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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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Abstract

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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Authors and Affiliations

  1. Department of general and specialized surgery - Unit of Bariatric Surgery, University of Siena, Policlinico “Le Scotte”, Viale Bracci 14, 53100, Siena, Italy

    Costantino Voglino, Andrea Tirone, Ilaria Gaggelli, Maria Laura Vuolo, Simona Badalucco & Giuseppe Vuolo

  2. Department of medicine, surgery and neurosciences - Unit of Endocrinology, University of Siena, Viale Bracci - Policlinico “Le Scotte”, 53100, Siena, Italy

    Cristina Ciuoli, Nicoletta Benenati, Annalisa Bufano & Maria Grazia Castagna

  3. Department of Diagnostic Imaging - Hospital Campostaggia, Campostaggia, 53036, Poggibonsi, SI, Italy

    Federica Croce

  4. Department of Advanced Biomedical Science, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy

    Giovanna Berardi

  5. Department of Medicine, Surgery and Neurosciences - Unit of Plastic Surgery, University of Siena, Policlinico “Le Scotte”, Viale Bracci 14, 53100, Siena, Italy

    Roberto Cuomo

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Correspondence to Costantino Voglino.

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Key Points

1. Malnutrition after weight loss surgery is one of the main concerns.

2. CONUT score is a simple tool that could be used as a malnutrition measure of choice in bariatric patients.

3. 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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Voglino, C., Tirone, A., Ciuoli, C. et al. 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. OBES SURG 31, 3715–3726 (2021). https://doi.org/10.1007/s11695-021-05486-8

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