title: Ethnic variation in weight loss, but not co-morbidity remission, after laparoscopic gastric banding and Roux-en-Y gastric bypass.
abstract: BACKGROUND
  Demographic factors such as ethnicity may affect bariatric surgery outcomes. We examined weight loss and co-morbidities outcomes in African American, Caucasian, and Hispanic patients who underwent laparoscopic gastric banding (LAGB) and Roux-en-Y gastric bypass (RYGB). The primary aim was to investigate demographic differences in weight loss and co-morbidities outcomes.
  
  
  METHODS
  We retrospectively examined weight change and co-morbidities outcomes in our prospective database. A total of 1,903 patients underwent LAGB or RYGB between January 1, 2005 and March 31, 2012. Of those, 1828 completed their 1-year follow-up visit (9-15 mo) and had complete data. We excluded patients who were missing ethnicity information, resulting in a final cohort of 1,684 patients. Multivariate analyses and χ2 tests were used to examine demographic variables in body mass index (BMI) change, percent excess weight loss (%EWL), and remission of co-morbidities. We also examined weight loss outcomes at 2- and 3-year follow-up.
  
  
  RESULTS
  Overall, those who underwent RYGB had a lower BMI and greater %EWL at 1, 2, and 3 years compared to those who had undergone LAGB. Overall, African American patients had a higher postoperative BMI than either Caucasian or Hispanic patients. African American patients also showed less %EWL than Caucasian and Hispanic patients. When we examined within surgery type, ethnic differences between African American and Caucasian patients were present across all 3 years in RYGB, but there were no ethnic differences by year 3 in LAGB. Additionally, African American and Hispanic patients no longer differed by year 3 in RYGB and by year 2 in LAGB. There were no significant ethnic differences in remission of diabetes, hyperlipidemia, hypertension, and sleep apnea at 1 year.
  
  
  CONCLUSIONS
  Our study found significant ethnic differences in the postoperative BMI and %EWL, which were more pronounced in patients undergoing RYGB than LAGB at the 3-year time point. These weight loss differences did not translate to a lower rate of co-morbidities remission.
authors.affiliation: Division of Metabolic and Bariatric Surgery, Hartford Hospital, Hartford, Connecticut.
authors.forename: Janet
authors.initials: J
authors.lastname: Ng
authors.affiliation: Genetic Research Center, Hartford Hospital, Hartford, Connecticut.
authors.forename: Richard
authors.initials: R
authors.lastname: Seip
authors.affiliation: Division of Metabolic and Bariatric Surgery, Hartford Hospital, Hartford, Connecticut.
authors.forename: Andrea
authors.initials: A
authors.lastname: Stone
authors.affiliation: Genetic Research Center, Hartford Hospital, Hartford, Connecticut.
authors.forename: Gualberto
authors.initials: G
authors.lastname: Ruano
authors.affiliation: Division of Metabolic and Bariatric Surgery, Hartford Hospital, Hartford, Connecticut.
authors.forename: Darren
authors.initials: D
authors.lastname: Tishler
authors.affiliation: Division of Metabolic and Bariatric Surgery, Hartford Hospital, Hartford, Connecticut. Electronic address: pavlos.papasavas@hhchealth.org.
authors.forename: Pavlos
authors.initials: P
authors.lastname: Papasavas
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology; D000704:Analysis of Variance; D048909:Diabetes Complications / Q000150:complications; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D015391:Gastroplasty / Q000379:methods*; D006630:Hispanic or Latino / Q000208:ethnology; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000208:ethnology* / Q000601:surgery; D011446:Prospective Studies; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000150:complications; D014481:United States / Q000453:epidemiology; D015431:Weight Loss / Q000208:ethnology*; D044465:White People / Q000208:ethnology
keywords: Bariatric surgery; Ethnicity; Gender; Race