Anemia, iron and vitamin B12 deficiencies after sleeve gastrectomy compared to Roux-en-Y gastric bypass: A meta-analysis

Yeongkeun Kwon, Hyun Jung Kim, Emanuele Lo Menzo, Sungsoo Park, Samuel Szomstein, Raul J. Rosenthal

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Background: The effective treatment of postoperative anemia and nutritional deficiencies is critical for the successful management of bariatric patients. However, the evidence for nutritional risk or support of bariatric patients remains scarce. The aims of this study were to assess current evidence of the association between 2 methods of bariatric surgery, sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), and postoperative anemia and nutritional deficiencies.

Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for English-language studies using a list of keywords. Reference lists from relevant review articles were also searched. In the authors meta-analysis, they included studies with a duration of >12 months, those comparing SG with RYGB, and those with available outcome data for postoperative anemia and iron and vitamin B12 deficiencies. Of 36 potentially relevant studies, 9 met the inclusion criteria. Data were combined by means of a fixed-effects model or randomeffects model.

Results: Compared with the SG group, the odds ratio for postoperative vitamin B12 deficiency in the RYGB group was 3.55 (95% confidence interval, 1.26-10.01; P < .001). In the subgroup analysis, studies in which prophylactic iron or vitamin B12 was administered lost significance in the odds ratio for postoperative vitamin B12 deficiency.

Conclusion: The authors findings suggest that SG is more beneficial than RYGB with regard to postoperative vitamin B12 deficiency risk, whereas the 2 methods are comparable with regard to the risk of postoperative anemia and iron deficiency. Postoperative prophylactic iron and B12 supplementation, in addition to general multivitamin and mineral supplementation, is recommended based on the comparable deficiency risk of the 2 methods as indicated by subgroup analysis. (Surg Obes Relat Dis 2014;10:589-599.).

Original languageEnglish
Pages (from-to)589-599
Number of pages11
JournalSurgery for Obesity and Related Diseases
Volume10
Issue number4
DOIs
Publication statusPublished - 2014 Jan 1

Fingerprint

Vitamin B 12 Deficiency
Gastric Bypass
Gastrectomy
Meta-Analysis
Anemia
Iron
Bariatrics
Malnutrition
Odds Ratio
Bariatric Surgery
Iron-Deficiency Anemias
Vitamin B 12
MEDLINE
Minerals
Language
Confidence Intervals

Keywords

  • Anemia
  • Iron
  • Roux-en-Y gastric bypass
  • Sleeve gastrectomy
  • Vitamin B

ASJC Scopus subject areas

  • Surgery

Cite this

Anemia, iron and vitamin B12 deficiencies after sleeve gastrectomy compared to Roux-en-Y gastric bypass : A meta-analysis. / Kwon, Yeongkeun; Kim, Hyun Jung; Lo Menzo, Emanuele; Park, Sungsoo; Szomstein, Samuel; Rosenthal, Raul J.

In: Surgery for Obesity and Related Diseases, Vol. 10, No. 4, 01.01.2014, p. 589-599.

Research output: Contribution to journalArticle

Kwon, Yeongkeun ; Kim, Hyun Jung ; Lo Menzo, Emanuele ; Park, Sungsoo ; Szomstein, Samuel ; Rosenthal, Raul J. / Anemia, iron and vitamin B12 deficiencies after sleeve gastrectomy compared to Roux-en-Y gastric bypass : A meta-analysis. In: Surgery for Obesity and Related Diseases. 2014 ; Vol. 10, No. 4. pp. 589-599.
@article{67f16fd0f57345c089611d5e9d2bad6a,
title = "Anemia, iron and vitamin B12 deficiencies after sleeve gastrectomy compared to Roux-en-Y gastric bypass: A meta-analysis",
abstract = "Background: The effective treatment of postoperative anemia and nutritional deficiencies is critical for the successful management of bariatric patients. However, the evidence for nutritional risk or support of bariatric patients remains scarce. The aims of this study were to assess current evidence of the association between 2 methods of bariatric surgery, sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), and postoperative anemia and nutritional deficiencies.Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for English-language studies using a list of keywords. Reference lists from relevant review articles were also searched. In the authors meta-analysis, they included studies with a duration of >12 months, those comparing SG with RYGB, and those with available outcome data for postoperative anemia and iron and vitamin B12 deficiencies. Of 36 potentially relevant studies, 9 met the inclusion criteria. Data were combined by means of a fixed-effects model or randomeffects model.Results: Compared with the SG group, the odds ratio for postoperative vitamin B12 deficiency in the RYGB group was 3.55 (95{\%} confidence interval, 1.26-10.01; P < .001). In the subgroup analysis, studies in which prophylactic iron or vitamin B12 was administered lost significance in the odds ratio for postoperative vitamin B12 deficiency.Conclusion: The authors findings suggest that SG is more beneficial than RYGB with regard to postoperative vitamin B12 deficiency risk, whereas the 2 methods are comparable with regard to the risk of postoperative anemia and iron deficiency. Postoperative prophylactic iron and B12 supplementation, in addition to general multivitamin and mineral supplementation, is recommended based on the comparable deficiency risk of the 2 methods as indicated by subgroup analysis. (Surg Obes Relat Dis 2014;10:589-599.).",
keywords = "Anemia, Iron, Roux-en-Y gastric bypass, Sleeve gastrectomy, Vitamin B",
author = "Yeongkeun Kwon and Kim, {Hyun Jung} and {Lo Menzo}, Emanuele and Sungsoo Park and Samuel Szomstein and Rosenthal, {Raul J.}",
year = "2014",
month = "1",
day = "1",
doi = "10.1016/j.soard.2013.12.005",
language = "English",
volume = "10",
pages = "589--599",
journal = "Surgery for Obesity and Related Diseases",
issn = "1550-7289",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Anemia, iron and vitamin B12 deficiencies after sleeve gastrectomy compared to Roux-en-Y gastric bypass

