Comparison of Oral Iron Supplement Formulations for Normalization of Iron Status Following Roux-EN-y Gastric Bypass Surgery: a Randomized Trial

Renee A. Mischler, Seth M. Armah, Bruce A. Craig, Arthur D. Rosen, Ambar Banerjee, Don Selzer, Jennifer Choi, Nana Gletsu-Miller

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background: The evidence behind recommendations for treatment of iron deficiency (ID) following roux-en-y gastric bypass surgery (RYGB) lacks high quality studies. Setting: Academic, United States Objective: The objective of the study is to compare the effectiveness of oral iron supplementation using non-heme versus heme iron for treatment of iron deficiency in RYGB patients. Methods: In a randomized, single-blind study, women post-RYGB and iron deficient received non-heme iron (FeSO4, 195 mg/day) or heme iron (heme-iron-polypeptide, HIP, 31.5 to 94.5 mg/day) for 8 weeks. Measures of iron status, including blood concentrations of ferritin, soluble transferrin receptor (sTfR), and hemoglobin, were assessed. Results: At baseline, the mean ± standard deviation for age, BMI, and years since surgery of the sample was 41.5 ± 6.8 years, 34.4 ± 5.9 kg/m2, and 6.9 ± 3.1 years, respectively; and there were no differences between FeSO4 (N = 6) or HIP (N = 8) groups. Compliance was greater than 94%. The study was stopped early due to statistical and clinical differences between groups. Values before and after FeSO4 supplementation, expressed as least square means (95% CI) were hemoglobin, 10.8 (9.8, 11.9) to 13.0 (11.9, 14.0) g/dL; sTfR, 2111 (1556, 2864) to 1270 (934, 1737) μg/L; ferritin, 4.9 (3.4, 7.2) to 15.5 (10.6, 22.6) μg/L; and sTfR:ferritin ratio, 542 (273, 1086) to 103 (51, 204); all p < 0.0001. With HIP supplementation, no change was observed in any of the iron status biomarkers (all p > 0.05). Conclusions: In accordance with recommendations, oral supplementation using FeSO4, but not HIP, was efficacious for treatment of iron deficiency after RYGB.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalObesity Surgery
DOIs
StateAccepted/In press - Aug 4 2017

Fingerprint

Gastric Bypass
Iron
Transferrin Receptors
Heme
Ferritins
Hemoglobins
Apoferritins
Single-Blind Method
Least-Squares Analysis
Compliance
Therapeutics
Peptides

Keywords

  • Bariatric surgery
  • Iron deficiency
  • Iron supplementation
  • Nutritional complications

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Comparison of Oral Iron Supplement Formulations for Normalization of Iron Status Following Roux-EN-y Gastric Bypass Surgery : a Randomized Trial. / Mischler, Renee A.; Armah, Seth M.; Craig, Bruce A.; Rosen, Arthur D.; Banerjee, Ambar; Selzer, Don; Choi, Jennifer; Gletsu-Miller, Nana.

In: Obesity Surgery, 04.08.2017, p. 1-9.

Research output: Contribution to journalArticle

Mischler, Renee A. ; Armah, Seth M. ; Craig, Bruce A. ; Rosen, Arthur D. ; Banerjee, Ambar ; Selzer, Don ; Choi, Jennifer ; Gletsu-Miller, Nana. / Comparison of Oral Iron Supplement Formulations for Normalization of Iron Status Following Roux-EN-y Gastric Bypass Surgery : a Randomized Trial. In: Obesity Surgery. 2017 ; pp. 1-9.
@article{a65c4b0dfb314ffe841a42eff158785e,
title = "Comparison of Oral Iron Supplement Formulations for Normalization of Iron Status Following Roux-EN-y Gastric Bypass Surgery: a Randomized Trial",
abstract = "Background: The evidence behind recommendations for treatment of iron deficiency (ID) following roux-en-y gastric bypass surgery (RYGB) lacks high quality studies. Setting: Academic, United States Objective: The objective of the study is to compare the effectiveness of oral iron supplementation using non-heme versus heme iron for treatment of iron deficiency in RYGB patients. Methods: In a randomized, single-blind study, women post-RYGB and iron deficient received non-heme iron (FeSO4, 195 mg/day) or heme iron (heme-iron-polypeptide, HIP, 31.5 to 94.5 mg/day) for 8 weeks. Measures of iron status, including blood concentrations of ferritin, soluble transferrin receptor (sTfR), and hemoglobin, were assessed. Results: At baseline, the mean ± standard deviation for age, BMI, and years since surgery of the sample was 41.5 ± 6.8 years, 34.4 ± 5.9 kg/m2, and 6.9 ± 3.1 years, respectively; and there were no differences between FeSO4 (N = 6) or HIP (N = 8) groups. Compliance was greater than 94{\%}. The study was stopped early due to statistical and clinical differences between groups. Values before and after FeSO4 supplementation, expressed as least square means (95{\%} CI) were hemoglobin, 10.8 (9.8, 11.9) to 13.0 (11.9, 14.0) g/dL; sTfR, 2111 (1556, 2864) to 1270 (934, 1737) μg/L; ferritin, 4.9 (3.4, 7.2) to 15.5 (10.6, 22.6) μg/L; and sTfR:ferritin ratio, 542 (273, 1086) to 103 (51, 204); all p < 0.0001. With HIP supplementation, no change was observed in any of the iron status biomarkers (all p > 0.05). Conclusions: In accordance with recommendations, oral supplementation using FeSO4, but not HIP, was efficacious for treatment of iron deficiency after RYGB.",
keywords = "Bariatric surgery, Iron deficiency, Iron supplementation, Nutritional complications",
author = "Mischler, {Renee A.} and Armah, {Seth M.} and Craig, {Bruce A.} and Rosen, {Arthur D.} and Ambar Banerjee and Don Selzer and Jennifer Choi and Nana Gletsu-Miller",
year = "2017",
month = "8",
day = "4",
doi = "10.1007/s11695-017-2858-4",
language = "English (US)",
pages = "1--9",
journal = "Obesity Surgery",
issn = "0960-8923",
publisher = "Springer New York",

