Short-term weight loss and metabolic outcomes after LSG and LRYGB in Chinese patients: a propensity score-matched retrospective analysis.

Aims: To compare weight loss and metabolic parameters changes between laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-gastric bypass (LRYGB) in obese patients.

Materials and methods: This retrospective study included 824 patients treated with LSG or LRYGB between January 2014 and August 2022 at the First Affiliated Hospital of Jinan University. A 1:1 propensity score matching method was used to compare the LSG and LRYGB groups. Differences in weight loss outcomes, changes in biochemical levels, and differences in nutritional status at 6- and 12- months postoperatively were assessed in different Chinese populations.

Results: LSG and LRYGB groups each comprised 412 patients. The baseline characteristics of the two groups showed no significant differences. However, patients with type 2 diabetes mellitus (T2DM) who underwent LRYGB exhibited significantly reduced glycated hemoglobin (HbA1c) levels compared to those who had LSG after the 12-month postoperative follow-up. Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) levels are reduced in patients with nonalcoholic fatty liver disease (NAFLD). Alcohol consumption was shown to adversely affect surgical outcomes, with a notable association observed in postoperative weight regain. Females had lower body mass index (BMI) and blood glucose levels 6 months after LSG and lower BMI and blood pressure levels 12 months after LRYGB. Bariatric surgery caused severe nutritional deficiencies, notably affecting vitamin D levels, with over 60% of patients in both groups experiencing insufficiency postoperatively.

Conclusions: Both LSG and LRYGB surgeries were determined to be safe and efficacious. LSG proved particularly beneficial for patients with NAFLD, while LRYGB was more efficacious for those with T2DM, hypercholesterolemia, and hypertensive women.