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Long-Term Outcomes of Iron Deficiency Before and After Bariatric Surgery: a Systematic Review and Meta-analysis

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Abstract

Purpose

This study reviews the prevalence of iron deficiency (ID) in bariatric surgery candidates and the long-term outcomes of the prevalence of ID after bariatric surgery.

Materials and Methods

A systematic literature search and meta-analysis were performed in PubMed for articles published by August 31, 2022, including these search terms: bariatric surgery, metabolic surgery, weight loss surgery, obesity surgery, sleeve gastrectomy, gastric banding, gastric bypass, duodenal switch, duodenojejunal bypass, iron, iron deficiency, sideropenia, and hypoferritinemia. Fifty-seven studies examining a total of 26,328 patients with morbidly obese were included in this meta-analysis finally.

Results

The results showed a prevalence of 17% of ID in bariatric surgery candidates and a prevalence of 14%, 17%, 26%, 34%, 23%, 38%, and 23% of ID at 1-, 2-, 3-, 4-, 5-, 8-, and 10-year follow-up after bariatric surgery, respectively. Additionally, the results showed a prevalence of 15%, 19%, 35%, 38%, 29%, 30%, and 23% of ID at 1-, 2-, 3-, 4-, 5-, 8-, and 10-year follow-up after Roux-en-Y gastric bypass, respectively; a prevalence of 12%, 12%, 15%, 31%, and 17% of ID at 1-, 2-, 3-, 4-, and 5-year follow-up after sleeve gastrectomy, respectively; and a prevalence of 19% of ID at 1-year follow-up after anastomosis gastric bypass.

Conclusion

As a result, preoperative evaluation and correction of ID may lead to better outcomes for bariatric surgery candidates. ID is also common in patients after bariatric procedures, especially RYGB. Long-term, even lifelong, medical and nutritional monitoring and tailored interventions are critical.

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Abbreviations

BMI:

Body mass index

BPD/DS:

Biliopancreatic diversion with duodenal switch

Hep:

Hepcidin

ID:

Iron deficiency

OAGB:

One anastomosis gastric bypass

RYGB:

Roux-en-Y gastric bypass

SG:

Sleeve gastrectomy

GB:

Gastric banding

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Author notes

  1. Chuqi Xia, Taifu Xiao, Sheng Hu, Haibo Luo, Qiyu Lu and Hongrui Fu contributed equally to this work.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, the Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, China

    Chuqi Xia, Taifu Xiao, Haibo Luo, Qiyu Lu, Hongrui Fu & Daoming Liang

  2. Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Kunming Medical University, Kunming, 650101, China

    Sheng Hu

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Key Points

1. Iron deficiency is common in bariatric surgery candidates; preoperative evaluation and correction of iron deficiency may lead to better outcomes for patients.

2. Iron deficiency may be found after any type of bariatric surgery, especially RYGB.

3. Long-term, even lifelong, medical and nutritional monitoring and tailored interventions are critical for patients after bariatric surgery.

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Xia, C., Xiao, T., Hu, S. et al. Long-Term Outcomes of Iron Deficiency Before and After Bariatric Surgery: a Systematic Review and Meta-analysis. OBES SURG 33, 897–910 (2023). https://doi.org/10.1007/s11695-023-06465-x

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