Memarian Ensieh, Sundquist Kristina, Calling Susanna, Sundquist Jan, Li Xinjun
Center for Primary Healthcare Research, Lund University/Region Skåne, Malmö, Sweden.
Center for Primary Healthcare Research, Lund University/Region Skåne, Malmö, Sweden; Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California, USA.
Surg Obes Relat Dis. 2015 Nov-Dec;11(6):1332-41. doi: 10.1016/j.soard.2015.03.014. Epub 2015 Mar 28.
The prevalence of obesity, as well as use of bariatric surgery, has increased worldwide. The aim of the present study was to investigate the potential differences in the use of bariatric surgery among Swedes and immigrants in Sweden and whether the hypothesized differences remain after adjustment for socioeconomic factors.
A closed cohort of all individuals aged 20-64 years was followed during 2001-2010. Further analyses were performed in 2 periods separately (2001-2005 and 2006-2010). Age-standardized cumulative incidence rates (CR) of bariatric surgery were compared between Swedes and immigrants considering individual variables. Cox proportional hazards models were used in univariate and multivariate models for males and females.
A total of 12,791 Swedes and 2060 immigrants underwent bariatric surgery. The lowest rates of bariatric surgery were found in immigrant men. The largest difference in CR between Swedes and immigrants was observed among low-income individuals (3.4 and 2.3 per 1000 individuals, respectively). Adjusted hazard ratios (HRs) were lower for all immigrants compared with Swedes in the second period. The highest HRs were observed among immigrants from Chile and Lebanon and the lowest among immigrants from Bosnia. Except for Nordic countries, immigrants from all other European countries had a lower HR compared with Swedes.
Men in general and some immigrant groups had a lower HR of bariatric surgery. Moreover, the difference between Swedes and immigrants was more pronounced in individuals with low socioeconomic status (income). It is unclear if underlying barriers to receive bariatric surgery are due to patients' preferences/lack of knowledge or healthcare structures. Future studies are needed to examine potential causes behind these differences.
肥胖症的患病率以及减肥手术的使用在全球范围内均有所增加。本研究的目的是调查瑞典人与瑞典移民在减肥手术使用方面的潜在差异，以及在对社会经济因素进行调整后，假设的差异是否仍然存在。
对2001年至2010年期间所有年龄在20至64岁的个体组成的封闭队列进行随访。在两个时期（2001 - 2005年和2006 - 2010年）分别进行进一步分析。考虑个体变量，比较瑞典人和移民之间减肥手术的年龄标准化累积发病率（CR）。在单变量和多变量模型中，对男性和女性使用Cox比例风险模型。
共有12791名瑞典人和2060名移民接受了减肥手术。减肥手术率最低的是移民男性。瑞典人和移民之间CR的最大差异在低收入个体中观察到（分别为每1000人中有3.4人和2.3人）。在第二个时期，与瑞典人相比，所有移民的调整后风险比（HRs）都较低。来自智利和黎巴嫩的移民中HR最高，来自波斯尼亚的移民中HR最低。除北欧国家外，来自所有其他欧洲国家的移民与瑞典人相比HR较低。
一般男性和一些移民群体接受减肥手术的HR较低。此外，瑞典人和移民之间的差异在社会经济地位（收入）较低的个体中更为明显。尚不清楚接受减肥手术的潜在障碍是由于患者的偏好/知识缺乏还是医疗保健结构。需要进一步研究来检查这些差异背后的潜在原因。
