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Endocrine Abstracts (2015) 37 EP564 | DOI: 10.1530/endoabs.37.EP564

1Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia; 2Dietary Unit, Clinical Center of Serbia, Belgrade, Serbia; 3Emergency Center, Clinical Center of Serbia, Belgrade, Serbia.


Bariatric surgery, especially malapsorptive procedures like gastric bypass, can lead to anaemia due to lack of iron absorption as well as vitamins essential for the normal functioning of the hematopoietic system.

Methods: We have analysed changes in red blood cells (RBC), haemoglobin (Hb), white blood cells (WBC), serum iron (Fe), and vitamin B12 3 years after gastric bypass in 142 morbidly obese patients (female, n=108 and male, n=34). All patients were on oral supplementation with 100 mg of iron and 200–400 mg of folic acid after surgery as well as 2500 μg of OHB12, i.m. injections every 3 months.

Results: Before surgery average BMI was 43.9 kg/m2 and 3 years after BMI was 30.5 kg/m2 (P<0.001). Change in number of RBC was nonsignificant (4.65.9±1.31×1012/l vs 4.42±1.12×1012/l; P>0.05) before and after surgery. There was no difference in Hb concentration between two measurements (137.9±15.5 g/l vs 128.9±16.3 g/l; P>0.05). Number of WBC was lower after surgery (10.7±3.2×109/l vs 5.7±1.3×109/l) with significance: P>0.001, but among reference range. Serum iron level increased after surgery but that was not significant (11.4±1.3 μmol/l vs 13.03±1.8 μmol/l; P>0.05). Vitamin B12 level remained within normal range 3 years after gastric bypass (922.5±212.2 pmol/l vs 866.7±201.1 pmol/l; P>0.05) without difference.

Conclusion: Even gastric bypass as malapsorptive bariatric procedure, can lead to anaemia, adequate supplementation of iron, folic acid and vitamin B12, after surgery, may prevent anaemia and vitamins essential for haematopoietic system deficiency during 3 years follow-up period.

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