PMID- 31422079
OWN - NLM
STAT- MEDLINE
DCOM- 20200831
LR  - 20200831
IS  - 1878-7533 (Electronic)
IS  - 1550-7289 (Linking)
VI  - 15
IP  - 10
DP  - 2019 Oct
TI  - Effect of long-term proton pump inhibitor therapy on hemoglobin and serum iron 
      levels after sleeve gastrectomy.
PG  - 1682-1689
LID - S1550-7289(19)30294-1 [pii]
LID - 10.1016/j.soard.2019.06.019 [doi]
AB  - BACKGROUND: Iron deficiency anemia and iron deficiency are commonly seen after 
      bariatric surgery. Gastroesophageal reflux disease is commonly associated with 
      sleeve resections and warrants postoperative acid reducing therapy. OBJECTIVE: To 
      analyze the impact of long-term proton pump inhibitors on iron deficiency or iron 
      deficiency anemia in laparoscopic sleeve gastrectomy (LSG) patients. SETTING: 
      University hospital, USA. METHODS: A single-institution case control study 
      included 2 groups of bariatric patients who underwent LSG. Patient 
      characteristics such as age, sex, American Society of Anesthesiologists risk, 
      body mass index, nutritional status, and co-morbidities were comparable. 
      Postoperative follow-up was scheduled at 1-week, and 1-, 3-, 6-, and 12-month 
      durations. All received standard postoperative iron, multivitamin therapy, and 
      nutritional screening and evaluation. All patients were placed on postoperative 
      proton pump inhibitors (PPI) therapy for at least 3 months. At third 
      postoperative visit, anemia indicators were assessed by serum iron concentration, 
      total iron binding capacity, transferrin saturation, red blood cell count, 
      hemoglobin concentration, mean corpuscular volume, and mean corpuscular 
      hemoglobin concentration. Postoperative hemoglobin and serum iron levels were 
      compared between those patients still taking PPIs to those not taking PPIs at 12 
      months. RESULTS: A total of 287 patients underwent LSG from January 2016 to 
      December 2017, 203 were included and 84 patients were excluded. Patients taking 
      long-term PPIs (>12 mo, n = 85) were compared with those not taking PPIs (n = 
      118) and outcomes were respectively as follows: mean pre- and postoperative 
      hemoglobin levels (in g/DL) were 13.2 and 10.7, and 13.3 and 13.7; mean 
      postoperative serum iron levels (in mug/DL) were 41.7 and 88.7. Results were 
      computed using paired t test and odds ratio that showed iron deficiency anemia in 
      12.9% (11/85) in PPI group compared with 4.23% (5/118) in the non-PPI group (odds 
      ratio of 3.3, 95% confidence interval [1.21-10], and P = .03). Iron deficiency 
      was seen in 22.3% (19/85) in the PPI group and 11% (13/118) in the non-PPI group 
      (odds ratio of 2.3, 95% confidence interval [1.07-5.02] and P = .031). 
      CONCLUSIONS: Our study indicates that PPIs can increase the severity of iron 
      deficiency and iron deficiency anemia in patients who underwent LSG. Aggressive 
      surveillance is needed in those taking long-term PPIs after LSG. It is encouraged 
      to further analyze these findings in a larger randomized study model design.
CI  - Copyright (c) 2019 American Society for Bariatric Surgery. Published by Elsevier 
      Inc. All rights reserved.
FAU - Sharma, Nitin
AU  - Sharma N
AD  - Penn Medicine Princeton Medical Centre, Bariatric and Metabolic Surgery, 
      Plainsboro, New Jersey. Electronic address: nitin4871@yahoo.com.
FAU - Chau, Wai Yip
AU  - Chau WY
AD  - Penn Medicine Princeton Medical Centre, Bariatric and Metabolic Surgery, 
      Plainsboro, New Jersey.
FAU - Dobruskin, Lisa
AU  - Dobruskin L
AD  - Penn Medicine Princeton Medical Centre, Bariatric and Metabolic Surgery, 
      Plainsboro, New Jersey.
LA  - eng
PT  - Journal Article
DEP - 20190627
PL  - United States
TA  - Surg Obes Relat Dis
JT  - Surgery for obesity and related diseases : official journal of the American 
      Society for Bariatric Surgery
JID - 101233161
RN  - 0 (Hemoglobins)
RN  - 0 (Proton Pump Inhibitors)
RN  - E1UOL152H7 (Iron)
SB  - IM
MH  - Adult
MH  - *Anemia, Iron-Deficiency/blood/chemically induced/epidemiology
MH  - Bariatric Surgery
MH  - Female
MH  - *Gastrectomy
MH  - Gastroesophageal Reflux/complications/drug therapy
MH  - Hemoglobins/*analysis
MH  - Humans
MH  - Iron/blood
MH  - Male
MH  - Middle Aged
MH  - Obesity/complications/surgery
MH  - Postoperative Care/adverse effects/methods
MH  - *Postoperative Complications/blood/chemically induced/epidemiology
MH  - Proton Pump Inhibitors/*adverse effects/therapeutic use
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Iron deficiency anemia
OT  - Proton pump inhibitors
OT  - Sleeve gastrectomy
EDAT- 2019/08/20 06:00
MHDA- 2020/09/01 06:00
CRDT- 2019/08/19 06:00
PHST- 2019/03/11 00:00 [received]
PHST- 2019/05/01 00:00 [revised]
PHST- 2019/06/18 00:00 [accepted]
PHST- 2019/08/20 06:00 [pubmed]
PHST- 2020/09/01 06:00 [medline]
PHST- 2019/08/19 06:00 [entrez]
AID - S1550-7289(19)30294-1 [pii]
AID - 10.1016/j.soard.2019.06.019 [doi]
PST - ppublish
SO  - Surg Obes Relat Dis. 2019 Oct;15(10):1682-1689. doi: 10.1016/j.soard.2019.06.019. 
      Epub 2019 Jun 27.