T2 - A meta-analysis

AU - Kwon, Yeongkeun

AU - Kim, Hyun Jung

AU - Lo Menzo, Emanuele

AU - Park, Sungsoo

AU - Szomstein, Samuel

AU - Rosenthal, Raul J.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: The effective treatment of postoperative anemia and nutritional deficiencies is critical for the successful management of bariatric patients. However, the evidence for nutritional risk or support of bariatric patients remains scarce. The aims of this study were to assess current evidence of the association between 2 methods of bariatric surgery, sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), and postoperative anemia and nutritional deficiencies.Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for English-language studies using a list of keywords. Reference lists from relevant review articles were also searched. In the authors meta-analysis, they included studies with a duration of >12 months, those comparing SG with RYGB, and those with available outcome data for postoperative anemia and iron and vitamin B12 deficiencies. Of 36 potentially relevant studies, 9 met the inclusion criteria. Data were combined by means of a fixed-effects model or randomeffects model.Results: Compared with the SG group, the odds ratio for postoperative vitamin B12 deficiency in the RYGB group was 3.55 (95% confidence interval, 1.26-10.01; P < .001). In the subgroup analysis, studies in which prophylactic iron or vitamin B12 was administered lost significance in the odds ratio for postoperative vitamin B12 deficiency.Conclusion: The authors findings suggest that SG is more beneficial than RYGB with regard to postoperative vitamin B12 deficiency risk, whereas the 2 methods are comparable with regard to the risk of postoperative anemia and iron deficiency. Postoperative prophylactic iron and B12 supplementation, in addition to general multivitamin and mineral supplementation, is recommended based on the comparable deficiency risk of the 2 methods as indicated by subgroup analysis. (Surg Obes Relat Dis 2014;10:589-599.).

AB - Background: The effective treatment of postoperative anemia and nutritional deficiencies is critical for the successful management of bariatric patients. However, the evidence for nutritional risk or support of bariatric patients remains scarce. The aims of this study were to assess current evidence of the association between 2 methods of bariatric surgery, sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), and postoperative anemia and nutritional deficiencies.Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for English-language studies using a list of keywords. Reference lists from relevant review articles were also searched. In the authors meta-analysis, they included studies with a duration of >12 months, those comparing SG with RYGB, and those with available outcome data for postoperative anemia and iron and vitamin B12 deficiencies. Of 36 potentially relevant studies, 9 met the inclusion criteria. Data were combined by means of a fixed-effects model or randomeffects model.Results: Compared with the SG group, the odds ratio for postoperative vitamin B12 deficiency in the RYGB group was 3.55 (95% confidence interval, 1.26-10.01; P < .001). In the subgroup analysis, studies in which prophylactic iron or vitamin B12 was administered lost significance in the odds ratio for postoperative vitamin B12 deficiency.Conclusion: The authors findings suggest that SG is more beneficial than RYGB with regard to postoperative vitamin B12 deficiency risk, whereas the 2 methods are comparable with regard to the risk of postoperative anemia and iron deficiency. Postoperative prophylactic iron and B12 supplementation, in addition to general multivitamin and mineral supplementation, is recommended based on the comparable deficiency risk of the 2 methods as indicated by subgroup analysis. (Surg Obes Relat Dis 2014;10:589-599.).

KW - Anemia

KW - Iron

KW - Roux-en-Y gastric bypass

KW - Sleeve gastrectomy

KW - Vitamin B

UR - http://www.scopus.com/inward/record.url?scp=84908094987&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908094987&partnerID=8YFLogxK

U2 - 10.1016/j.soard.2013.12.005

DO - 10.1016/j.soard.2013.12.005

M3 - Article

C2 - 24582411

AN - SCOPUS:84908094987

VL - 10

SP - 589

EP - 599

JO - Surgery for Obesity and Related Diseases

JF - Surgery for Obesity and Related Diseases

SN - 1550-7289

IS - 4

ER -