Response: Cut-off Values and Clinical Utility of Surrogate Markers for Insulin Resistance and Beta-Cell Function to Identify Metabolic Syndrome and Its Components among Southern Indian Adults (J Obes Metab Syndr 2020;29:281-91) Response

Background : One-anastomosis gastric bypass (OAGB) is a simpler procedure than Roux-en-Y gastric bypass (RYGB); however, biliary reflux can occur and impair outcomes. This study aimed to compare outcomes of OAGB and RYGB. Methods : Twenty patients with morbid obesity were randomized prospectively into two groups: OAGB (n=10) or RYGB (n=10). Quality of life (36-item short-form health survey [SF-36]), satisfaction (Visick scale), and body mass index (BMI) were evaluated before and 6 months after the operation. All patients underwent esophagogastroduodenoscopy with gastric and esophageal mucosal biopsies at 3 and 6 months after their operation. Results : The study found no significant difference in BMI before surgery (OAGB, 43.2 kg/m2; RYGB, 43.1 kg/m2; P=0.90) or at 6 months postoperative (OAGB, 32.1 kg/m2; RYGB, 31.8 kg/m2; P=0.91). There was no significant difference in improvement of quality of life (four SF-36 domains) or satisfaction (P=0.08) between groups at 6 months. There was no statistical difference between gastric (P=0.10) and esophageal (P=0.76) inflammation grade at three or 6 months between the two groups. Conclusion : OAGB and RYGB are equally effective in terms of weight loss, patient satisfaction, and quality of life improvement at 6 months after the procedures. Inflammation grade and cellular damage in the gastric pouch and in the esophagus were similar.