Ebrahimian Jektaji Ramin, Moosavi Seyed Soroush, Moghaddam Ahmadi Moein
Department of Surgery, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
Clinical Research Development Unit, Poursina Hospital, Guilan University of Medical Sciences, Rasht, Iran.
BMC Surg. 2025 Aug 19;25(1):375. doi: 10.1186/s12893-025-03119-w.
One-anastomosis gastric bypass (OAGB) is an established bariatric procedure for managing obesity and related metabolic conditions. This study evaluated the impact of OAGB on weight loss, metabolic markers, and nutritional outcomes over one year, with specific focus on the percentage of small intestine bypassed.
In this prospective study, 42 patients (aged 29–65 years; BMI > 35 kg/m²) underwent OAGB with intraoperative measurement of total small bowel length to calculate bypass percentage. Patients were followed at six months and one year. Clinical and biochemical parameters—including BMI, HbA1c, lipid profile, transferrin, malnutrition, and steatorrhea—were assessed. Generalized estimating equations and Bonferroni-adjusted pairwise comparisons were used (SPSS v24; significance level < 0.05).
The mean bypass percentage was 34.9 ± 4.7%. Mean BMI decreased significantly from 46.5 ± 7.9 kg/m² preoperatively to 29.0 ± 5.3 kg/m² at one year ( < 0.001). Higher bypass percentages were associated with greater BMI reduction. HbA1c decreased significantly ( < 0.001) but was not related to bypass percentage. HDL increased while LDL and triglycerides declined significantly over time ( < 0.05). Transferrin levels remained unchanged. The incidence of malnutrition increased ( < 0.001) and steatorrhea decreased ( < 0.05) at one year; neither was significantly associated with bypass percentage.
OAGB led to significant weight loss and metabolic improvements over one-year follow-up. Greater bypass percentage correlated with greater BMI reduction but did not affect glycemic or nutritional outcomes. Ongoing monitoring is recommended to manage potential nutritional risks.
The online version contains supplementary material available at 10.1186/s12893-025-03119-w.
单吻合口胃旁路术（OAGB）是一种成熟的治疗肥胖症及相关代谢疾病的减肥手术。本研究评估了OAGB在一年时间内对体重减轻、代谢指标和营养结局的影响，特别关注小肠被旁路的比例。
在这项前瞻性研究中，42例患者（年龄29 - 65岁；BMI＞35kg/m²）接受了OAGB手术，并在术中测量了小肠总长度以计算旁路比例。对患者进行了6个月和1年的随访。评估了临床和生化参数，包括BMI、糖化血红蛋白（HbA1c）、血脂谱、转铁蛋白、营养不良和脂肪泻。使用广义估计方程和Bonferroni校正的成对比较（SPSS v24；显著性水平＜0.05）。
平均旁路比例为34.9±4.7%。平均BMI从术前的46.5±7.9kg/m²显著降至1年时的29.0±5.3kg/m²（＜0.001）。更高的旁路比例与更大程度的BMI降低相关。HbA1c显著降低（＜0.001），但与旁路比例无关。高密度脂蛋白（HDL）升高，而低密度脂蛋白（LDL）和甘油三酯随时间显著下降（＜0.05）。转铁蛋白水平保持不变。1年时营养不良的发生率增加（＜0.001），脂肪泻减少（＜0.05）；两者均与旁路比例无显著关联。
在一年的随访中，OAGB导致显著的体重减轻和代谢改善。更高的旁路比例与更大程度的BMI降低相关，但不影响血糖或营养结局。建议持续监测以管理潜在的营养风险。
在线版本包含可在10.1186/s12893 - 025 - 03119 - w获取的补充材料。
