Abstract：
OBJECTIVE: Bariatric surgery induces several micronutrient deficiencies that require supplementation. For iron, parenteral infusions are usually preferred over oral supplementation. Ferric carboxymaltose infusion has been associated with hypophosphataemia, mostly transient and asymptomatic. However, in some cases, ferric carboxymaltose-induced hypophosphataemia may persist for weeks to months and may induce muscle weakness, osteomalacia and bone fractures. The aim of this study was to identify possible predictors of a clinically relevant decrease in serum phosphate after ferric carboxymaltose infusion in patients with previous Roux-en-Y gastric bypass.
METHODS: Patients with previous Roux-en-Y gastric bypass who received ferric carboxymaltose infusions between January 2018 and September 2019 and had recorded phosphataemia before and after ferric carboxymaltose infusion at the Lausanne University Hospital, Lausanne, Switzerland, were studied retrospectively. A multiple linear regression model was built with delta phosphataemia as the outcome to investigate the factors related to magnitude of serum phosphate lowering.
RESULTS: Seventy-seven patients (70 females and 7 males) with previous Roux-en-Y gastric bypass were studied. Mean age (SD) was 43.2 (10.7) years and median BMI was 30.9 kg/m2 (IQR 27.9-36.4). Sixty-eight patients (88.3%) received an infusion of 500 mg ferric carboxymaltose and 9 patients (11.7%) received 250 mg ferric carboxymaltose. Forty-nine patients (63.6%) developed hypophosphataemia (<0.8 mmol/l) after ferric carboxymaltose infusion. Median plasma phosphate significantly decreased by 0.33 mmol/l (IQR 0.14-0.49) (p<0.0001). Multiple linear regression identified the ferric carboxymaltose dose as the only risk factor significantly associated with the magnitude of serum phosphate lowering, with an additional mean loss of 0.26 mmol/l with a 500 mg infusion compared to a 250 mg infusion (p = 0.020).
CONCLUSIONS: Ferric carboxymaltose infusions substantially decreased plasma phosphate levels in patients with previous Roux-en-Y gastric bypass. Compared to a dose of 250 mg, infusion of a dose of 500 mg ferric carboxymaltose decreased the plasma phosphate further in this population.
METHODS: Patients with previous Roux-en-Y gastric bypass who received ferric carboxymaltose infusions between January 2018 and September 2019 and had recorded phosphataemia before and after ferric carboxymaltose infusion at the Lausanne University Hospital, Lausanne, Switzerland, were studied retrospectively. A multiple linear regression model was built with delta phosphataemia as the outcome to investigate the factors related to magnitude of serum phosphate lowering.
RESULTS: Seventy-seven patients (70 females and 7 males) with previous Roux-en-Y gastric bypass were studied. Mean age (SD) was 43.2 (10.7) years and median BMI was 30.9 kg/m2 (IQR 27.9-36.4). Sixty-eight patients (88.3%) received an infusion of 500 mg ferric carboxymaltose and 9 patients (11.7%) received 250 mg ferric carboxymaltose. Forty-nine patients (63.6%) developed hypophosphataemia (<0.8 mmol/l) after ferric carboxymaltose infusion. Median plasma phosphate significantly decreased by 0.33 mmol/l (IQR 0.14-0.49) (p<0.0001). Multiple linear regression identified the ferric carboxymaltose dose as the only risk factor significantly associated with the magnitude of serum phosphate lowering, with an additional mean loss of 0.26 mmol/l with a 500 mg infusion compared to a 250 mg infusion (p = 0.020).
CONCLUSIONS: Ferric carboxymaltose infusions substantially decreased plasma phosphate levels in patients with previous Roux-en-Y gastric bypass. Compared to a dose of 250 mg, infusion of a dose of 500 mg ferric carboxymaltose decreased the plasma phosphate further in this population.
摘要：
目的：减重手术会导致多种微量营养素缺乏，需要补充。对于铁，肠胃外输注通常优于口服补充。羧基麦芽糖铁输注与低磷酸盐血症有关，大多是短暂的和无症状的。然而,在某些情况下,羧基麦芽糖铁诱导的低磷酸盐血症可能持续数周至数月，并可能导致肌肉无力，骨软化和骨折。这项研究的目的是确定先前进行Roux-en-Y胃旁路手术的患者在输注羧基麦芽糖铁后血清磷酸盐临床相关降低的可能预测因素。
方法：在2018年1月至2019年9月期间接受过Roux-en-Y胃旁路术的患者，在洛桑大学医院接受了羧基麦芽糖铁输注之前和之后记录了磷酸盐血症，洛桑,瑞士,进行了回顾性研究。以δ磷酸盐血症为结局建立多元线性回归模型，以研究与血清磷酸盐降低幅度相关的因素。
结果：研究了77例患者（70例女性和7例男性）曾接受过Roux-en-Y胃旁路手术。平均年龄（SD）为43.2（10.7）岁，中位BMI为30.9kg/m2（IQR27.9-36.4）。68例患者（88.3％）接受了500mg羧基麦芽糖铁的输注，9例（11.7％）接受了250mg羧基麦芽糖铁。49名患者（63.6％）在输注三磷酸麦芽糖铁后出现了低磷酸盐血症（<0.8mmol/l）。血浆磷酸盐中位数显着降低了0.33mmol/l（IQR0.14-0.49）（p<0.0001）。多元线性回归确定羧基麦芽糖铁剂量是唯一与血清磷酸盐降低幅度显着相关的危险因素，与250mg输注相比，500mg输注的额外平均损失为0.26mmol/l（p=0.020）。
结论：在Roux-en-Y胃旁路术患者中，输注羧基麦芽糖铁显著降低了血浆磷酸盐水平。与250毫克的剂量相比，在该人群中，输注500mg羧基麦芽糖铁的剂量进一步降低了血浆磷酸盐。
方法：在2018年1月至2019年9月期间接受过Roux-en-Y胃旁路术的患者，在洛桑大学医院接受了羧基麦芽糖铁输注之前和之后记录了磷酸盐血症，洛桑,瑞士,进行了回顾性研究。以δ磷酸盐血症为结局建立多元线性回归模型，以研究与血清磷酸盐降低幅度相关的因素。
结果：研究了77例患者（70例女性和7例男性）曾接受过Roux-en-Y胃旁路手术。平均年龄（SD）为43.2（10.7）岁，中位BMI为30.9kg/m2（IQR27.9-36.4）。68例患者（88.3％）接受了500mg羧基麦芽糖铁的输注，9例（11.7％）接受了250mg羧基麦芽糖铁。49名患者（63.6％）在输注三磷酸麦芽糖铁后出现了低磷酸盐血症（<0.8mmol/l）。血浆磷酸盐中位数显着降低了0.33mmol/l（IQR0.14-0.49）（p<0.0001）。多元线性回归确定羧基麦芽糖铁剂量是唯一与血清磷酸盐降低幅度显着相关的危险因素，与250mg输注相比，500mg输注的额外平均损失为0.26mmol/l（p=0.020）。
结论：在Roux-en-Y胃旁路术患者中，输注羧基麦芽糖铁显著降低了血浆磷酸盐水平。与250毫克的剂量相比，在该人群中，输注500mg羧基麦芽糖铁的剂量进一步降低了血浆磷酸盐。
