Weight Loss After Bariatric Surgery: Do Clinical and Behavioral Factors Explain Racial Differences?
Weight Loss After Bariatric Surgery: Do Clinical and Behavioral Factors Explain Racial Differences?
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减肥手术后的体重减轻：临床和行为因素可以解释种族差异吗？
DOI：
10.1007/s11695-017-2701-y
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发表时间：
2017
期刊：
影响因子：
2.9
通讯作者：
Hamel,MaryBeth
中科院分区：
文献类型：
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作者：
Wee,ChristinaC;Jones,DanielB;Apovian,Caroline;Hess,DonaldT;Chiodi,SarahN;Bourland,AshleyC;Davis,RogerB;Schneider,Benjamin;Blackburn,GeorgeL;Marcantonio,EdwardR;Hamel,MaryBeth
背景先前的研究表明，与白人患者相比，非裔美国人的体重减轻更少；然而，很少有研究能够同时解释其他人口统计学、临床或行为因素的基线差异。方法我们在两个减肥手术中心采访了患者，并在减肥手术前后进行了图表回顾。结果在接受Roux-en-Y胃分流术(54%)或胃束带术(46%)的537名参与者中，85%的人完成了1年的随访期，73%的人完成了2年的随访期。术后第1年和第2年患者体重平均下降33.00%和32.43%，环扎术后分别下降16.07%和17.56%。在对其他人口统计特征和手术类型进行调整后，非裔美国人在搭桥手术后体重比白人患者减少了5.93%±1.49%(p<；0.001)，环扎术后体重减少了4.72%±1.96%。在考虑的其他人口统计学、临床、行为因素中，在胃旁路手术患者中，患有糖尿病和感觉难以做出基线饮食改变与较少的体重减轻相关，而在胃束带患者中，诊断为焦虑症与较少的体重减轻相关。然而，在对这些临床和行为因素进行额外调整后，种族和体重减轻之间的关联并没有显著减弱。结论非裔美国人患者的体重减轻程度明显低于白人患者。种族差异不能用我们检查的基线人口统计、临床或行为特征来解释。
BackgroundPrior studies have suggested less weight loss among African American compared to Caucasian patients; however, few studies have been able to simultaneously account for baseline differences in other demographic, clinical, or behavioral factors.MethodsWe interviewed patients at two weight loss surgery (WLS) centers and conducted chart reviews before and after WLS. We compared weight loss post-WLS by race/ethnicity and examined baseline demographic, clinical (BMI, comorbidities, quality of life), and behavioral (eating behavior, physical activity level, alcohol intake) factors that might explain observed racial differences in weight loss at 1 and 2 years after WLS.ResultsOf 537 participants who underwent either Roux-en-Y Gastric Bypass (54%) or gastric banding (46%), 85% completed 1-year follow-up and 73% completed 2-year follow-up. Patients lost a mean of 33.00% of initial weight at year 1 and 32.43% at year 2 after bypass and 16.07% and 17.56 % respectively after banding. After adjustment for other demographic characteristics and type of surgery, African Americans lost an absolute 5.93 ± 1.49% less weight than Caucasian patients after bypass (p< 0.001) and 4.72 ± 1.96% less weight after banding. Of the other demographic, clinical, behavioral factors considered, having diabetes and perceived difficulty making dietary changes at baseline were associated with less weight loss among gastric bypass patients whereas having a diagnosis of anxiety disorder was associated with less weight loss among gastric banding patients. The association between race and weight loss did not substantially attenuate with additional adjustment for these clinical and behavioral factors, however.ConclusionAfrican American patients lost significantly less weight than Caucasian patients. Racial differences could not be explained by baseline demographic, clinical, or behavioral characteristics we examined.