Bond Dale S, Phelan Suzanne, Wolfe Luke G, Evans Ronald K, Meador Jill G, Kellum John M, Maher James W, Wing Rena R
Department of Psychiatry and Behavioral Medicine, Brown Alpert Medical School/The Miriam Hospital, Providence, Rhode Island, USA.
Obesity (Silver Spring). 2009 Jan;17(1):78-83. doi: 10.1038/oby.2008.501. Epub 2008 Nov 6.
The purpose of this study was to determine whether pre- to postoperative increases in physical activity (PA) are associated with weight loss and health-related quality of life (HRQoL) following bariatric surgery. Participants were 199 Roux-en-Y gastric bypass (RYGB) surgery patients. The International Physical Activity Questionnaire (IPAQ) was used to categorize participants into three groups according to their preoperative and /1-year postoperative PA level: (i) Inactive/Active (<200-min/week/>or=200-min/week), (ii) Active/Active (>or=200-min/week/>or=200-min/week) and (iii) Inactive/Inactive (<200-min/week/<200-min/week). The Medical Outcomes Study Short Form-36 (SF-36) was used to assess HRQoL. Analyses of covariance were conducted to examine the effects of PA group on weight and HRQoL changes. Inactive/Active participants, compared with Inactive/Inactive individuals, had greater reductions in weight (52.5 +/- 15.4 vs. 46.4 +/- 12.8 kg) and BMI (18.9 +/- 4.6 vs. 16.9 +/- 4.2 kg/m(2)). Weight loss outcomes in the Inactive/Active and Active/Active groups were similar to each other. Inactive/Active and Active/Active participants reported greater improvements than Inactive/Inactive participants on the mental component summary (MCS) score and the general health, vitality and mental health domains (P < 0.01). Although the direction of causation is not clear, these findings suggest that RYGB patients who become active postoperatively achieve weight losses and HRQoL improvements that are greater than those experienced by patients who remain inactive and comparable to those attained by patients who stay active. Future randomized controlled trials should examine whether assisting patients who are inactive preoperatively to increase their PA postoperatively contributes to optimization of weight loss and HRQoL outcomes.
本研究的目的是确定减肥手术后体力活动（PA）从术前到术后的增加是否与体重减轻及健康相关生活质量（HRQoL）相关。研究对象为199例行Roux-en-Y胃旁路术（RYGB）的患者。采用国际体力活动问卷（IPAQ）根据患者术前及术后1年的PA水平将其分为三组：（i）不活跃/活跃组（<200分钟/周/>或=200分钟/周），（ii）活跃/活跃组（>或=200分钟/周/>或=200分钟/周），以及（iii）不活跃/不活跃组（<200分钟/周/<200分钟/周）。使用医学结局研究简表36（SF-36）评估HRQoL。进行协方差分析以检验PA组对体重和HRQoL变化的影响。与不活跃/不活跃个体相比，不活跃/活跃参与者体重减轻更多（52.5±15.4 vs. 46.4±12.8 kg），BMI降低更多（18.9±4.6 vs. 16.9±4.2 kg/m²）。不活跃/活跃组和活跃/活跃组的体重减轻结果相似。不活跃/活跃组和活跃/活跃组参与者在心理成分总结（MCS）评分以及总体健康、活力和心理健康领域的改善程度高于不活跃/不活跃组参与者（P<0.01）。尽管因果关系尚不明确，但这些发现表明，术后变得活跃的RYGB患者在体重减轻和HRQoL改善方面比仍不活跃的患者更大，且与保持活跃的患者相当。未来的随机对照试验应研究协助术前不活跃的患者术后增加PA是否有助于优化体重减轻和HRQoL结果。
