Effect of ethnicity on weight loss among adolescents 1 year after bariatric surgery

doi:10.4239/wjd.v4.i5.202

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Diabetes. Oct 15, 2013; 4(5): 202-209
Published online Oct 15, 2013. doi: 10.4239/wjd.v4.i5.202

Table 1 Characteristics of 890 adolescents who underwent bariatric surgery between 2004 and 2010

Characteristic	n (%)	Baseline BMI Z	P
		score, mean ± SD
Sex			< 0.001
Boys	225 (25.3)	3.14 ± 0.24
Girls	665 (74.7)	2.41 ± 0.19
Type of surgery			< 0.001
Gastric bypass	454 (51.0)	2.67 ± 0.38
Adjustable gastric band	436 (49.0)	2.53 ± 0.36
Race
Non-hispanic white	606 (68.1)	2.57 ± 0.37	Reference
Hispanic	129 (14.5)	2.68 ± 0.40	0.004¹
Non-hispanic black	98 (11.0)	2.67 ± 0.34	0.02²
Other	57 (6.4)	2.60 ± 0.42

¹Non-Hispanic white vs Hispanic;

²Non-Hispanic white vs non-Hispanic black. BMI: Body mass index.

Table 2 Estimated anthropometric values of morbidly obese adolescents at baseline to 1 year after bariatric surgery by ethnicity

Measurement	Non-hispanic whites,	Non-hispanic blacks,	Hispanics,	Overall,
	estimate (95%CI)	estimate (95%CI)	estimate (95%CI)	estimate¹ (95%CI)
Baseline
n	601	98	128	827
BMI (kg/m²)	47.9 (47.3-48.4)	51.7 (50.1-53.4)	48.9 (47.7-50.2)	48.5 (48.0-49.0)
BMI (%)	99.3 (99.2-99.4)	99.5 (99.4-99.6)	99.4 (99.3-99.5)	99.4 (99.3-99.4)
Weight (kg)	136.8 (135.0-138.6)	147.9 (142.5-153.3)	137.7 (134.1-141.3)	138.4 (136.8-140.0)
3 mo after surgery
n	536	88	115	739
BMI (kg/m²)	43.9 (43.4-44.5)	47.9 (46.4-49.4)	44.5 (43.3-45.6)	44.48 (43.98-44.97)
BMI (%)	99.0 (98.0-99.1)	99.3 (99.2-99.4)	99.1 (99.0-99.2)	99.02 (98.96-99.08)
Weight (kg)	125.6 (123.9-127.4)	137.0 (132.0-141.9)	125.1 (121.7-128.4)	126.84 (125.33-128.35)
EWL (kg)	10.7 (10.1-11.3)	10.57 (9.11-12.04)	12.3 (10.5-14.1)	10.9 (10.4-11.5)
EWL (%)	7.8 (7.3-8.2)	6.9 (6.0-7.8)	8.6 (7.4-9.7)	7.8 (7.4-8.2)
6 mo after surgery
n	380	54	78	512
BMI (kg/m²)	39.0 (38.3-39.7)	44.1 (42.4-45.7)	39.9 (38.5-41.2)	39.70 (39.1-40.3)
BMI (%)	97.0 (96.5-97.5)	98.9 (98.6-99.1)	97.8 (97.3-98.3)	97.3 (96.9-97.7)
Weight (kg)	111.7 (109.7-113.7)	125.7 (120.4-131.0)	111.9 (108.2-115.6)	113.3 (111.6-115.0)
EWL (kg)	25.1 (24.1-26.0)	22.3 (19.7-25.0)	25.4 (22.8-28.0)	24.8 (23.9-25.7)
EWL (%)	18.3 (17.66-19.0)	14.5 (12.9-16.1)	18.1 (16.2-19.9)	17.8 (17.2-18.4)
12 mo after surgery
n	193	26	28	247
BMI (kg/m²)	36.6 (35.7-37.4)	40.3 (37.5-43.0)	36.7 (34.7-38.8)	37.0 (36.3-37.8)
BMI (%)	94.7 (93.6-95.7)	96.8 (94.3-99.2)	94.7 (92.2-97.2)	94.9 (94.0-95.8)
Weight (kg)	104.6 (102.1-107.0)	114.7 (106.4-123.0)	103.1 (97.3-109.0)	105.6 (103.4-107.8)
EWL (kg)	32.8 (30.9-34.7)	33.8 (27.3-40.3)	34.3 (30.0-38.5)	33.1 (31.4-34.82)
EWL (%)	23.6 (22.3-24.9)	21.6 (17.4-25.7)	24.7 (21.8-27.7)	23.5 (22.4-24.7)

Model adjusted by age, sex, and type of surgery; “Other” group not included as result of a small sample size. EWL: Estimated weight loss or the difference between baseline weight (kg) and weight as each respective time point;

¹P < 0.001 for change across all time points. BMI: Body mass index.

