Excess Weight Loss and Cardiometabolic Parameter Reduction Diminished among Hispanics Undergoing Bariatric Surgery: Outcomes in More than 2,000 Consecutive Hispanic Patients at a Single Institution

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• 作者：Oscar K. Serrano ; MD ; MBA^a ; ^b ; ^{serra061@umn.edu" class="auth_mail" title="E-mail the corresponding author} ; Yang Zhang ; BS^b ; Lindsay Cumella ; BS^a ; Emily Kintzer ; BS^b ; Nicole Ng ; PharmD^b ; Eduardo Sandoval ; MD^a ; ^b ; Jenny Choi ; MD ; FACS^a ; ^b ; W. Scott Melvin ; MD ; FACS^a ; ^b ; Diego R. Camacho ; MD ; FACS^a ; ^b
• 关键词：EWL ; estimated weight loss ; GERD ; gastroesophageal reflux disease ; HDL ; high-density lipoprotein ; LDL ; low-density lipoprotein ; LGB ; laparoscopic gastric banding ; LGBP ; laparoscopic Roux-en-Y gastric bypass ; LSG ; laparoscopic sleeve gastrectomy ; NHW ; non-Hispanic white ; ORD ; obesity-related disease ; TG ; triglycerides
• 刊名：Journal of the American College of Surgeons
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：222
• 期：2
• 页码：166-173
• 全文大小：415 K

文摘

Bariatric surgery has been established as the most effective long-term treatment for morbid obesity and obesity-related comorbidities. Despite its success, there is a paucity of data on the outcomes of bariatric surgery on Hispanic patients.

Study design

We performed a retrospective review of obese patients treated at our institute between 2008 and 2014. We identified self-reported Hispanic patients who underwent a laparoscopic gastric bypass (LGBP), sleeve gastrectomy (LSG), or gastric band (LGB) procedure. The primary end point was excess weight loss (EWL) at 6, 12, 24, and 36 months. Secondary end points included improvement of obesity-related metabolic parameters at 1 year. We performed a repeated measures analysis of variance to calculate statistical significance throughout our study time period.

Results

We identified 2002 Hispanic patients who underwent bariatric surgery (1,235 LGBP, 600 LSG, 167 LGB) at our institute from 2008 to 2014. Follow-ups at 6, 12, 24, and 36 months were 62.2%, 54.5%, 36.2%, and 19.8%, respectively. Mean preoperative BMIs were 47.0 ± 7.2 kg/m², 46.1 ± 7.8 kg/m², and 44.9 ± 6.0 kg/m² for the LGBP, LSG, and LGB cohorts, respectively. Excess weight loss was significantly more pronounced in the LGBP and the LSG groups than in the LGB group; this difference was accentuated over time (p < 0.0001). Obesity-related metabolic parameters and the need for comorbidity medical therapy decreased in all 3 surgical groups.

Conclusions

Bariatric surgery is highly successful in Hispanic obese patients. In the largest series to date, LGBP and LSG seem to yield more effective EWL and reduction of cardiometabolic parameters than LGB among Hispanics; however, outcomes are still markedly reduced when compared with those in non-Hispanic populations.