Iron deficiency before and after bariatric surgery: the need for iron supplementation.
Study Goal
The researchers aimed to understand the role of hepcidin in iron homeostasis and the challenges of iron absorption and supplementation in obese patients, particularly after bariatric surgery.
Results Summary
The study found that elevated hepcidin in obese patients leads to functional iron deficiency, and iron malabsorption post-bariatric surgery exacerbates this, often causing anemia and fatigue. Intravenous iron supplements were shown to rapidly restore iron status and alleviate symptoms more effectively than oral supplements.
Population
Obese patients, particularly those who underwent bariatric surgery.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
elevated cytokine production | increase | hepcidin synthesis | obese patients | - | stimulates | #1 |
stimulated hepcidin synthesis | increase | iron retention as ferritin | obese patients | - | causing | #2 |
bariatric surgery | increase | iron deficiency | patients | - | may cause | #3 |
iron deficiency | increase | anaemia | patients | - | may cause | #4 |
stomach reduction | decrease | reduction of Fe3+ by gastric acid into Fe2+ | - | - | is not so effective | #5 |
malabsorptive interventions | decrease | iron absorption | - | - | reduced | #6 |
oral iron supplements | no change | - | patients after bariatric surgery | - | have little effect | #7 |
intravenous supplements of iron | increase | iron status | patients after bariatric surgery | rapidly | can restore | #8 |
restored iron status | decrease | fewer symptoms such as fatigue | patients after bariatric surgery | - | resulting in | #9 |
Hepcidin inhibits the iron export from duodenal cells and liver cells into the plasma and therefore plays a key role in controlling iron homeostasis. In obese patients, elevated cytokine production stimulates hepcidin synthesis, causing iron to be retained as ferritin in e.g. macrophages (functional iron deficiency). In addition, patients often develop iron deficiency after bariatric surgery due to malabsorption, which may cause anaemia and thereby lead to complaints such as fatigue. In these patients, the absorption of iron may be disrupted because the reduction of Fe3+ by gastric acid into Fe2+ (the form that is easily absorbed) is not so effective after stomach reduction. Iron absorption is further reduced after malabsorptive interventions as a result of bypassing the duodenum and the proximal part of the small intestine, where the absorption takes place. Oral iron supplements often have little effect after bariatric surgery. Intravenous supplements of iron can restore the iron status rapidly after bariatric surgery, resulting in fewer symptoms such as fatigue.