One-anastomosis gastric bypass vs sleeve gastrectomy for diabetes remission and weight loss: A meta-analysis

Table 1 Basic characteristics of patients who underwent conventional treatment and bariatric surgery, mean ± SD

Ref.	Age (years), OAGB	Age (years), SG	Females, OAGB	Females, SG	BMI (kg/m2), OAGB	BMI (kg/m2), SG	Outcomes	Comments
Musella et al[24]	48.5 ± 8.7	49.2 ± 9.1	39.6%	27.3%	48.3 ± 9.2	48.1 ± 7.8	DR & EWL%	More females in OAGB
Abdel-Rahim et al[26]	42.9 ± 6.17	42.95 ± 7.63	65%	85%	50.88±3.99	47.77 ± 6.18	DR & EWL%	Higher BMI in OAGB
Ahmad et al[27]	47.1 ± 10.8	44.6 ± 10.9	59.1%	60.9%	43.04 ± 7.87	42.85 ± 5.02	DR	No significant differences at the baseline
Abdelshafy et al[28]	44.2 ± 4.99	43.6 ± 3.7	64.5%	64.5%	44.2 ± 4.99	43.6 ± 3.7	DR	No significant differences at the baseline
Dayan et al[29]	67.6 ± 2.8	67.6 ± 2.6	61.4%	61.4%	41.8 ± 7.8	43.3 ± 5.9	DR & EWL%	No significant differences at the baseline
Madhok et al[31]	45.0 ± 25	51 ± 30	47.4%	55.4%	67.0 ± 60	65.0 ± 60	DR & EWL%	OAGB were younger, more males
Milone et al[32]	34.9 ± 6.01	33.7 ± 5.61	62.2%	53.5%	47.3 ± 3.88	46.0 ± 4.77	DR & EWL%	More women in OAGB
Toksoy et al[33]	43.9 ± 12.1	40.5 ± 10.8	65.3%	59.3%	43.1 ± 3.9	42.2 ± 4.5	DR	OAGB were older
Alkhalifah et al[36]	33.8 ± 10.4.1	35.2 ± 10	70%	74.9%	40.4 ± 7.7	36.4 ± 7.6	DR & EWL%	Higher BMI in OAGB
Catro et al[37]	42.4 ± 11	43.5 ± 10.2	73.2%	75.9%	43.8 ± 9.2	45.2 ± 9.2	DR & EWL%	No significant differences at the baseline
Das et al[38]	47.1	46.7	84.2%	69.2%	47.1 ± 9.75	52.7 ± 7.17	DR & EWL%	Less body mass index in OAGB
Ding et al[39]	46	30	15.4%	80%	34.7	43.8	DR	OAGB were older, fewer females, and had lower BMI
Gambardella et al[40]	40.1 ± 5.1	38.9 ± 4.6	45%	44.5%	47.1 ± 2.3	46.2 ± 3.6	DR & EWL%	No significant differences at the baseline
Jammu and Sharma[41]	38	23	71.2%	45.4%	42.5	35	DR	OAGB were older, more females, and high BMI
Jain et al[42]	42.9±14.0	39.9±11.7	38.6%	35%	44.3±7.88	44.5±7.16	DR & EWL%	OAGB were older
Kansou et al[43]	41.2 ± 11.3	41.2 ± 12.3	93.4%	91.9%	42.8 ± 5.0	43.4 ± 6.5	DR & EWL%	No significant differences at the baseline
Kular et al[44]	NA	NA	NA	NA	NA	NA	DR & EWL%	NA
Moradi et al[45]	47.3 ± 10.2	47.5 ± 10.9	77.3%	80.1%	44.6 ± 7.0	43.8 ± 6.9	DR	No significant differences at the baseline
Plamper et al[46]	42. ± 11	44 ± 11	76.2%	61.8%	54.1 ± 6.6	54.6 ± 10.3	DR & EWL%	OAGB younger, more females, less BMI
Ruiz-Tovar et al[47]	43.8 ± 11.5	43.9 ± 10.9	75%	75%	45 ± 4.1	46.5 ± 3.4	DR & EWL%	No significant differences at the baseline
Schmitz et al[48]	39.11 ± 0.9	41.57 ± 1.07	74.5% vs 58.1%	58.1%	64.14 ± 0.3	66.91 ± 0.6	DR & EWL%	More females, lower BMI in OAGB
Seetharamaiah et al[49]	42.89 ± 14.02	39.89 ± 11.75	62%	65%	44.32 ± 7.88	44.57 ± 7.16	DR & EWL%	No significant differences at the baseline
Shen et al[50]	42.9	42.9	NA	NA	39.0 ± 7.2	39.0 ± 7.2	DR	NA
Shivakumar et al[51]	42.9 ± 14.02	39.9 ± 11.75	61.3%	65%	44.3 ± 7.88	44.6 ± 7.16	DR & EWL%	OAGB were older
Singla et al[52]	Matched	Matched	Matched	Matched	> 50	> 50	DR & EWL%	No significant differences at the baseline
Tabesh et al[53]	41.54 ± 11.20	41.42 ± 11.77	76%	84.4%	46 ± 6.15	455.71	24 years, 17.2% vs 12.9% diabetes	Higher BMI in OAGB
Toh et al[54]	47 ± 9	40 ± 11	69.8%	61.8%	40.3 ± 9.1	43±7.9	DR & EWL%	OAGB were older with lower BMI
Vrakopoulou et al[55]	46.6 ± 7.8	45.9 ± 7.5	60%	57.1%	52.7 ± 10.8	52.2 ± 8.6	DR & EWL%	No significant differences at the baseline
Wazir et al[56]	48.21 ± 9.77	48.21 ± 9.77	70.2% females	70.2% females	49.80 ± 6.225	49.80 ± 6.225	DR	Not assessed
Sari et al[57]	20-59	20-59	79.6% females	79.6% females	≥ 35	≥ 35	DR & EWL%	Not assessed
Yang et al[58]	NA	NA	NA	NA	32.1 ± 10.3	33.9 ± 9.4	DR & EWL%	No significant differences at the baseline