Table 3 Estimated anthropometric values from morbidly obese boys 1 year after bariatric surgery by ethnicity

Measurement	Non-hispanic whites,	Non-hispanic blacks,	Hispanics,	Overall,
	estimate (95%CI)	estimate (95%CI)	estimate (95%CI)	estimate¹ (95%CI)
Before surgery
n	142	23	42	207
BMI (kg/m²)	51.2 (49.8-52.7)	52.3 (49.0-55.5)	52.8 (50.8-54.9)	51.68 (50.53-52.84)
BMI (%)	99.9 (99.6-100.0)	99.9 (99.8-100.0)	99.9 (99.8-100.0)	99.9 (99.8-100..0)
Weight (kg)²	162.4 (158.0-166.7)	166.7 (155.3-178.2)	161.8 (155.8-167.8)	162.8 (159.3-166.3)
3 mo after surgery
n	127	21	38	186
BMI (kg/m²)	46.9 (45.5-48.3)	47.5 (44.8-50.2)	47.1 (45.2-48.9)	46.9 (45.9-48.1)
BMI (%)	99.7 (99.6-99.8)	99.9 (99.7-99.9)	99.8 (99.7-99.9)	99.8 (99.7-99.9)
Weight (kg)²	148.5 (144.1-152.8)	151.7 (141.7-161.7)	144.3 (138.6-149.9)	148.0 (144.5-151.4)
EWL (kg)²	13.2 (11.7-14.6)	14.4 (10.9-17.9)	17.3 (13.3-21.3)	14.1 (12.8-15.4)
EWL (%)	8.1 (7.3-8.9)	8.5 (6.6-10.3)	10.4 (8.2-12.6)	8.6 (7.9-9.4)
6 mo after surgery
n	83	17	26	126
BMI (kg/m²)	41.9 (40.3-43.9)	43.4 (40.9-45.9)	41.8 (39.9-43.6)	42.0 (40.8-43.2)
BMI (%)	98.7 (98.1-99.3)	99.6 (99.4-99.8)	99.6 (99.4-99.7)	98.9 (98.6-99.4)
Weight (kg)²	132.7 (127.8-137.6)	138.5 (129.8-147.1)	128.1 (122.4-133.8)	132.4 (128.7-136.1)
EWL (kg)²	29.7 (27.4-31.9)	28.1 (22.8-33.5)	34.0 (29.6-38.4)	30.3 (28.4-32.1)
EWL (%)	18.3 (16.8-19.8)	16.2 (13.9-18.6)	20.5 (18.2-22.8)	18.4 (17.3-19.6)
12 mo after surgery²³
n	49	7	9	65
BMI (kg/m²)	39.6 (37.8-41.5)	40.2 (35.5-44.8)	37.0 (34.0-40.0)	39.3 (37.8-40.9)
BMI (%)	97.5 (95.8-99.1)	98.6 (96.9-100.4)	98.2 (96.8-99.7)	97.7 (96.5-98.9)
Weight (kg)²	125.3 (119.6-130.9)	127.9 (113.3-142.5)	113.7 (104.6-122.9)	128.7 (118.9-128.5)
EWL (kg)²	37.9 (33.7-42.1)	40.4 (26.8-54.0)	47.9 (41.2-54.6)	40.1 (36.5-43.7)
EWL (%)	22.9 (20.4-25.4)	23.0 (16.0-30.0)	29.4 (25.2-33.6)	24.0 (21.9-26.2)

Model adjusted by age and type of surgery; “Other” group not included due to small sample size;

¹P < 0.01 for change across all time points for Hispanics;

²P < 0.001 for change across all time points;

³P < 0.001 for change across all time points, except for weight percentile was not significant for non-Hispanic black; EWL: Estimated weight loss or the difference between baseline weight (kg) and weight at each respective time point; BMI: Body mass index.

Table 4 Mean anthropometric values from morbidly obese girls 1 year after bariatric surgery by ethnicity

