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Influence of Asian Ethnicities on Short- and Mid-term Outcomes Following Laparoscopic Sleeve Gastrectomy

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Abstract

Purpose

Prevalence of obesity in Asia has been on the increasing trend, with corresponding increase in utilisation of bariatric surgery. The objective of this study was to examine differences in weight loss outcomes following bariatric surgery between Asian ethnicities.

Materials and Methods

A retrospective database review was conducted of patients undergoing primary laparoscopic sleeve gastrectomy between 2009 and 2013 in 14 centres from Singapore, Malaysia, Taiwan, Hong Kong, Japan, Korea, India, Australia, Switzerland, and the USA. All patients with available follow-up data at 12 months and 36 months post-surgery were included in this study. Outcome measures used were percentage excess weight loss (%EWL) and percentage total weight loss (%TWL). Differences in outcomes between ethnicities were analysed after adjusting for age, gender, baseline body mass index (BMI), and presence of diabetes.

Results

The study population (n = 2150) consisted of 1122 Chinese, 187 Malays, 309 Indians, 67 Japanese, 259 Koreans, and 206 Caucasians. 67.1% were female and 32.9% were male. Mean age was 37.1 ± 11.2 years. Mean pre-operative BMI was 40.7 ± 8.1 kg/m2. With the Caucasian population as reference, Japanese had the best %TWL (3.90, 95% CI 1.16–6.63, p < 0.05) and %EWL (18.55, 95% CI 10.33–26.77, p < 0.05) while the Malays had the worst outcomes. Both Chinese and Koreans had better %EWL but worse %TWL as compared to Caucasians and there were no significant differences with the Indian study group.

Conclusion

There are differences in weight loss outcomes following bariatric surgery between Asian ethnicities.

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Author information

Authors and Affiliations

  1. Division of General Surgery, National University Health System, 1E, Kent Ridge Road, Singapore, 119228, Singapore

    Zong Jie Koh, Guo Wei Kim, Jimmy Bok Yan So & Asim Shabbir

  2. Epidemiology and Public Health, Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore

    Bee Choo Tai

  3. Bariatric Surgery, Flinders Medical Centre, Flinders University, GPO Box 2100, Adelaide, South Australia, 5001, Australia

    Lilian Kow & James Toouli

  4. Bariatric Surgery, Digestive Health Institute, #L301, 3rd Floor, Trade View, Oasis City, Gate No. 4, Pandurang Budhkar Marg, Worli, Mumbai, 400013, India

    Muffazal Lakdawala

  5. General Surgery, Clarunis University Center for Gastrointestinal and Liver Diseases Basel, Basel, Switzerland

    Tarik Delko & Marko Kraljević

  6. General Surgery, China Medical University Hospital, No. 2, Yude Road, North District, 404, Taichung City, Taiwan

    Chih-Kun Huang

  7. General Surgery, GEM Hospital and Research Center, 45, Pankaja Mill Rd, Coimbatore, 641045, India

    Praveen Raj

  8. General Surgery, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore, 768828, Singapore

    Anton Cheng

  9. General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore

    Jaideepraj Rao

  10. General Surgery, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    Alvin Eng

  11. Department of Surgery, Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Batu 9 Cheras, Wilayah Persekutuan, 56000, Kuala Lumpur, Malaysia

    Nik Ritza Kosai & Reynu Rajan

  12. General Surgery, Gangnam CHA General Hospital, 569, Nonhyon-ro, Gangnam-gu, Seoul, 135-081, South Korea

    Sang-Moon Han

  13. General Surgery, Yotsuya Medical Cube, 7-7 Nibanchō, Chiyoda-ku, Tokyo, 102-0084, Japan

    Kazunori Kasama

  14. General Surgery, Min-Sheng General Hospital, #168 Jin-Kuo Rd, 330, Taoyuan City, Taiwan, Republic of China

    Wei-Jei Lee

  15. General Surgery, Soonchunhyang University Seoul Hospital, 59 Daesagwan-ro, Hannam-dong, Yongsan-gu, Seoul, South Korea

    Yong Jin Kim

  16. General Surgery, Institute of Digestive Disease, The Chinese University of Hong Kong, Room 94020, 7/F, Lui Che Woo Clinical Sciences Building, Prince of Wales Hospital, Shatin, NT, Hong Kong

    Simon Kin Hung Wong

  17. General Surgery, GI/Bariatric Surgery, University of Minnesota, 420 Delaware St SE, MMC 195, Minneapolis, MN, 55455, USA

    Sayeed Ikramuddin

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  1. Zong Jie Koh
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  2. Bee Choo Tai
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  20. Yong Jin Kim
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  23. Asim Shabbir
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Correspondence to Zong Jie Koh.

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The authors declare that they have no conflict of interests.

Statement of Informed Consent

No formal consent was required as this was a retrospective study.

A Statement of Human and Animal Rights

This study has been approved by the Institutional Review Board of each institution and all procedures were conducted in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Koh, Z.J., Tai, B.C., Kow, L. et al. Influence of Asian Ethnicities on Short- and Mid-term Outcomes Following Laparoscopic Sleeve Gastrectomy. OBES SURG 29, 1781–1788 (2019). https://doi.org/10.1007/s11695-019-03716-8

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