OAGB: One-anastomosis gastric bypass; NA: Not available; SG: Sleeve gastrectomy; BMI: Body mass index; DR: Diabetes remission; EWL: Excess weight loss.

Table 2 Diabetes mellitus complete remission

Ref.	Country	Study type	OAGB, 1 year	SG, 1 year	OAGB, 3 years	SG, 3 years	OAGB, 5 years	SG, 5 years
Musella et al[24]	Italy	Retrospective	82/96	67/110
Abdel-Rahim et al[26]	Egypt	Prospective	11/20	11/20
Ahmad et al[27]	Syria	Prospective	110/137	57/92
Abdelshafy et al[28]	Egypt	Trial	18/22	14/22
Dayan et al[29]	Israel	Retrospective	36/41	25/83
Lee et al[30]	Taiwan	Trial	18/30	9/30
Madhok et al[31]	United Kingdom	Retrospective	4/6	9/17
Milone et al[32]	Italy	Prospective	14/16	10/15
Toksoy et al[33]	Turkey	Retrospective	94/108	32/39
Alkhalifah et al[36]	Taiwan	Prospective	496/533	186/205			488/533	205/205
Catro et al[37]	Spain	Retrospective	114/123	68/83			110/123	63/83
Das et al[38]	United Kingdom	Retrospective	3/4	3/5
Ding et al[39]	China	Retrospective	7/10	1/3
Gambardella et al[40]	Italy	Prospective	48/60	79/131	53/57	105/128
Jammu and Sharma[41]	India	Retrospective	59/473	13/339
Jain et al[42]	India	Trial	49/49	47/47			40/55	37/52
Kansou et al[43]	France	Retrospective	25/27	19/21
Kular et al[44]	India	Retrospective	58/63	49/61
Moradi et al[45]	Iran	Retrospective	509/675	142/201	336/675	94/201
Plamper et al[46]	Germany	Retrospective	302/3 19	83/98	NA	NA	NA	NA
Ruiz-Tovar et al[47]	Spain	Trial	66/70	53/61			61/70	50/61
Schmitz et al[48]	Germany	Retrospective	34/51	42/45
Seetharamaiah et al[49]	India	Trial	41/49	36/47
Shen et al[50]	Taiwan	Retrospective	64/81	91/130
Shivakumar et al[51]	India	Trial	41/49	36/47	46/49	44/47
Singla et al[52]	India	Retrospective	58/75	64/75
Tabesh et al[53]	Iran	Retrospective	2/35	1/151
Toh et al[54]	Singapore	Retrospective	23/32	60/73
Vrakopoulou et al[55]	Greece	Retrospective	22/25	10/28
Wazir et al[56]	United Kingdom	Retrospective	1/2	10/18
Sari et al[57]	Turkey	Retrospective					27/28	29/31

Data are events/total. NA: Not available; OAGB: One-anastomosis gastric bypass; SG: Sleeve gastrectomy.

