Khan Murad A, Siddiq Ghulam, Uneeb Muhammad, Khan Muhammad Sohaib, Yusufi Maaz A, Siddiqi Najaf N
General Surgery, Shifa International Hospital Islamabad, Islamabad, PAK.
Surgery, University Hospitals Dorset, Poole, GBR.
Cureus. 2024 Oct 19;16(10):e71837. doi: 10.7759/cureus.71837. eCollection 2024 Oct.
Obesity is a chronic disease that can be effectively managed with bariatric surgery, such as gastric bypass. Both Roux-en-Y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB) surgeries are associated with malnutrition. OAGB is associated with higher weight loss and remission of diabetes. However, it is also associated with a significantly greater incidence of malnutrition than RYGB. We conducted this study to assess the association of both procedures with different micronutrient deficiencies.
A retrospective single-center cohort study was conducted. Patients undergoing RYGB and OAGB between January 1, 2022, and June 30, 2023, were included. Micronutrient deficiencies following RYGB and OAGB were compared. Vitamin B12, vitamin D, ferritin, and folate levels were assessed preoperatively and between six months to one year after the surgery.
A total of 116 patients underwent gastric bypass surgery, from which 50 (43.1%) patients were excluded due to loss of follow-up, and 66 (56.9%) were included. There were 50 (75.8%) RYGB cases and 16 (24.2%) OAGB cases. There were 24 (36.0%) males. The mean age was 46.2 ± 9.6 years, and the mean preoperative body weight was 131.8 ± 27.9 kg. The mean height was 165.8 ± 9.9 cm, and the mean body mass index (BMI) was 47.7 ± 7.6 kg/m. Both groups were comparable in age, gender distribution, and height. However, patients' mean weight in the OAGB group was higher than in the RYGB group, with a correspondingly higher BMI. Folate deficiency was more common following OAGB (30.8%; N = 4) than RYGB (8.0%; N = 4) (p = 0.028). A fall in folate levels from the initial value was found in the OAGB group, while a rise was found in the RYGB group. However, the two groups had no statistically significant differences in vitamin B12, vitamin D, and ferritin deficiencies (or fall from the initial values).
Both RYGB and OAGB are associated with micronutrient deficiencies. However, OAGB is associated with an increased incidence of micronutrient deficiencies compared to RYGB after six months to one year following the surgery, especially folate deficiency (p = 0.028). Larger, prospective studies and randomized controlled trials are needed, with standardization of the BP limb, the inclusion of multiple ethnicities, and longer follow-up periods.
肥胖是一种慢性疾病，可通过减肥手术（如胃旁路手术）有效控制。Roux-en-Y胃旁路术（RYGB）和单吻合口胃旁路术（OAGB）均与营养不良有关。OAGB与更高的体重减轻和糖尿病缓解相关。然而，与RYGB相比，它还与更高的营养不良发生率相关。我们进行了这项研究，以评估这两种手术与不同微量营养素缺乏之间的关联。
进行了一项回顾性单中心队列研究。纳入2022年1月1日至2023年6月30日期间接受RYGB和OAGB手术的患者。比较RYGB和OAGB术后的微量营养素缺乏情况。术前以及术后6个月至1年评估维生素B12、维生素D、铁蛋白和叶酸水平。
共有116例患者接受了胃旁路手术，其中50例（43.1%）因失访被排除，66例（56.9%）被纳入研究。RYGB病例50例（75.8%），OAGB病例16例（24.2%）。男性24例（36.0%）。平均年龄为46.2±9.6岁，术前平均体重为131.8±27.9kg。平均身高为165.8±9.9cm，平均体重指数（BMI）为47.
