2010 Papers - Murariu

Surgical weight loss and co-morbid disease resolution in ethnically diverse populations: analysis of outcomes among native Hawaiians undergoing roux-en-y gastric bypass

Daniel Murariu Department of Surgery, University of Hawaii

Introduction: Native Hawaiians (NH) have higher incidence of obesity and associated comorbidities such as diabetes, hypertension, obstructive sleep apnea, and gastroesophageal reflux disease. Given the successful outcomes (weight loss and comorbidities resolution) achieved with Roux-en-Y gastric bypass (RYGB) surgery, NH patients undergoing RYGB have the potential to receive the greatest benefit. While there are reported variations in post-operative outcomes based on ethnic background, no study has evaluated the outcomes of bariatric surgery among NH patients. Henceforth, our objective is to analyze weight loss and co-morbid disease resolution in this population undergoing bariatric surgery through the Queen’s Medical Center’s Comprehensive Weight Management Program (CWMP).

Methods: We reviewed our collected database of bariatric patients who underwent surgical weight loss procedures through the CWMP between January 2004 and April 2009. Demographics, baseline BMI and obesity related conditions, as well as peri-operative data were collected and analyzed for statistical significance (p <0.05). Continuous variables were analyzed by Student’s T-test and independent variables were evaluated by Chi-square analysis. Multivariate analysis (ANOVA) was performed utilizing standard SPSS software application.

Results: 54 of 182 patients undergoing RYGB were NH and 40 of those were female. Non-NH population was ethnically diverse (Caucasian, Asian, Hispanic, Black or mixed). The average pre-operative BMI was similar for NH (48.8) and non-NH (47.1). Obesity-related comorbidities (hypertension, diabetes, sleep apnea, asthma, reflux disease and arthalgias) were similar between the two groups except for asthma (18.5% NH vs. 34.3% non-NH, p=0.032) and reflux disease (24.1% NH vs. 41.4% non-NH, p=0.0243). Excess weight loss (EWL) was similar for both NH (61.6%) vs. non-NH (63.1%). Resolution of obesity related comorbidities noted above were similar for both study groups.

Conclusions: RYGB provided effective weight loss for obese NH patients. NH patients on average experienced similar weight loss trends and obesity related comorbidies resolution as non-NH. Obese NH patients did have lower incidence of asthma and reflux disease pre-operatively, but they experienced similar disease resolution as non-NH group in all comorbidities. Based on these findings, Native Hawaiians benefit equally from RYGB surgery as other ethnic groups.