Racial differences in weight loss, hemoglobin A1C, and blood lipid profiles after Roux-en-Y gastric bypass surgery

Background: It is known that African American (AA) patients with obesity achieve less weight loss after Roux-en-Y gastric bypass surgery (RYGB) than their Caucasian (CA) counterparts. However, it is unclear how these differences in weight loss are reflected in clinical outcomes. Objectives: To determine the effects of RYGB on hemoglobin Ale (Ale) and blood lipids in relationship to the variability in weight loss outcomes in a racially mixed patient population. Setting: University medical center. Methods: Retrospective analysis of clinical data from electronic medical records of CA, AA, and Hispanic American (HA) patients undergoing RYGB. Results: We used 2-way cluster analysis and identified 4 distinct weight loss x race clusters. CA patients separated into 2 clusters (45.5% and 28.2% weight loss, respectively), whereas, AA and HA patients separated into 1 cluster each (33.2% and 34.4% weight loss, respectively). Factors that significantly affected weight loss were race, age, gender, and physical activity as well as presence of hypertension and degenerative joint disease. Although all clusters had significant improvements in blood lipids, HA had an increase in total cholesterol (Total-c) and low-density lipoprotein cholesterol (LDL-c) at 2 years after surgery. All clusters had significant decreases in Ale in the first year. At 2 years after RYGB, Ale levels remained stable in CA and HA; however, AA had a significant increase. These racial differences in Ale could not be explained by the smaller weight loss in AA patients. Conclusion: Race is an important factor in the clinical outcomes of RYGB, especially in regard to diabetes control; however, its effect is not completely understood. (C) 2016 American Society for Metabolic and Bariatric Surgery. All rights reserved.