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Risk Factors of Iron Deficiency and Iron Deficiency Anemia After Laparoscopic Sleeve Gastrectomy: A Retrospective
Xiaorui Wang1, Xuewei Fu1, Yikai Shao2
1Department of Hematology, Huashan Hospital, Fudan University, Shanghai, China.
Introduction:
Metabolic and bariatric surgery (MBS) can effectively improve obesity and its related complications, but it may lead to side effects such as iron deficiency (ID) and iron deficiency anemia (IDA). However, the specific risk factors for ID and IDA after laparoscopic sleeve gastrectomy (LSG) remain unclear.
Methods:
We retrospectively enrolled 465 patients who underwent LSG from April 2014 to December 2021. The risk factors for postoperative ID and IDA were evaluated using logistic regression analysis. Patients who underwent LSG from December 2020 to December 2021 were given low-dose iron and vitamin B12 orally based on the iron-containing multivitamin supplementation throughout the year after surgery. We analyzed the incidence of postoperative ID and IDA in patients who received additional prophylactic treatment compared with those who did not.
Results:
One hundred one (21.7%) patients were diagnosed with ID, 23(4.9%) patients with IDA, and 19 (4.1%) cases with anemia of chronic disease (ACD) before LSG. One year after LSG, 53 (11.4%) patients were diagnosed with ID, 50 (10.8%) patients with IDA, and 32 (6.9%) cases with ACD. Female sex (OR = 3.660, 95% CI 1.676 ~ 7.995, P = 0.001) and preoperative anemia (OR = 2.139, 95% CI 0.992 ~ 4.613, P = 0.052) were associated with an increased risk of ID and IDA independently. The higher level of iron saturation (OR = 0.914, 95% CI 0.887 ~ 0.942, P < 0.001) was identified as a protective factor against postoperative anemia. The incidence of ID and IDA was reported in 12.0% of patients taking 0.1 g of iron succinate and 0.5 mg of vitamin B12 orally once a day. For patients who did not receive prophylactic medication, the incidence 1 year after surgery was 12.6%, which showed no statistical difference (P = 0.858).
Conclusions:
In conclusion, the incidence of anemia increased after LSG. Female sex and preoperative anemia are independent risk factors for ID and IDA after LSG. The higher level of iron saturation was a protective factor against postoperative anemia. Low-dose prophylactic medication does not significantly reduce the incidence of ID and IDA.
