Pankowska Aleksandra, Kotlęga Dariusz, Ryterska Karina, Gutowska Izabela, Ziętek Maciej, Szczuko Małgorzata
Independent Provincial Public Hospital Complex in Szczecin-Zdunowo, 70-880 Szczecin, Poland.
Department of Human Nutrition and Metabolomics, Pomeranian Medical University in Szczecin, 71-460 Szczecin, Poland.
Nutrients. 2025 Sep 3;17(17):2857. doi: 10.3390/nu17172857.
Introduction: Bariatric surgery, including laparoscopic sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB), is an effective treatment for severe obesity and its metabolic complications. This study aimed to assess and compare the clinical outcomes of both procedures over a 24-month follow-up. Few studies have compared 24-month SG and RYGB results in terms of metabolic and nutritional profiles in the Polish cohort. A retrospective analysis was conducted on 54 patients (27 SG, 27 RYGB) treated between 2018 and 2022. Anthropometric (body weight, BMI), biochemical (lipid profile, glucose, HbA1c, and liver enzymes), and nutritional (iron, ferritin, and vitamin B12) parameters were measured at 1, 6, 12, and 24 months postoperatively. Both surgical techniques led to a significant reduction in body weight and BMI during the first postoperative year. After 24 months, weight stabilization was observed in the RYGB group, while statistically significant weight regain occurred in the SG group ( < 0.0001). HDL levels significantly increased and triglyceride levels decreased in both groups ( < 0.0001), with no significant changes in LDL levels. AST, ALT, decreased dramatically at the first measurement in both methods, while a greater decrease in glycemia was recorded with the SG method (at the same time). A significant reduction in ferritin and vitamin B12 levels was observed in both groups but was more pronounced after RYGB. Iron levels increased until 12 months, followed by a decline by month 24. Both RYGB and SG are effective for weight loss and metabolic improvement. RYGB demonstrates greater long-term weight stability but carries a higher risk of nutritional deficiencies. SG should be the first method to consider due to its lower risk, invasiveness, and lower risk of nutritional deficiencies.
减重手术，包括腹腔镜袖状胃切除术（SG）和 Roux-en-Y 胃旁路术（RYGB），是治疗重度肥胖及其代谢并发症的有效方法。本研究旨在评估和比较这两种手术在 24 个月随访期内的临床结果。在波兰队列中，很少有研究比较 24 个月的 SG 和 RYGB 在代谢和营养状况方面的结果。对 2018 年至 2022 年期间接受治疗的 54 例患者（27 例 SG，27 例 RYGB）进行了回顾性分析。在术后 1、6、12 和 24 个月测量人体测量学指标（体重、BMI）、生化指标（血脂谱、血糖、糖化血红蛋白和肝酶）和营养指标（铁、铁蛋白和维生素 B12）。两种手术技术在术后第一年均导致体重和 BMI 显著降低。24 个月后，RYGB 组体重稳定，而 SG 组出现统计学上显著的体重反弹（<0.0001）。两组的高密度脂蛋白水平显著升高，甘油三酯水平降低（<0.0001），低密度脂蛋白水平无显著变化。两种方法在首次测量时谷草转氨酶、谷丙转氨酶均显著下降，而 SG 方法在同一时间血糖下降幅度更大。两组铁蛋白和维生素 B12 水平均显著降低，但 RYGB 术后更明显。铁水平在 12 个月前升高，随后在 24 个月时下降。RYGB 和 SG 对减重和代谢改善均有效。RYGB 显示出更好的长期体重稳定性，但营养缺乏风险更高。由于 SG 风险较低、侵入性较小且营养缺乏风险较低，应首先考虑采用该方法。
