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

Voglino, Costantino; Tirone, Andrea; Ciuoli, Cristina; Benenati, Nicoletta; Bufano, Annalisa; Croce, Federica; Gaggelli, Ilaria; Vuolo, Maria Laura; Badalucco, Simona; Berardi, Giovanna; Cuomo, Roberto; Castagna, Maria Grazia; Vuolo, Giuseppe

doi:10.1007/s11695-021-05486-8

Cited by 15 publications

(7 citation statements)

References 60 publications

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“…Another interesting result is that a relevant number of obese patients in both groups were malnourished before surgery (5–17%). This is consistent with the findings from a few other authors [ 28 , 29 ]. Since many studies do not take into account the pre-operative nutritional status of obese patients, results on postoperative development of malnutrition could have been highly biased by undetected differences in this fundamental baseline characteristic.…”

Section: Discussionsupporting

confidence: 94%

“…In this study, the use of the CONUT score, an objective, laboratory-based index that has been validated in many clinical situations in detecting malnutrition with good positive and negative predictive values, adds considerable value to the accuracy of results. Consistent with our results, in a similar study by Voglino et al, RYGB and OAGB groups were found to harbour no differences in malnutrition 3 years after surgery [28].…”

Section: Discussionsupporting

confidence: 93%

“…The CONUT score may be limited in the BS setting as a reduction in cholesterol levels is expected and therefore this could “intentionally” increase the CONUT score. Nonetheless, many patients were not dyslipidemic at baseline and the score takes into consideration other unrelated parameters (i.e., albuminemia and lymphocyte count) and therefore it should still be considered appropriate in this setting as well [ 28 ]. Finally, we had a large predominance of female patients, limiting generalizability of results to the opposite gender.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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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.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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

et al. 2022

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“…Furthermore, Chang and colleagues in a retrospective 5 year follow-up study of 247 patients who underwent SG or RYGB showed that SG is an independent risk factor of insufficient weight loss [ 38 ]. In our previous paper, we reported the non-inferiority of OAGB, in terms of 3 year %TWL, compared to RYGB [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…Despite marked weight loss following BS, there is a subset of patients that fails to achieve a successful weight loss or experiences long-term weight regain. In fact, in our 3 year follow-up previous paper we reported the highest value of %Excess Weight Loss (%EWL) at 12 months after surgery and, after this time, a slight but constant decrease of %EWL with the lowest value observed at 3 years [ 5 ].…”

Section: Introductionmentioning

confidence: 91%

Follow-up after bariatric surgery: is it time to tailor it? Analysis of early predictive factors of 3-year weight loss predictors of unsuccess in bariatric patients

et al. 2022

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Bariatric surgery (BS) is the most effective treatment strategy for obesity. Nevertheless, a subset of patients does not reach a successful weight loss or experience long-term weight regain. Conflicting evidence exists regarding predictors of BS outcomes. We aimed to define the early factors linked to 3 year unsuccessful weight loss in order to promote a tailored close follow-up. We enrolled 443 patients who underwent BS from January 2014 to December 2018 with a 3 year follow-up. An unsuccessful BS outcome was defined as a percentage of total weight loss (%TWL) < 20. We compared the characteristics between successful and unsuccessful patients in order to identify predictor factors of unsuccess after surgery. We found that the proportion of patients with unsuccessful weight loss progressively increased from one to three years after BS. In a multiple regression model, only 1 month %TWL and sleeve gastrectomy (SG) were significantly associated with 3 year unsuccessful weight loss. We stratified our cohort in four groups according to the risk of BS unsuccess, in terms of 1 month %TWL and type of surgery (SG vs gastric bypass). Interestingly, groups showed a significant difference in terms of %TWL at each follow-up point. Patients submitted to SG with lower 1 month %TWL must be considered at higher risk of future weight regain; consequently, they require a tailored and closer follow-up. Graphical abstract

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Indikation, Technik und Ergebnisse des Magenbypasses

Denecke¹,

Dobrindt²

2023

Springer Reference Medizin

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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

Cited by 15 publications

References 60 publications

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

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

Follow-up after bariatric surgery: is it time to tailor it? Analysis of early predictive factors of 3-year weight loss predictors of unsuccess in bariatric patients

Indikation, Technik und Ergebnisse des Magenbypasses

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