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Comparative Study
. 2025 Dec 6;26(1):20.
doi: 10.1186/s12893-025-03364-z.

Trends of copper deficiency following one anastomosis gastric bypass and Roux-en-Y gastric bypass

Mohammad Moradi  1 , Shahab Shahabi Shahmiri  2   3 , Masoumeh Shahsavan  1 , Mohammad Javad Farzadmanesh  4 , Elyas Mostafapour  1 , Faridadin Ebrahimi Meimand  1 , Abdolreza Pazouki  2   3 , Mohammad Kermansaravi  5   6
Affiliations
Comparative Study

Trends of copper deficiency following one anastomosis gastric bypass and Roux-en-Y gastric bypass

Mohammad Moradi et al. BMC Surg. .

Abstract

Background: Copper deficiency is an under-recognized complication after metabolic and bariatric surgery (MBS) with hematologic and neurologic sequelae. Comparative evidence between one-anastomosis gastric bypass (OAGB) and Roux-en-Y gastric bypass (RYGB) is limited. We compared time-dependent copper trends and deficiency prevalence after OAGB versus RYGB and identified associated factors.

Methods: We conducted a single-center retrospective cohort study of consecutive adults undergoing primary OAGB or RYGB (January 2020-December 2022). Serum copper was measured preoperatively and at 6 months and 12 months. Copper deficiency was defined as serum copper < 75 µg/dL. Multivariable logistic regression assessed associations of age, sex, procedure type, and 6-month percent total weight loss (%TWL) with deficiency; receiver operating characteristic (ROC) analysis explored a 6-month %TWL threshold.

Results: Among 294 patients (OAGB n = 107; RYGB n = 187; mean age 38.8 ± 9.9 years; 83% women), deficiency prevalence across 6, and 12 months did not differ between procedures. Mean serum copper declined from baseline to 6 months in both groups and remained below baseline at 12 months. In adjusted analyses, female sex and greater 6-month %TWL were independently associated with copper deficiency at 6 months; age and procedure type were not. ROC analysis suggested an exploratory 6-month %TWL threshold of ~ 29% for identifying higher-risk patients (AUC 0.64). No consistent between-group differences were observed in hematologic or iron indices by copper status.

Conclusion: Copper deficiency rates through 12 months were comparable after OAGB and RYGB; however, mean serum copper declined after both procedures. Greater early weight loss was associated with deficiency, supporting targeted biochemical surveillance-particularly within the first postoperative year-and reinforcement of supplementation adherence.

Keywords: Bariatric surgery; Copper deficiency; Micronutrients; One-anastomosis gastric bypass; Roux-en-Y gastric bypass.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All procedures performed in the study involving human participants followed the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of the Iran University of Medical Sciences (IR.IUMS.REC.1400.107). Written informed consent was obtained from all participants prior to enrollment. Consent for publication: No individual person’s data in any form (including images or quotes) are included in this manuscript; consent for publication was therefore not required, as confirmed by the Ethics Committee of the Iran University of Medical Sciences. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
ROC curve for %TWL at 6 months in predicting copper deficiency
Fig. 2
Fig. 2
Temporal changes in mean serum copper levels at baseline, 6 months, and 12 months following OAGB and RYGB
See this image and copyright information in PMC

References

    1. Verras GI, Mulita F, Pouwels S, Parmar C, Drakos N, Bouchagier K, et al. Outcomes at 10-year follow-up after Roux-en-Y gastric bypass, biliopancreatic diversion, and sleeve gastrectomy. J Clin Med. 2023. 10.3390/jcm12154973. - DOI - PMC - PubMed
    1. Mulita F, Lampropoulos C, Kehagias D, Verras GI, Tchabashvili L, Kaplanis C, et al. Long-term nutritional deficiencies following sleeve gastrectomy: a 6-year single-centre retrospective study. Menopause Rev. 2021;20(4):170–6. - DOI - PMC - PubMed
    1. Eisenberg D, Shikora SA, Aarts E, Aminian A, Angrisani L, Cohen RV, et al. 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): indications for metabolic and bariatric surgery. Surg Obes Relat Dis. 2022;18(12):1345–56. - DOI - PubMed
    1. Malik A, Malik MI, Javaid S, Qureshi S, Nadir A. Comparative effectiveness of metabolic and bariatric surgeries: a network meta-analysis. Int J Obes. 2024;(1):9. 10.1038/s41366-024-01648-7. - PubMed
    1. Huppler L, Robertson AG, Wiggins T, Hollyman M, Welbourn R. How safe bariatric surgery is—An update on perioperative mortality for clinicians and patients. Clin Obes. 2022;12(3):e12515. - DOI - PubMed

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