Roux-en-Y gastric bypass induced a more pronounced postprandial glucose response than One-Anastomosis gastric bypass, with higher peak glucose values during oral glucose tolerance tests at 12 months (10.0 mmol/l vs. 7.8 mmol/l).
RCT (n=44)
Randomized
No
Does Roux-en-Y gastric bypass compared to One-Anastomosis gastric bypass result in different postprandial glucose and insulin responses in participants with obesity?
Computational modeling reveals distinct postprandial glucose and insulin response patterns depending on the type of bariatric surgery, with higher responses after RYGB compared to OAGB.
Absolute Event Rate: 10% vs 7.8%
Bariatric surgery enhances glucose metabolism, yet the detailed postprandial joint glucose and insulin responses, variability in individual outcomes, and differences in surgical approaches remain poorly understood. We used hierarchical multi-output Gaussian process (HMOGP) regression to reveal clinically relevant patterns between persons undergoing two types of bariatric surgery by modeling the individual postprandial glucose and insulin responses and estimating the average response curves from individual data. 44 participants with obesity underwent either Roux-en-Y gastric bypass (RYGB; n = 24) or One-Anastomosis gastric bypass (OAGB; n = 20) surgery. The participants were followed up at the 6th and 12th months after the operation, during which they underwent an oral glucose tolerance test (OGTT) and a mixed meal test (MMT). A marked reduction in glycemia, an earlier glucose peak, and an increase and sharpening in the postprandial glucose and insulin responses are evident in both metabolic tests post-operation. MMT results in higher postprandial glucose and insulin peaks compared with OGTT. Higher glucose and insulin responses are observed after RYGB compared with OAGB, suggesting differences between the procedures that may influence the clinical practice. Computational modeling with HMOGP regression can thus be used to, in detail, predict the combined responses of patient cohorts to ingested glucose or a mixed meal and help in assessing individual metabolic improvement after weight loss. This can lead to new knowledge in personalized metabolic interventions. Bariatric surgery is used to reduce stomach size or nutrient absorption in people with obesity. However, the effects can vary depending on the person and the type of operation performed. This study used a computational model to analyze the amount of sugar and insulin, a hormone that impacts how the body responds to consumption of sugar, in the blood of 44 individuals who underwent two common types of bariatric surgery. The model revealed that while both operations improved people’s ability to process food, they had different impacts on the amounts of sugar and insulin in the blood after consuming a meal. This knowledge could be used to ensure the best strategy to treat obesity is used for each person with obesity. Poyraz, Heinonen et al. model the individual postprandial glucose and insulin responses in people with obesity who underwent either Roux-en-Y gastric bypass or One-Anastomosis gastric bypass surgery. They find differences in postprandial glucose and insulin responses related to the surgery method used.
Poyraz et al. (Thu,) conducted a rct in Obesity (n=44). Roux-en-Y gastric bypass (RYGB) vs. One-Anastomosis gastric bypass (OAGB) was evaluated on Peak value (PV) of glucose during oral glucose tolerance test (OGTT) at 12 months. Roux-en-Y gastric bypass induced a more pronounced postprandial glucose response than One-Anastomosis gastric bypass, with higher peak glucose values during oral glucose tolerance tests at 12 months (10.0 mmol/l vs. 7.8 mmol/l).