title: Racial differences in weight loss, hemoglobin A1C, and blood lipid profiles after Roux-en-Y gastric bypass surgery.
abstract: BACKGROUND
  It is known that African American (AA) patients with obesity achieve less weight loss after Roux-en-Y gastric bypass surgery (RYGB) than their Caucasian (CA) counterparts. However, it is unclear how these differences in weight loss are reflected in clinical outcomes.
  
  
  OBJECTIVE
  To determine the effects of RYGB on hemoglobin A1c(A1c) and blood lipids in relationship to the variability in weight loss outcomes in a racially mixed patient population.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  Retrospective analysis of clinical data from electronic medical records of CA, AA, and Hispanic American (HA) patients undergoing RYGB.
  
  
  RESULTS
  We used 2-way cluster analysis and identified 4 distinct weight loss×race clusters. CA patients separated into 2 clusters (45.5% and 28.2% weight loss, respectively), whereas, AA and HA patients separated into 1 cluster each (33.2% and 34.4% weight loss, respectively). Factors that significantly affected weight loss were race, age, gender, and physical activity as well as presence of hypertension and degenerative joint disease. Although all clusters had significant improvements in blood lipids, HA had an increase in total cholesterol (Total-c) and low-density lipoprotein cholesterol (LDL-c) at 2 years after surgery. All clusters had significant decreases in A1cin the first year. At 2 years after RYGB, A1clevels remained stable in CA and HA; however, AA had a significant increase. These racial differences in A1ccould not be explained by the smaller weight loss in AA patients.
  
  
  CONCLUSIONS
  Race is an important factor in the clinical outcomes of RYGB, especially in regard to diabetes control; however, its effect is not completely understood.
authors.affiliation: Section of Endocrinology, Diabetes and Nutrition, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts. Electronic address: Nawfal.istfan@bmc.org.
authors.forename: Nawfal
authors.initials: N
authors.lastname: Istfan
authors.affiliation: Department of Surgery, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Anderson
authors.affiliation: Section of Endocrinology, Diabetes and Nutrition, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Caroline
authors.initials: C
authors.lastname: Apovian
authors.affiliation: Section of Endocrinology, Diabetes and Nutrition, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Megan
authors.initials: M
authors.lastname: Ruth
authors.affiliation: Department of Surgery, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Brian
authors.initials: B
authors.lastname: Carmine
authors.affiliation: Department of Surgery, Boston Medical Center and Boston University School of Medicine, Boston, Massachusetts.
authors.forename: Donald
authors.initials: D
authors.lastname: Hess
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology; D000367:Age Factors; D000704:Analysis of Variance; D016000:Cluster Analysis; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000208:ethnology; D005260:Female; D015390:Gastric Bypass; D006442:Glycated Hemoglobin / Q000378:metabolism; D006630:Hispanic or Latino; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000208:ethnology / Q000601:surgery; D011182:Postoperative Care; D044469:Racial Groups / Q000208:ethnology*; D012189:Retrospective Studies; D015431:Weight Loss / Q000208:ethnology*; D044465:White People / Q000208:ethnology
chemical_list: D006442:Glycated Hemoglobin; D008055:Lipids
keywords: Bariatric surgery; Black; Blood lipids; Diabetes; Hemoglobin A(1c); Weight loss