Table 3 Excess weight loss following one-anastomosis gastric bypass and sleeve gastrectomy at 1-year post-surgery, mean ± SD/n

Ref.	Country	Study type	OAGB, 1 year	SG, 1 year	OAGB, 3 years	SG, 3 years	OAGB, 5 years	SG, 5 years
Musella et al[24]	Italy	Retrospective	64.7 ± 22.9/96	52.4 ± 18.3/110			22.8 ± 5.9/96	20.1 ± 5.3/110
Abdel-Rahim et al[26]	Egypt	Prospective	95.11 ± 7.00/20	78.48 ± 19.07/20
Dayan et al[29]	Israel	Retrospective	67.2 ± 22.3/41	45.8 ± 18.0/83
Lee et al[30]	Taiwan	Trial					78.2 ± 19.7/519	68.7 ± 30.3/519
Madhok et al[31]	United Kingdom	Retrospective	58.0 ± 7.75/19	45 ± 21.5/56	NA	NA	NA	NA
Milone et al[32]	Italy	Prospective	24.19 ± 4.42/16	24.33 ± 4.48/15
Alkhalifah et al[36]	Taiwan	Prospective	84.5 ± 35.2/533	64.8 ± 34.3/205
Catro et al[37]	Spain	Retrospective	72.5 ± 16.4/123	68.8 ± 18.6/83
Das et al[38]	United Kingdom	Retrospective	50.2 ± 28.6/19	49.9 ± 19.5/26
Gambardella et al[40]	Italy	Prospective	83.6 ± 18.1/60	74.3 ± 13.8/131
Jain et al[42]	India	Trial	65.9 ± 10.9/101	64.8 ± 14.3/100	67.5 ± 16.6/101	61 ± 26.4/100	65.3 ± 13.9/101	55.9 ± 27/100
Kansou et al[43]	France	Retrospective	79.3 ± 17.8/136	71.4 ± 19 /136
Kular et al[44]	India	Retrospective	63 ± 21.2/104	69 ± 22.5/118	70 ± 22.6/104	61 ± 26.4/118	68 ± 24/104	51.2 ± 23/118
Plamper et al[46]	Germany	Retrospective	66.2 ± 13/169	57.3 ± 19/118	NA	NA	NA	NA
Ruiz-Tovar et al[47]	Spain	Trial					97.9 ± 7/70	76.3 ± 6/61
Schmitz et al[48]	Germany	Retrospective	36 ± 0.8/150	29 ± 1.2/93	42.5 ± 1.9	32.4 ± 2.7
Seetharamaiah et al[49]	India	Trial	66.87 ± 10.87/101	63.97 ± 13.24/100
Shivakumar et al[51]	India	Trial	66.2 ± 10.9/101	63.9 ± 13.5/100	66.5 ± 15.7/93	61.2 ± 25.2/92
Singla et al[52]	India	Retrospective	74.57 ± 13.2/75	56.20 ± 18.9/75
Toh et al[54]	Singapore	Retrospective	68 ± 28.5/40	61.2 ± 20/195	66.2 ± 35.6/31	47.9 ± 22.8/53	65.2 ± 27.5/8	47.3 ± 27.5/15
Vrakopoulou et al[55]	Greece	Retrospective	98.2 ± 29.0/115	79.7 ± 14.5/437
Sari et al[57]	Turkey	Retrospective					77.66 ± 30.55/62	71.11 ± 27.81/129
Yang et al[58]	Taiwan	Prospective	72 ± 20/89	67.2 ± 18.4/32

Data are events/total. NA: Not available; OAGB: One-anastomosis gastric bypass; SG: Sleeve gastrectomy.

