title: Ethnic differences in weight loss and diabetes remission after bariatric surgery: a meta-analysis.
abstract: OBJECTIVE
  It has been postulated that the effectiveness of bariatric surgery varies between ethnic groups. However, data regarding this topic are inconclusive, as most studies included few patients from minority groups. We conducted a meta-analysis to determine the difference in percentage of excess weight loss (%EWL) 1-2 years after bariatric surgery in people of African and Caucasian descent. We also studied differences in diabetes mellitus (DM) remission.
  
  
  METHODS
  We performed a MEDLINE and EMBASE search for studies reporting %EWL and/or DM remission after bariatric surgery and including both African Americans and Caucasians. The 613 publications obtained were reviewed. We included 14 studies (1,087 African Americans and 2,714 Caucasians); all provided data on %EWL and 3 on DM remission. We extracted surgery type, %EWL, and DM remission 1-2 years after surgery. After analyzing %EWL for any surgery type, we performed subanalyses for malabsorptive and restrictive surgery.
  
  
  RESULTS
  The overall absolute mean %EWL difference between African Americans and Caucasians was -8.36% (95% CI -10.79 to -5.93) significantly in favor of Caucasians. Results were similar for malabsorptive (-8.39% [-11.38 to -5.40]) and restrictive (-8.46% [-12.95 to -3.97]) surgery. The remission of DM was somewhat more frequent in African American patients than in Caucasian patients (1.41 [0.56-3.52]). However, this was not statistically significant.
  
  
  CONCLUSIONS
  In %EWL terms, bariatric surgery is more effective in Caucasians than in African Americans, regardless of procedure type. Further studies are needed to investigate the exact mechanisms behind these disparities and to determine whether ethnic differences exist in the remission of comorbidities after bariatric surgery.
authors.affiliation: Department of Internal Medicine, Academic Medical Centre, Amsterdam, the Netherlands. w.m.admiraal@amc.nl
authors.forename: Wanda M
authors.initials: WM
authors.lastname: Admiraal
authors.forename: Funda
authors.initials: F
authors.lastname: Celik
authors.forename: Victor E
authors.initials: VE
authors.lastname: Gerdes
authors.forename: Ramsey M
authors.initials: RM
authors.lastname: Dallal
authors.forename: Joost B
authors.initials: JB
authors.lastname: Hoekstra
authors.forename: Frits
authors.initials: F
authors.lastname: Holleman
mesh_terms: D001741:Black or African American; D050110:Bariatric Surgery; D003920:Diabetes Mellitus / Q000208:ethnology*; D006801:Humans; D015431:Weight Loss / Q000208:ethnology*; D044465:White People