Changes in Iron Absorption After Roux-en-Y Gastric Bypass

  • Wendy Schijns
  • Marjolein A. P. Ligthart
  • Frits J. Berends
  • Ignace M. C. Janssen
  • Cees J. H. M. van Laarhoven
  • Edo O. Aarts
  • Hans de Boer
Original Contributions

Abstract

Introduction

Iron deficiency is one of the most common deficiencies that may occur after Roux-en-Y gastric bypass (RYGB). Little is known about the optimal treatment of post-RYGB iron deficiency.

Aim

The aim of this study is to evaluate the changes in iron absorption characteristics after RYGB for two oral iron formulations, one presented in tablet form and one as in the form of a solution.

Method

Iron absorption in 24 obese women was studied before and 1 month after RYGB. Twelve patients were tested with a single dose of 600 mg ferrous fumarate in tablet form (195 mg of elementary iron, group 1), and 12 patients received a single dose of 1390 mg ferrous gluconate as a solution (160 mg of elementary iron, group 2). Serum iron levels were measured before (T0) and every hour after ingestion of the supplement (T1–T9).

Results

Before surgery, iron absorption was similar for the two supplements (P = 0.71). However, RYGB was associated with a decrease in fumarate iron absorption (P < 0.001) but did not affect gluconate iron absorption (P = 0.13). Postoperative absorption of fumarate iron was significantly lower than gluconate iron at T1 (P < 0.05), but the overall difference over 9 h did not reach statistical significance (P = 0.53).

Conclusion

RYGB adversely affects the absorption of ferrous fumarate tablets but not that of solubilized ferrous gluconate. A solubilized supplement is therefore preferred as the supplement of first choice after RYGB.

Keywords

Morbid obesity Iron Ferritin Deficiency Absorption Roux-en-Y gastric bypass 

Notes

Acknowledgements

We would like to thank Dr. L Roovers for her significant contribution to the statistical analyses.

Compliance with Ethical Standards

The study was approved by the national ethics and was registered at clinicaltrials.gov as NCT02228902. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Conflict of Interest

The authors declare that they have no conflict of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryRijnstate HospitalArnhemThe Netherlands
  2. 2.Department of SurgeryRadboud UMCNijmegenThe Netherlands
  3. 3.Department of Internal MedicineRijnstate HospitalArnhemThe Netherlands

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