Comparative Impact of Sleeve Gastrectomy and One Anastomosis Gastric Bypass on Glycemic Control and Abdominal Adiposity:ARandomized Controlled Study

Background Abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) depots are implicated in the interplay between obesity and metabolic complications. The present study aimed to compare the impact of sleeve gastrectomy (SG) and one anastomosis gastric bypass (OAGB) on weight loss and glycemic control and to assess the potential role of VAT in type 2 diabetes mellitus (DM) remission. Patients and methods Patients with obesity and DM participated in this randomized controlled study were randomly allocated to the SG and OAGB groups. Computed tomography was used to assess VAT and SAT. Patients were followed up one year after surgery. Results At the 12-month follow-up, the two groups showed significant weight loss and improvement in the metabolic profile. The OAGB group showed a statistically significant higher percentage reduction in HbA1c. The incidence of complete remission was 76.0% in the SG group and 87.0% in the OAGB group (p = 0.331). The OAGB group showed significantly lower mean VAT/SAT and higher mean reduction rates. DM duration and VAT/SAT still significantly predicted DM remission. Conclusion Both SG and OAGB procedures are effective in achieving weight loss and improving metabolic performance at 12 months postoperatively. The OAGB group showed superior glycemic control and a higher reduction in the VAT area relative to abdominal fat.