}

TY - JOUR

T1 - Comparison of Oral Iron Supplement Formulations for Normalization of Iron Status Following Roux-EN-y Gastric Bypass Surgery

T2 - a Randomized Trial

AU - Mischler, Renee A.

AU - Armah, Seth M.

AU - Craig, Bruce A.

AU - Rosen, Arthur D.

AU - Banerjee, Ambar

AU - Selzer, Don

AU - Choi, Jennifer

AU - Gletsu-Miller, Nana

PY - 2017/8/4

Y1 - 2017/8/4

N2 - Background: The evidence behind recommendations for treatment of iron deficiency (ID) following roux-en-y gastric bypass surgery (RYGB) lacks high quality studies. Setting: Academic, United States Objective: The objective of the study is to compare the effectiveness of oral iron supplementation using non-heme versus heme iron for treatment of iron deficiency in RYGB patients. Methods: In a randomized, single-blind study, women post-RYGB and iron deficient received non-heme iron (FeSO4, 195 mg/day) or heme iron (heme-iron-polypeptide, HIP, 31.5 to 94.5 mg/day) for 8 weeks. Measures of iron status, including blood concentrations of ferritin, soluble transferrin receptor (sTfR), and hemoglobin, were assessed. Results: At baseline, the mean ± standard deviation for age, BMI, and years since surgery of the sample was 41.5 ± 6.8 years, 34.4 ± 5.9 kg/m2, and 6.9 ± 3.1 years, respectively; and there were no differences between FeSO4 (N = 6) or HIP (N = 8) groups. Compliance was greater than 94%. The study was stopped early due to statistical and clinical differences between groups. Values before and after FeSO4 supplementation, expressed as least square means (95% CI) were hemoglobin, 10.8 (9.8, 11.9) to 13.0 (11.9, 14.0) g/dL; sTfR, 2111 (1556, 2864) to 1270 (934, 1737) μg/L; ferritin, 4.9 (3.4, 7.2) to 15.5 (10.6, 22.6) μg/L; and sTfR:ferritin ratio, 542 (273, 1086) to 103 (51, 204); all p < 0.0001. With HIP supplementation, no change was observed in any of the iron status biomarkers (all p > 0.05). Conclusions: In accordance with recommendations, oral supplementation using FeSO4, but not HIP, was efficacious for treatment of iron deficiency after RYGB.

AB - Background: The evidence behind recommendations for treatment of iron deficiency (ID) following roux-en-y gastric bypass surgery (RYGB) lacks high quality studies. Setting: Academic, United States Objective: The objective of the study is to compare the effectiveness of oral iron supplementation using non-heme versus heme iron for treatment of iron deficiency in RYGB patients. Methods: In a randomized, single-blind study, women post-RYGB and iron deficient received non-heme iron (FeSO4, 195 mg/day) or heme iron (heme-iron-polypeptide, HIP, 31.5 to 94.5 mg/day) for 8 weeks. Measures of iron status, including blood concentrations of ferritin, soluble transferrin receptor (sTfR), and hemoglobin, were assessed. Results: At baseline, the mean ± standard deviation for age, BMI, and years since surgery of the sample was 41.5 ± 6.8 years, 34.4 ± 5.9 kg/m2, and 6.9 ± 3.1 years, respectively; and there were no differences between FeSO4 (N = 6) or HIP (N = 8) groups. Compliance was greater than 94%. The study was stopped early due to statistical and clinical differences between groups. Values before and after FeSO4 supplementation, expressed as least square means (95% CI) were hemoglobin, 10.8 (9.8, 11.9) to 13.0 (11.9, 14.0) g/dL; sTfR, 2111 (1556, 2864) to 1270 (934, 1737) μg/L; ferritin, 4.9 (3.4, 7.2) to 15.5 (10.6, 22.6) μg/L; and sTfR:ferritin ratio, 542 (273, 1086) to 103 (51, 204); all p < 0.0001. With HIP supplementation, no change was observed in any of the iron status biomarkers (all p > 0.05). Conclusions: In accordance with recommendations, oral supplementation using FeSO4, but not HIP, was efficacious for treatment of iron deficiency after RYGB.

KW - Bariatric surgery

KW - Iron deficiency

KW - Iron supplementation

KW - Nutritional complications

UR - http://www.scopus.com/inward/record.url?scp=85026801537&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85026801537&partnerID=8YFLogxK

U2 - 10.1007/s11695-017-2858-4

DO - 10.1007/s11695-017-2858-4

M3 - Article

C2 - 28779269

AN - SCOPUS:85026801537

SP - 1

EP - 9

JO - Obesity Surgery

JF - Obesity Surgery

SN - 0960-8923

ER -