Controlling Nutritional Status (CONUT) Score and Micronutrient Deficiency in Bariatric Patients: Midterm Outcomes of Roux-en-Y Gastric Bypass Versus One Anastomosis Gastric Bypass/Mini Gastric Bypass

May 25, 2021Obesity surgery

Nutrition Status and Vitamin Deficiency in Weight Loss Surgery Patients: Midterm Results Comparing Two Types of Gastric Bypass

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Abstract

A 3-year mild malnutrition rate was observed in 38% of patients after Roux-en-Y gastric bypass (RYGB) and 37.05% after one anastomosis gastric bypass (OAGB).

No significant differences were found in percentage of total weight loss (%TWL) or percentage of adjustable weight loss (%AWL) between RYGB and OAGB groups.
Vitamin deficiencies were similar in both OAGB and RYGB patients.
Anemia, hypoproteinemia, hypoalbuminemia, and hypocalcemia rates were comparable between the two procedures.
At the 3-year follow-up, total protein and albumin levels were similar in both groups, but prealbumin deficiency was more common after OAGB.
Remission rates for type 2 diabetes, arterial hypertension, and dyslipidemia were not significantly different between the RYGB and OAGB groups.

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BACKGROUND: Two of the most common bariatric procedures performed worldwide are Roux-en-Y gastric bypass (RYGB) and one anastomosis gastric bypass (OAGB). Comparative data regarding nutritional status are lacking and no previous study focus on malnutrition according to a validated score.

METHODS: Retrospective data from a single institution were reviewed. Anthropometric variables and nutritional data were assessed. The primary aim was to analyze and compare the nutritional status before and 3 years after RYGB vs OAGB using the controlling nutritional status (CONUT) score. The incidence of micronutrient deficiency and the remission of comorbidities in each group were defined as secondary outcomes.

RESULTS: Fifty-seven patients in each arm were enrolled. A 3-year mild malnutrition (CONUT score 2-3) was found in 38% and 37.05% in the RYGB and OAGB groups, respectively (p > 0.05). In terms of percentage of total weight loss (%TWL) and percentage of adjustable weight loss (%AWL), no differences were found between OAGB and RYGB groups. OAGB and RYGB patients had similar vitamin deficiencies. Anemia, hypoproteinemia, hypoalbuminemia, and hypocalcemia were comparable between groups. At 3-year follow-up, total protein and albumin values were similar between arms while prealbumin deficit was more frequent after OAGB than after RYGB. The rate of type 2 diabetes (87.5% in OAGB and 92% in RYGB), arterial hypertension (51.6% in OAGB and 58.3% in RYGB), and dyslipidemia (69.7% in OAGB and 78.6% in RYGB) remission was not significantly different between the two groups.

CONCLUSIONS: Postoperative CONUT score, micronutrient deficiency, comorbidity remission, and improvement of anthropometric parameters 3 years postoperatively were comparable between RYGB and OAGB groups.

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Controlling Nutritional Status (CONUT) Score and Micronutrient Deficiency in Bariatric Patients: Midterm Outcomes of Roux-en-Y Gastric Bypass Versus One Anastomosis Gastric Bypass/Mini Gastric Bypass

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