Jersey
Matthew Seymour
George Hopkins
Ingrid Hickman
Emma Osland
Publikationsdatum
12.08.2020
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 11/2020
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04872-y

Weitere Artikel der Ausgabe 11/2020

Obesity Surgery 11/2020 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.