Table 4 Newcastle Ottawa Scale risk of bias of the included studies

Ref.	Selection	Compatibility	Exposure	Total score
Musella et al[24]	4	2	2	8
Abdel-Rahim et al[26]	3	2	2	7
Ahmad et al[27]	3	2	3	8
Dayan et al[29]	4	2	2	9
Madhok et al[31]	3	1	2	7
Milone et al[32]	4	2	2	8
Toksoy et al[33]	4	2	3	9
Alkhalifah et al[36]	3	2	2	7
Catro et al[37]	4	2	3	9
Das et al[38]	4	2	2	8
Ding et al[39]	3	2	2	7
Gambardella et al[40]	3	2	3	8
Jammu and Sharma[41]	3	2	2	7
Kansou et al[43]	4	2	2	8
Kular et al[44]	4	2	2	8
Moradi et al[45]	4	2	3	8
Plamper et al[46]	3	2	2	7
Schmitz et al[48]	4	2	2	8
Shen et al[50]	4	2	2	7
Singla et al[52]	3	2	2	7
Tabesh et al[53]	3	2	3	8
Toh et al[54]	4	2	2	8
Vrakopoulou et al[55]	N/A	N/A	N/A	N/A
Wasir et al[56]	4	1	2	7
Sari et al[57]	3	2	2	7
Yang et al[58]	3	2	1	6

N/A: Not applicable.

Table 5 Risk of bias assessment of the included studies according to the Cochrane risk of bias tool for randomized controlled trials

Ref.	Selection bias1	Selection bias2	Performance bias	Attrition bias	Detection bias	Reporting bias	Overall bias
Abdelshafy et al[28]	Some concern	Low	Some concern	Low	Low	Some concern	Some concerns
Lee et al[30]	Some concern	Some concern	Low	Low	Low	High	Low
Jian et al[42]	Low	Low	High	Low	Some concern	Some concern	Some concerns
Ruiz-Tovar et al[47]	Low	Low	Some concerns	Some concerns	Some concerns	Low	Some concerns
Seetharamaiah et al[49]	Low	Some concerns	Some concerns	Some concerns	Some concerns	Low	Some concerns
Shivakumar et al[51]	Low	Low	Some concerns	Some concerns	Low	Low	Low

¹Random sequence generation bias.

²Allocation concealment.

Table 6 Effects of different studies on heterogeneity (all patients with diabetes remission)

Ref.	Effect
Musella et al[24]	1% increase
Abdel-Rahim et al[26]	1% increase
Ahmad et al[27]	1% increase
Abdelshafy et al[28]	1% increase
Dayan et al[29]	9% decrease
Lee et al[30]	1% increase
Madhok et al[31]	1% increase
Milone et al[32]	1% increase
Toksoy et al[33]	1% increase
Alkhalifah et al[36]	1% increase
Catro et al[37]	1% increase
Das et al[38]	1% increase
Ding et al[39]	1% increase
Gambardella et al[40]	1% increase
Jammu and Sharma[41]	1% decrease
Jian et al[42]	No effect
Kansou et al[43]	1% increase
Kular et al[44]	1% increase
Moradi et al[45]	2% decrease
Plamper et al[46]	No effect
Ruiz-Tovar et al[47]	1% increase
Schmitz et al[48]	7% decrease
Seetharamaiah et al[49]	1% increase
Shen et al[50]	1% increase
Shivakumar et al[51]	1% increase
Singla et al[52]	3% decrease
Tabesh et al[53]	No effect
Toh et al[54]	2% decrease
Vrakopoulou et al[55]	2% decrease
Wazir et al[56]	1% increase
Sari et al[57]	1% increase

Table 7 Effects of different studies on heterogeneity (all patients with excess weight loss)

Ref.	Change
Musella et al[24]	1% increase
Abdel-Rahim et al[26]	1% increase
Dayan et al[29]	No change
Lee et al[30]	1% increase
Madhok et al[31]	4% decrease
Milone et al[32]	No change
Alkhalifah et al[36]	No change
Catro et al[37]	1% increase
Das et al[38]	1% increase
Gambardella et al[40]	1% increase
Jian et al[42]	No change
Kansou et al[43]	1% increase
Kular et al[44]	No change
Plamper et al[46]	1% increase
Schmitz et al[48]	1% increase
Seetharamaiah et al[49]	1% increase
Shivakumar et al[51]	1% increase
Singla et al[52]	No effect
Toh et al[54]	1% increase
Vrakopoulou et al[55]	No effect
Sari et al[57]	No effect
Yang et al[58]	1% increase