Guajardo-Salinas Gustavo E, Hilmy Ashraf, Martinez-Ugarte Maria L
Department of Surgery, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.
Obes Surg. 2008 Nov;18(11):1369-75. doi: 10.1007/s11695-008-9461-7. Epub 2008 Mar 7.
Co-morbidities and the metabolic response to intervention in morbid obesity have been reported to vary among different ethnic groups. We compared the rate of weight loss, effectiveness of gastric bypass surgery, and variables influencing success after gastric bypass in Hispanics compared to Caucasians.
Morbidly obese adult (>18 years old) patients (body mass index [BMI] 40 or above) evaluated by our bariatric group from 2005 to 2006 who underwent Roux-en-Y gastric bypass (RYGBP) were studied. Every patient was evaluated for height, weight, BMI, percent body fat, fat mass, serum metabolic analysis (SMA) 12, lipid profile, complete blood count (CBC), iron, ferritin, Vitamins A, D, and B1, complete urinalysis and Fibrospect score II. Weight loss was evaluated at 1, 3, 6, and 12 months.
Seventy-five patients underwent successful open RYGBP with no mortality. Regardless of the significant difference in age and co-morbidities, the mean percentage of total weight loss after 1 year of follow-up was 32% for Hispanics and 30% for Caucasians with no significant difference (p > .5). When comparing the percentage of excess weight lost (% EWL) at 1, 3, 6, and 12 months, there was no significant difference between both groups. Using multiple regression analysis, we found that high-density lipoprotein (HDL) and systolic blood pressure (SBP) significantly predicted EWL at 12 months in Caucasians and Fibrospect predicted significantly EWL at 1 year.
At 1 year after RYGBP, both ethnic groups lost approximately 77-80% of their EWL and BMI. All Caucasians and 95.7% of Hispanics achieved successful weight loss (>50% EWL).
据报道，不同种族群体中，合并症以及病态肥胖患者对干预措施的代谢反应存在差异。我们比较了西班牙裔与白种人在胃旁路手术后的体重减轻率、手术效果以及影响手术成功的变量。
对2005年至2006年间由我们的减肥团队评估并接受了Roux-en-Y胃旁路术（RYGBP）的病态肥胖成年患者（年龄>18岁，体重指数[BMI]40及以上）进行研究。对每位患者进行身高、体重、BMI、体脂百分比、脂肪量、血清代谢分析（SMA）12项、血脂谱、全血细胞计数（CBC）、铁、铁蛋白、维生素A、D和B1、尿常规以及Fibrospect评分II的评估。在1、3、6和12个月时评估体重减轻情况。
75例患者成功接受了开放性RYGBP手术，无死亡病例。尽管在年龄和合并症方面存在显著差异，但随访1年后，西班牙裔患者总体重减轻的平均百分比为32%，白种人为30%，差异无统计学意义（p>.5）。比较1、3、6和12个月时多余体重减轻百分比（%EWL），两组之间无显著差异。通过多元回归分析，我们发现高密度脂蛋白（HDL）和收缩压（SBP）在白种人中显著预测了12个月时的EWL，而Fibrospect在1年时显著预测了EWL。
RYGBP术后1年，两个种族群体均减轻了约77-80%的EWL和BMI。所有白种人和95.7%的西班牙裔患者实现了成功减重（>50%EWL）。
