Association of Race and Socioeconomic Status with Outcomes Following Laparoscopic Roux-en-Y Gastric Bypass

Gullick, Allison A.; Graham, Laura A.; Richman, Joshua S.; Kakade, Manasi; Stahl, Richard; Grams, Jayleen

doi:10.1007/s11695-014-1447-z

Cited by 26 publications

(7 citation statements)

References 43 publications

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“…This is an important finding, as prior studies have not identified such statistically and clinically significant variations by race in the resolution of hypertension after LRYGB. 13,17,18,22 Consistent with the known increased prevalence of hypertension in the general African-American population, Adams observed the highest rates of hypertension in Asians and African-Americans among morbidly obese patients pre-operative for LRYGB. 1 The results here indicate that the increased African-American propensity for hypertension extends to impaired high blood pressure resolution following LRYGB.…”

Section: Discussionmentioning

confidence: 84%

Interaction of race with weight loss and resolution of obesity co-morbidities in patients undergoing laparoscopic roux-en-y gastric bypass (lrygb): an analysis of 83,059 bold database patients00000000000

Emrich¹,

Sheck²,

Kushnir³

et al. 2021

AOWMC

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Background: Previous studies identified differences by race in the distribution of medical problems associated with morbid obesity. Whether or not outcomes after LRYGB also vary by race is unknown. Objective: To identify racial variations in weight loss and resolution of obesity co-morbidities after LRYGB. Methods: Data from 83,059 BOLD database LRYGB patients was analyzed retrospectively in five groups: African-American (n=9,055), Caucasian (n=63,352), Hispanic (n=6,893), Asian (n=198), and Other (n=3,561). Results: Weight and BMI were higher in African-Americans versus Caucasians, Hispanics, Other (12 months, p<0.0001). Hypertension persisted increased among African-Americans versus Caucasians, Hispanics, Other through 24 months (p<0.01). Caucasian cholelithiasis (18 months, p<0.05), abdominal panniculitis (12 months, p<0.01,) and depression (24 months, p<0.05) continued higher than other races. GERD was highest in African-Americans and Caucasians. Dyslipidemia affected Caucasians, African-Americans, and Other most (12 months, p<0.05). Hispanic depression was lowest (24 months, p<0.05). Other had highest stress urinary incontinence (12 months, p<0.05). Racial differences in diabetes, liver disease, obstructive sleep apnea, obesity hypoventilation syndrome, gout, back and musculoskeletal pain, leg edema, alcohol use, and non-depression psychological issues were not significant beyond 6 months. Resolution of angina, CHF, pulmonary hypertension, and polycystic ovarian disease did not vary by race. Conclusions: LRYGB improves obesity weight and co-morbidity outcomes overall, but long-term treatment effects vary by race. African-American weight and hypertension, and African-American/Caucasian GERD, and dyslipidemia resolve least. Caucasian abdominal issues and depression dominate. Racial variations in many obesity co-morbidities disappear by 12 months post-operatively.

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Section: Discussionmentioning

confidence: 84%

Interaction of race with weight loss and resolution of obesity co-morbidities in patients undergoing laparoscopic roux-en-y gastric bypass (lrygb): an analysis of 83,059 bold database patients00000000000

Emrich¹,

Sheck²,

Kushnir³

et al. 2021

AOWMC

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“…This suggests that race/ethnicity driven metabolic risk may explain attenuated responses to surgery [32–36]. Although not the purpose of the present review, it is important to consider that psychosocial factors including but not limited to eating behavior, eating disorders, mental illness, substance abuse, and socioeconomic status may also contribute to bariatric surgery resistance [37–40]. In summary, targeting metabolically modifiable risk factors with lifestyle medicine in high-risk populations may be beneficial for bariatric surgery resistant patients.…”

Section: Bariatric Surgery Resistancementioning

confidence: 99%

Bariatric Surgery Resistance: Using Preoperative Lifestyle Medicine and/or Pharmacology for Metabolic Responsiveness

et al. 2017

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Bariatric surgery is an effective and durable treatment for individuals with obesity and its associated comorbidities. However, not all patients meet weight loss and/or cardiometabolic goals following bariatric surgery, suggesting that some people are “bariatric surgery resistant”. The reason for this resistance is unclear, but potential factors, such as adiposity-derived inflammation, insulin resistance, hyperglycemia, and aerobic fitness prior to surgery have been related to blunted surgery responsiveness. Exercise, diet, and/or pharmacology are effective at reducing inflammation and improving insulin action as well as physical function. Herein, we present data that supports the novel hypothesis that intervening prior to surgery can enhance disease resolution in people who are resistant to bariatric surgery.

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“…The majority but not all studies report that after laparoscopic Roux-en-Y gastric bypass, NH black subjects achieve smaller percent weight loss, percent excess weight loss and change in BMI than NH white subjects [106][107][108][109][110]. Of even greater importance are changes in co-existing diseases, but the data are so far conflicting: one study showed comparable remission or improvement in obesity-associated comorbidities after gastric bypass [108], while another found that the metabolic syndrome is less likely to resolve in NH black patients [111].…”

Section: Response To Weight Loss Treatmentsmentioning

confidence: 99%

“…Of even greater importance are changes in co-existing diseases, but the data are so far conflicting: one study showed comparable remission or improvement in obesity-associated comorbidities after gastric bypass [108], while another found that the metabolic syndrome is less likely to resolve in NH black patients [111].…”

Section: Response To Weight Loss Treatmentsmentioning

confidence: 99%

The Interplay Between Sex, Ethnicity, and Adipose Tissue Characteristics

Karastergiou

2015

Curr Obes Rep

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The obesity epidemic in the USA affects disproportionately women and the ethnic minorities. On the other hand, female sex is traditionally associated with a favorable fat distribution preferentially in the subcutaneous depots of the lower body and with improved endocrine and metabolic function of the adipose tissue. However, these data are derived from predominantly non-Hispanic white populations. This review discusses fat distribution patterns in women of diverse ethnic backgrounds, together with data on the release of adipokines from adipose tissue in these populations. Very little information is available on how the metabolic function of the adipocyte differs depending on ethnicity. Thus, it becomes clear that future clinical and translational research should explicitly discuss and take into account the sex and ethnic background of the populations studied.

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Association of Race and Socioeconomic Status with Outcomes Following Laparoscopic Roux-en-Y Gastric Bypass

Cited by 26 publications

References 43 publications

Interaction of race with weight loss and resolution of obesity co-morbidities in patients undergoing laparoscopic roux-en-y gastric bypass (lrygb): an analysis of 83,059 bold database patients00000000000

Interaction of race with weight loss and resolution of obesity co-morbidities in patients undergoing laparoscopic roux-en-y gastric bypass (lrygb): an analysis of 83,059 bold database patients00000000000

Bariatric Surgery Resistance: Using Preoperative Lifestyle Medicine and/or Pharmacology for Metabolic Responsiveness

The Interplay Between Sex, Ethnicity, and Adipose Tissue Characteristics

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