title: Association of race and socioeconomic status with outcomes following laparoscopic Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Obesity poses serious health consequences, and bariatric surgery remains the most effective and durable treatment. The goal of this study was to identify the association of race and socioeconomic characteristics with clinical outcomes following laparoscopic Roux-en-Y gastric bypass (LRYGB).
  
  
  METHODS
  A retrospective review of all patients who underwent LRYGB between 2004 and 2010 was conducted. Outcomes analyzed included percent excess weight loss (%EWL), percent weight loss (%WL), change in body mass index (ΔBMI), and improvement or remission of obesity-associated medical conditions.
  
  
  RESULTS
  In total, 663 patients met inclusion criteria with 170 (25.6%) African Americans and 493 (74.4%) European Americans. When compared to European Americans, the African American group included significantly more women and had a significantly higher preoperative BMI and lower socioeconomic status. In adjusted analyses, African Americans had significantly lower %EWL, %WL, and ΔBMI than the European Americans at 1-, 2-, and 5-year intervals of follow-up. Adjusted spline models including all follow-up visits for all patients also demonstrated a significant difference between the races in %EWL, %WL, and ΔBMI. Both races had similar improvement or remission of type 2 diabetes mellitus, obstructive sleep apnea, hyperlipidemia, and hypertension.
  
  
  CONCLUSIONS
  Although African Americans had a statistically significant lower %EWL, %WL, and ΔBMI, both groups had durable weight loss and comparable rates of improvement or remission of obesity-associated comorbidities. Thus, both groups have significant improvement in their overall health after LRYGB.
authors.affiliation: Department of Surgery, University of Alabama at Birmingham, KB 428, 1720 2nd Ave S, Birmingham, AL, 35294-0016, USA, agullick@uab.edu.
authors.forename: Allison A
authors.initials: AA
authors.lastname: Gullick
authors.forename: Laura A
authors.initials: LA
authors.lastname: Graham
authors.forename: Joshua
authors.initials: J
authors.lastname: Richman
authors.forename: Manasi
authors.initials: M
authors.lastname: Kakade
authors.forename: Richard
authors.initials: R
authors.lastname: Stahl
authors.forename: Jayleen
authors.initials: J
authors.lastname: Grams
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D005260:Female; D015390:Gastric Bypass / Q000534:rehabilitation / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000175:diagnosis* / Q000453:epidemiology* / Q000208:ethnology / Q000601:surgery*; D044469:Racial Groups / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D012923:Social Class; D016896:Treatment Outcome; D015431:Weight Loss