Effects of Racial Variation on the Distribution of Demographics, Body Mass, and Medical Co-morbidities in Morbid Obesity: An Analysis of 83,059 Patients from the BOLD Database

Abstract

Purpose: Every clinical clue can be important in managing the morbidly obese. However, variations between racial groups in the distribution of weight-related problems have not been investigated completely. The purpose of this study was to evaluate differences in the manifestation of morbid obesity co-morbidities between the racial classifications listed in BOLD. Methods: Data from 83,059 patients in the Surgical Review Corporation's BOLD database who were about to undergo laparoscopic Roux-en-Y gastric bypass was analyzed in five groups: African-American (n=9,055), Caucasian (n=63,352), Hispanic (n=6,893), Asian (n=198), and Other (Pacific Islander, Native American, or >1 race listed in BOLD; n=3,561). Age, weight and body mass index (BMI) were compared by analysis of variance. Dichotomous variable distribution was assessed by the Chi-squared equation. Results: See Table.Table: Table. Distribution of obesity co-morbidities by raceConclusion: Weight-related medical problems were frequent, regardless of race. However, distribution of obesity co-morbidities varied significantly between African-American, Caucasian, Hispanic, Asian, and Other race patients. African-Americans had the highest BMI and rates of asthma and sleep apnea. The mechanism underlying a higher female/male % among African-Americans was not clear from the data. Asians and African-Americans had hypertension most frequently. Diabetes was highest among Asians. Ischemic heart disease, cholelithiasis, GERD, liver disease, somatic complaints, and depression were most prevalent among Caucasians. Age was highest for Hispanics. Conversely, Hispanic hypertension, sleep apnea and other co-morbidities were lower than other races. Clinically significant racial differences in weight-related medical problems should be incorporated into the clinical acumen of managing morbidly obese patients. Heightened index of suspicion for these racial variations could help improve medical care for these fragile patients.