Wee Christina C, Jones Daniel B, Apovian Caroline, Hess Donald T, Chiodi Sarah N, Bourland Ashley C, Davis Roger B, Schneider Benjamin, Blackburn George L, Marcantonio Edward R, Hamel Mary Beth
Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.
Division of Minimally Invasive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA.
Obes Surg. 2017 Nov;27(11):2873-2884. doi: 10.1007/s11695-017-2701-y.
Prior studies have suggested less weight loss among African American compared to Caucasian patients; however, few studies have been able to simultaneously account for baseline differences in other demographic, clinical, or behavioral factors.
We interviewed patients at two weight loss surgery (WLS) centers and conducted chart reviews before and after WLS. We compared weight loss post-WLS by race/ethnicity and examined baseline demographic, clinical (BMI, comorbidities, quality of life), and behavioral (eating behavior, physical activity level, alcohol intake) factors that might explain observed racial differences in weight loss at 1 and 2 years after WLS.
Of 537 participants who underwent either Roux-en-Y Gastric Bypass (54%) or gastric banding (46%), 85% completed 1-year follow-up and 73% completed 2-year follow-up. Patients lost a mean of 33.00% of initial weight at year 1 and 32.43% at year 2 after bypass and 16.07% and 17.56 % respectively after banding. After adjustment for other demographic characteristics and type of surgery, African Americans lost an absolute 5.93 ± 1.49% less weight than Caucasian patients after bypass (p < 0.001) and 4.72 ± 1.96% less weight after banding. Of the other demographic, clinical, behavioral factors considered, having diabetes and perceived difficulty making dietary changes at baseline were associated with less weight loss among gastric bypass patients whereas having a diagnosis of anxiety disorder was associated with less weight loss among gastric banding patients. The association between race and weight loss did not substantially attenuate with additional adjustment for these clinical and behavioral factors, however.
African American patients lost significantly less weight than Caucasian patients. Racial differences could not be explained by baseline demographic, clinical, or behavioral characteristics we examined.
先前的研究表明，与白种人患者相比，非裔美国人的体重减轻较少；然而，很少有研究能够同时考虑其他人口统计学、临床或行为因素的基线差异。
我们在两个减肥手术（WLS）中心对患者进行了访谈，并在WLS前后进行了病历审查。我们比较了WLS后按种族/民族划分的体重减轻情况，并研究了基线人口统计学、临床（体重指数、合并症、生活质量）和行为（饮食行为、身体活动水平、酒精摄入量）因素，这些因素可能解释WLS后1年和2年观察到的体重减轻种族差异。
在537名接受了Roux-en-Y胃旁路手术（54%）或胃束带手术（46%）的参与者中，85%完成了1年随访，73%完成了2年随访。旁路手术后，患者在第1年平均减轻了初始体重的33.00%，第2年减轻了32.43%；束带手术后分别减轻了16.07%和17.56%。在调整了其他人口统计学特征和手术类型后，非裔美国人在旁路手术后比白种人患者绝对少减轻5.93±1.49%的体重（p<0.001），在束带手术后少减轻4.72±1.96%的体重。在考虑的其他人口统计学、临床、行为因素中，患有糖尿病以及在基线时感觉饮食改变困难与胃旁路手术患者体重减轻较少有关，而被诊断患有焦虑症与胃束带手术患者体重减轻较少有关。然而, 在对这些临床和行为因素进行额外调整后，种族与体重减轻之间的关联并没有显著减弱。
非裔美国患者的体重减轻明显少于白种人患者。我们所研究的基线人口统计学、临床或行为特征无法解释种族差异。
