No Differences in Metabolic Parameters Between Roux-en-Y Gastric Bypass and Sleeve Gastrectomy, Regardless of Achieved Weight Loss

Abstract

Background: Roux-en-y (RYGB) is considered a procedure with more malabsorptive impact than sleeve Gastrectomy (SG), so the risk of chronic complications seems greater. Aim: To describe the metabolic profile and weight regain of patients who underwent bariatric surgery, according to each procedure. Method: A retrospective cohort with patients who underwent bariatric surgery (2003–2018). The sample was divided into SG group and RYGB group. Comparisons were made to analyze the relationship between the procedure itself and metabolic improvements, weight loss and weight regain. Results: We included 117 eligible participants (91.5 % female, 51.2% RYGB surgery), mean follow-up was 4.4± 3.3 years. Mean age was 41.8±6.8 years, without significant difference between the groups. Before the surgery, the groups were similar according metabolic profile (fasting glucose, Hba1c, total cholesterol, LDLc, triglycerides and HOMA IR), except by non-HDLc (RYGB 108.8±26.3 vs SG 127.2±33.2 mg/dl, p=0,002) and 25OHD (RYGB 28.9±4,7 vs SG 34.3±9,5 ng/ml, p=0.044). The RYGB group had greater weight than the SG group (mean 114.1±13.5 kg vs 122.7±20.5 Kg, p<0.0001) and almost 23.3% of the participants had T2DM and 36.2% of them had systemic arterial hypertension, without significant difference between the groups. The RYGB group had a greater postoperative time than the SG group (mean 5.0±4.0 vs 3.6± 2.9 years, respectively). After the surgery, although weight loss was greater in the RYGB group than the SG group (mean 39%±10.2 vs 34.1%±9.8, p<0.0001, respectively), both groups were similar regarding BMI, body fat percentage (BFP) and abdominal circumference. Also, there were no differences in the metabolic profile (fasting glucose, Hba1c, HOMA IR, leptin, triglycerides and HDLc), according to the type of surgery, except in the total cholesterol and LDLc levels (RYGB 167.9±28.2 vs SG 187.9±35.1 and RYGB 92.6±25.6 vs SG 109.5±30.8). Nearly the whole sample (95%) has reached > 20% weight loss. Despite that, 37.6% of the patients have regained > 20% of weight loss, with no relation regarding the type of surgery. Only 7% of the patients remained with some degree of glucose intolerance, with no difference between the groups. Conclusion: We found similar benefits among metabolic markers and weight regain after SG, compared to RYGB.