Steele T, Cuthbertson D J, Wilding J P H
Department of Obesity and Endocrinology, Clinical Sciences Centre, Aintree University Hospital NHS Foundation Trust, University of Liverpool, Liverpool, UK.
Obes Rev. 2015 Mar;16(3):248-58. doi: 10.1111/obr.12247. Epub 2015 Jan 12.
Obesity is associated with a profound impairment in the ability to perform the basic physical activities required for everyday function. This impacts on quality of life and contributes to disability. Bariatric surgery leads to weight loss and metabolic improvements in severe obesity; however, less is known about its effect on physical functioning. This narrative review summarizes current evidence on the effect of bariatric surgery on this outcome with a consideration of the mechanisms involved. Nine longitudinal observational studies reporting objective measures of physical functioning were identified. Inclusion criteria, follow-up time and outcomes reported varied considerably between studies and sample sizes were small. They all showed a significant improvement in performance following surgery despite variations in baseline patient characteristics. Additionally, six studies were found in which subjects were subjected to exercise testing protocols. Performance of the test protocol improved in all. Where reported, peak oxygen uptake related to body weight improved; however, absolute values were either unchanged or decreased. In conclusion, observational evidence suggests that patients' physical functioning improves following bariatric surgery. More evidence is required regarding mechanisms involved; however, it may be due to improved efficiency in performing activities as opposed to absolute improvements in cardiorespiratory or muscle function.
肥胖与日常功能所需的基本身体活动能力严重受损有关。这会影响生活质量并导致残疾。减肥手术可使重度肥胖患者体重减轻并改善代谢；然而，关于其对身体功能的影响却知之甚少。本叙述性综述总结了减肥手术对这一结果影响的现有证据，并考虑了其中涉及的机制。确定了九项报告身体功能客观测量指标的纵向观察性研究。研究之间的纳入标准、随访时间和报告的结果差异很大，样本量也很小。尽管基线患者特征存在差异，但所有研究均显示术后表现有显著改善。此外，还发现六项研究让受试者接受了运动测试方案。所有测试方案的表现均有所改善。在有报告的情况下，与体重相关的峰值摄氧量有所改善；然而，绝对值要么没有变化，要么有所下降。总之，观察性证据表明减肥手术后患者的身体功能有所改善。关于其中涉及的机制还需要更多证据；然而，这可能是由于活动执行效率提高，而非心肺或肌肉功能的绝对改善。
