Variations in weight loss and glycemic outcomes after sleeve gastrectomy by race and ethnicity.

Sally M Vanegas, Silvia Curado, Boyan Zhou, Nicholas Illenberger, Ericka N Merriwether, Evelyn Armijos, Ann Marie Schmidt, Christine Ren-Fielding, Manish Parikh, Brian Elbel, José O Alemán, Melanie Jay
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Abstract

Objective: This study examined racial and ethnic differences in percent total weight loss (%TWL) and glycemic improvement following sleeve gastrectomy (SG) and explored the role of socioeconomic and psychosocial factors in postsurgical outcomes.

Methods: This longitudinal study included patients who underwent SG between 2017 and 2020, with follow-up visits over 24 months.

Results: Non-Hispanic Black (NHB) participants had lower %TWL at 3, 12, and 24 months compared with Hispanic (H) and non-Hispanic White (NHW) participants. Fat mass index was initially lower in NHB, with smaller reductions over time and significant group differences persisting at 24 months. NHB participants had higher baseline fat-free mass index values; by 24 months, fat-free mass index values were lower in H participants. Hemoglobin A1c decreased across all groups but remained consistently higher in NHB and H compared with NHW at 24 months. NHB participants reported higher perceived discrimination, sleep disturbance, and perceived stress than H and NHW participants at all time points. Employment status predicted %TWL at 12 months. There was a significant interaction between race and ethnicity and employment status observed at 12 and 24 months, suggesting that employment-related disparities could impact surgical outcomes.

Conclusions: NHB participants experienced less favorable outcomes following SG, emphasizing the need for tailored interventions addressing socioeconomic and psychosocial disparities.

袖珍胃切除术后体重减轻和血糖变化的种族和民族。
目的:本研究考察了套管胃切除术(SG)后总体重减轻百分比(%TWL)和血糖改善的种族和民族差异,并探讨了社会经济和社会心理因素在术后结果中的作用。方法:该纵向研究纳入了2017年至2020年间接受SG治疗的患者,随访时间超过24个月。结果:与西班牙裔(H)和非西班牙裔白人(NHW)参与者相比,非西班牙裔黑人(NHB)参与者在3、12和24个月时的TWL %较低。脂肪质量指数最初在NHB组较低,随着时间的推移减少幅度较小,并且显著的组间差异持续到24个月。NHB参与者的基线无脂质量指数较高;24个月后,H组参与者的无脂质量指数值较低。24个月时,所有组的血红蛋白A1c均下降,但与NHW组相比,NHB组和H组的血红蛋白A1c始终较高。在所有时间点上,NHB参与者比H和NHW参与者报告了更高的感知歧视、睡眠障碍和感知压力。12个月的就业状况预测%TWL。在12个月和24个月时观察到,种族和民族与就业状况之间存在显著的相互作用,表明就业相关的差异可能影响手术结果。结论:NHB参与者在SG后经历了不太有利的结果,强调需要针对社会经济和社会心理差异进行量身定制的干预。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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