Khorgami Zhamak, Arheart Kristopher L, Zhang Chi, Messiah Sarah E, de la Cruz-Muñoz Nestor
Division of Laparoendoscopic and Bariatric Surgery, The DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, 3650 NW 82nd Avenue, Suite 302, Miami, FL, 33166, USA,
Obes Surg. 2015 May;25(5):769-76. doi: 10.1007/s11695-014-1474-9.
Previous studies have reported better weight loss after bariatric surgery among non-Hispanic whites (NHW) versus non-Hispanic blacks (NHB) and Hispanics. The majority of these studies took place in areas where NHW are the majority. This study aimed to compare post-surgery weight outcomes by ethnicity in a geographic area where Hispanics are the majority.
A retrospective medical chart review of 3268 patients (1561 Hispanic, 660 NHB, and 1047 NHW) who underwent Roux-en-Y gastric bypass (RYGB) or Adjustable Gastric Band (AGB) placement from 2002 to 2012 were analyzed. Percentages of excess weight loss (EWL) and body mass index (BMI) changes at 6, 12, and 24 months post-surgery were compared by ethnic group.
At 6 months, EWL was significantly different by ethnicity (52.7 ± 15.9 Hispanics, 49.7 ± 15.7 NHW, 43.0 ± 17.3 NHB, P < 0.001). These differences remained at 1 year (66.0 ± 20.3 Hispanics, 64.0 ± 20.3 NHW, 54.1 ± 21.3 NHB, P < 0.001) and 2 years (68.6 ± 24.1 Hispanics, 69.5 ± 21.2 NHW, 57.6 ± 25.4 NHB, P < 0.001). Ethnic group changes in BMI were similar to EWL changes. Analysis stratified by gender, type of surgery, and BMI category (<40, 40-49.99, ≥50 kg/m(2)) showed lower EWL in NHB than Hispanics and NHW. NHW had higher EWL than Hispanics only when they underwent AGB and had a BMI >40 kg/m(2).
Up to 2 years after RYGB, mean EWL and BMI reduction patterns are similar among NHW and Hispanics and significantly better than NHB. These patterns were comparable but not as pronounced among patients with AGB surgery. Our findings suggest that social factors may contribute to successful weight loss after bariatric surgery.
既往研究报道,非西班牙裔白人(NHW)在接受减肥手术后的体重减轻情况优于非西班牙裔黑人(NHB)和西班牙裔。这些研究大多在非西班牙裔白人占多数的地区进行。本研究旨在比较在西班牙裔占多数的地理区域中,不同种族术后的体重结局。
对2002年至2012年期间接受 Roux-en-Y 胃旁路术(RYGB)或可调节胃束带术(AGB)的3268例患者(1561例西班牙裔、660例非西班牙裔黑人、1047例非西班牙裔白人)的病历进行回顾性分析。比较不同种族在术后6个月、12个月和24个月时的超重减轻百分比(EWL)和体重指数(BMI)变化。
6个月时,不同种族的EWL存在显著差异(西班牙裔为52.7±15.9,非西班牙裔白人为49.7±15.7,非西班牙裔黑人为43.0±17.3,P<0.001)。这些差异在1年时(西班牙裔为66.0±20.3,非西班牙裔白人为64.0±20.3,非西班牙裔黑人为54.1±21.3,P<0.001)和2年时(西班牙裔为68.6±24.1,非西班牙裔白人为69.5±21.2,非西班牙裔黑人为57.6±25.4,P<0.001)仍然存在。不同种族的BMI变化与EWL变化相似。按性别、手术类型和BMI类别(<40、40 - 49.99、≥50 kg/m²)分层分析显示,非西班牙裔黑人的EWL低于西班牙裔和非西班牙裔白人。仅当非西班牙裔白人接受AGB且BMI>40 kg/m²时,其EWL高于西班牙裔。
RYGB术后长达2年,非西班牙裔白人和西班牙裔的平均EWL和BMI降低模式相似,且显著优于非西班牙裔黑人。在接受AGB手术的患者中,这些模式具有可比性,但不那么明显。我们的研究结果表明,社会因素可能有助于减肥手术后成功减重。