Predictors of long-term success after laparoscopic Roux-en-Y gastric bypass in African-American women

Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) provides sustained weight loss. However, short-term studies have suggested that African Americans (AAs) are not as successful as Caucasians (CAs) after LRYGB. Objective: The present study was designed to test the hypothesis that at longer term follow-up AAs are just as successful as CAs after LRYGB. Setting: University hospital, United States. Methods: A nested case-control study designed to examine the effect of race as covariate in the long-term success of women undergoing LRYGB. The study matched 3 controls per case subject, and the final numbers for analyses were 78 case patients (AA) and 204 control patients (CA). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using conditional logistic regression analysis. Results: The 2 cohorts (N = 282) were well matched for age (AA 40.3 +/- 9.1 years versus CA 41.1 +/- 8.9 years), preoperative body mass index (AA 50.6 +/- 7.5 kg/m(2) versus CA 50.2 +/- 7.1 kg/m(2)), prevalence of type 2 diabetes (T2D) (AA 20.5% versus CA 21.1%), hypertension (AA 69.1% versus CA 52%), and sleep apnea (AA 35.9% versus CA 34.8%). In the AA group, the long-term curve for percentage of excess weight loss (EWL) was significantly (P < .001) lower than the CA group at any time-point. In the present model, diagnosis of T2D in the AA group (OR = 6.1 E8) significantly (P = .002) predicted adequate EWL at 3 years, after controlling for relevant confounders. Conclusion: Race significantly affected the long-term EWL at 3 years for patients undergoing LRYGB at the authors' institution. Future research should be directed at determining potential genetic reasons for these differences, including genes associated with T2D. (C) 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved.