Nutritional Status after Roux-En-Y (Rygb) and One Anastomosis Gastric Bypass (Oagb) at 6-Month Follow-Up: A Comparative Study

Abstract

Introduction: Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB) are two effective bariatric surgical procedures with positive outcomes in terms of weight loss, comorbidities remission, and adverse events profiles. OAGB seems to carry a higher risk of malnutrition, but existing data are controversial. The aim of this study is to objectively evaluate and compare malnutrition in patients undergoing RYGB and OAGB. Methods: Retrospective monocentric study of obese patients undergoing RYGB or OAGB between the 15 September 2020 and the 31 May 2021. Nutritional status was assessed using the Controlling Nutritional Status (CONUT) score and compared between groups. The primary outcome was the mean CONUT score at 6 months. The secondary outcomes included the incidence of malnutrition, comorbidities, including hypertension, insulin resistance and type II diabetes mellitus, and weight loss. Results: 78 patients were included: 30 underwent RYGB and 48 underwent OAGB. At 6-Month Follow-Up there was no difference between groups in the mean CONUT score nor in incidence of malnutrition. In both groups, the nutritional status significantly worsened 6 months after surgery (preoperative and postoperative score of 0.48 ± 0.9 and 1.38 ± 1.5; p = 0.0066 for RYGB and of 0.86 ± 1.5 and 1.45 ± 1.3; p = 0.0422 for OAGB). Type II Diabetes mellitus (DMII) and hypertension remission were significant in the OAGB group with a 100% relative remission in the DMII-OAGB group (p = 0.0265), and a 67% relative remission in the hypertension-OAGB group (p = 0.0031). Conclusions: No difference in nutritional status has been detected between patients undergoing RYGB or OAGB at the 6-Month Follow-Up. Both procedures may have significant mal-absorptive effects leading to decline in nutritional status. OAGB may be more efficacious in inducing DMII and hypertension remission. Larger prospective studies dedicated specifically to nutritional status after gastric bypass are needed to confirm the impact of different bypass procedures on nutritional status.

Roux‐en‐Y versus one‐anastomosis gastric bypass (RYSA study): weight loss, metabolic improvements, and nutrition at 1 year after surgery, a multicenter randomized controlled trial

“…However, some of the deficiencies may require longer follow-up periods to develop. Consistent with our data, a recent study found no differences between procedures in nutritional status (using the Controlling Nutritional Status [CONUT] nutrition score) or malnutrition at 6 months [28]. After OAGB, vitamin deficiencies [11] and even malnutrition [3,17] have been reported.…”

Evolution of Bariatric Surgery in Italy in the Last 11 Years: Data from the SICOB Yearly National Survey

“…In an opposite fashion, OAGB saw an unprecedented rise. OAGB is easier to fashion and randomized trials have yielded similar efficacy results to RYGB in the medium term [ 22 , 23 ]. While no OAGB was performed in SICOB centers in 2011, it accounted for as many as 15% of BS in 2021.…”

Malnutrition and infection lead to poor prognosis and heavy financial burden of patients with chronic heart failure

“…It was calculated on three parameters, the serum albumin and total cholesterol levels and the total lymphocyte count. CONUT is usually used to evaluate the prognosis of cancer patients, ( 16 , 36 ). Our study revealed that the ratio of infection of CHF patients with high CONUT score is higher, therapeutic outcomes is poorer, financial burden is heavier.…”

“…Controlling Nutritional Status (CONUT) is a scoring system that is used to assess the host's nutrition and immune states ( 16 ). CONUT is calculated from the serum albumin concentration, total blood cholesterol level, and total peripheral lymphocyte count.…”