Ethnic Differences in Weight Loss and Diabetes Remission After Bariatric Surgery
Ethnic Differences in Weight Loss and Diabetes Remission After Bariatric Surgery
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DOI：
10.2337/dc12-0260
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发表时间：
2012-09-01
期刊：
影响因子：
16.2
通讯作者：
Holleman, Frits
中科院分区：
文献类型：
--
作者：
Admiraal, Wanda M.;Celik, Funda;Holleman, Frits
目的——据推测，减肥手术的效果因种族而异。然而，有关该主题的数据尚无定论，因为大多数研究只包括少数群体的患者。我们进行了一项荟萃分析，以确定非洲人和白人后裔减肥手术后 1-2 年超重减轻百分比 (%EWL) 的差异。我们还研究了糖尿病 (DM) 缓解的差异。 研究设计和方法 - 我们对报告减肥手术后 %EWL 和/或 DM 缓解的研究进行了 MEDLINE 和 EMBASE 搜索，其中包括非裔美国人和白种人。对获得的 613 篇出版物进行了审查。我们纳入了 14 项研究（1,087 名非裔美国人和 2,714 名白人）；全部提供了 %EWL 数据和 3 DM 缓解数据。我们提取了手术类型、%EWL 和手术后 1-2 年的 DM 缓解情况。在分析任何手术类型的 %EWL 后，我们对吸收不良和限制性手术进行了子分析。结果 - 非裔美国人和白种人之间的总体绝对平均 %EWL 差异为 -8.36%（95% CI -10.79 至 -5.93），明显有利于白种人。吸收不良手术（-8.39% [-11.38 至 -5.401）和限制性手术（-8.46% [-12.95 至 -3.971]）的结果相似。非洲裔美国患者的 DM 缓解率比白种人患者高一些 (1.41 [0.56-3.52])。然而，这在统计学上并不显着。 结论 - 以 %EWL 计算，减肥手术对白种人比非裔美国人更有效，无论手术类型如何。需要进一步的研究来调查这些差异背后的确切机制，并确定减肥手术后合并症缓解是否存在种族差异。
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.RESEARCH DESIGN AND 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 -5.401) and restrictive (-8.46% [-12.95 to -3.971) 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.