Measurement	Non-hispanic whites,	Non-hispanic blacks,	Hispanics,	Overalls,
	estimate (95%CI)	estimate (95%CI)	estimate (95%CI)	Estimate¹ (95%CI)
Before Surgery
n	459	75	86	620
BMI (kg/m²)	46.8 (46.2-47.5)	51.6 (49.6-53.6)	47.0 (45.5-48.6)	47.5 (46.9-48.1)
BMI (%)	99.1 (99.0-99.2)	99.4 (99.3-99.5)	99.2 (99.0-99.3)	99.2 (99.1-99.3)
Weight (kg)	129.1 (127.18-131.1)	141.6 (135.4-147.7)	125.9 (121.5-130.4)	130.3 (128.6-132.1)
3 mo after surgery
n	409	67	77	553
BMI (kg/m²)	43.0 (42.4-43.6)	48.0 (46.3-49.8)	43.3 (41.8-44.7)	43.7 (43.1-44.2)
BMI (%)	98.7 (98.6-98.8)	99.1 (98.9-99.2)	98.7 (98.5-98.9)	98.8 (98.7-98.9)
Weight (kg)	118.7 (116.9-120.5)	131.9 (126.3-137.6)	116.0 (111.8-120.2)	119.9 (118.2-121.6)
EWL (kg)	9.9 (9.3-10.7)	9.2 (7.6-10.7)	9.8 (8.0-11.6)	9.8 (9.2-10.4)
EWL (%)	7.7 (7.1-8.2)	6.3 (5.3-7.4)	7.7 (6.3-9.1)	7.5 (7.0-7.9)
6 mo after surgery
n	297	37	52	386
BMI (kg/m²)	38.1 (37.4-38.8)	44.4 (42.3-46.4)	39.0 (37.1-40.8)	38.9 (38.3-39.6)
BMI (%)	96.5 (95.9-97.1)	98.6 (98.3-98.9)	96.9 (96.2-97.7)	96.8 (96.3-97.2)
Weight (kg)	105.3 (103.2-107.4)	121.8 (115.4-128.3)	104.2 (99.3-109.1)	107.0 (105.1-108.8)
EWL (kg)	23.7 (22.6-24.8)	20.0 (16.9-23.2)	21.2 (17.9-24.5)	22.9 (21.9-24.0)
EWL (%)	18.3 (17.5-19.1)	13.8 (11.7-15.8)	16.9 (14.4-19.5)	17.6 (16.9-18.4)
12 mo after surgery
n	149	19	19	182
BMI (kg/m²)	35.6 (34.7-36.6)	40.32 (36.96-43.67)	36.65 (34.15-39.16)	36.28 (35.40-37.17)
BMI (%)	93.9 (92.6-95.1)	96.10 (92.81-99.39)	92.99 (89.48-96.51)	93.99 (92.87-95.12)
Weight (kg)	98.3 (95.5-101.0)	110.4 (100.5-120.2)	98.0 (91.3-104.6)	99.6 (97.1-102.1)
EWL (kg)	31.2 (29.1-33.4)	31.4 (24.0-38.8)	27.8 (22.9-32.6)	30.9 (28.9-32.8)
EWL (%)	23.8 (22.3-25.2)	21.1 (16.1-26.2)	22.5 (18.7-26.3)	23.4 (22.0-24.7)

Model adjusted for age and type of surgery; “Other” group not included due to small sample size;

¹P < 0.001 for change across all time points. EWL: Estimated weight loss or the difference between baseline weight (kg) and weight at each respective time point; BMI: Body mass index.

Table 5 Mean change in anthropometric values from before to 1 year after bariatric surgery by ethnicity

Measure	Estimated change 12 mo after surgery (mean ± SE)				P
	NHW	NHB	Hispanic	Overall	NHWvsNHB	NHWvsHispanic	NHBvsHispanic
BMI (kg/m²)	-11.4 ± 0.5	-11.2 ± 1.6	-12.7 ± 1.2	-11.5 ± 0.4	0.87	0.29	0.41
BMI (%)	-4.7 ± 0.6	-2.7 ± 1.3	-4.9 ± 1.3	-4.6 ± 0.5	0.2	0.89	0.29
Weight (kg)	-32.2 ± 1.3	-32.3 ± 4.6	-36 ± 3.5	-32.6 ± 1.2	0.89	0.31	0.44

Model adjusted for age, sex, and type of surgery. BMI: Body mass index; NHW: Non-hispanic white; NHB: Non-hispanic black.

Table 6 Effect of baseline body mass index on weight loss 1 year after bariatric surgery

Variable	Baseline BMI category
	Lowest	Middle	Highest
	(35-49 kg/m²)	(50-59 kg/m²)	(> 60 kg/m²)
Change in BMI, kg/ m² (%)¹	-9.88 (−22.6)	-14.34 (-26.5)	-17.8 (-26.7)
Rate of change over the year (kg/y)
Non Hispanic whites²	-9.6	-14.8	-19.7
Hispanics	-11.7	-11.7	-11.6
Non Hispanic blacks	-9.3	-11.1	-15.5

¹P < 0.0001 for lowest versus middle, lowest versus highest, and middle versus highest BMI category;

²P < 0.0001 for lowest versus middle, lowest versus highest, and P = 0.002 for middle versus highest BMI category. BMI: Body mass index.

Citation: Messiah SE, Lopez-Mitnik G, Winegar D, Sherif B, Arheart KL, Reichard KW, Michalsky MP, Lipshultz SE, Miller TL, Livingstone AS, Cruz-Muñoz NL. Effect of ethnicity on weight loss among adolescents 1 year after bariatric surgery. World J Diabetes 2013; 4(5): 202-209
URL: https://www.wjgnet.com/1948-9358/full/v4/i5/202.htm
DOI: https://dx.doi.org/10.4239/wjd.v4.i5.202