Brissman Markus, Ekbom Kerstin, Hagman Emilia, Mårild Staffan, Gronowitz Eva, Flodmark Carl-Erik, Olbers Torsten, Marcus Claude
Department of Clinical Science, Intervention and Technology, Division of Paediatrics, Karolinska Institutet, B62, 141 86, Stockholm, Sweden.
Department of Surgery, Sahlgrenska University of Gothenburg, Gothenburg, Sweden.
Obes Surg. 2017 Feb;27(2):330-337. doi: 10.1007/s11695-016-2282-1.
We have previously shown promising results 2 years after Roux-en-Y gastric bypass surgery, within the Adolescence Morbid Obesity Surgery study (AMOS). The aim of the current study was to describe the 2-year outcome in cardiorespiratory fitness, body composition, and functional capacity in the Stockholm subset of the AMOS study.
Forty-one adolescents (10 male, 31 female, age 14-18 years, body mass index 35-69 kg·m) were included. In addition to anthropometric measurements, participants performed a submaximal bicycle test, 6-min walk test, dual-energy X-ray absorptiometry, and a short interview at baseline, 1 and 2 years after surgery.
Relative improvements in maximal oxygen consumption (VOmax) per kilogram body mass (+62 %) and per kilogram fat-free mass (+21 %), as well as walking distance (+13 %) were observed after 1 year, and persisted 2 years after surgery. Despite a reduction of fat-free mass (-15 %), absolute VOmax was maintained across the full group (+8 %, p = ns) and significantly increased in non-smokers. Body mass and fat mass were significantly decreased (-45.4 and -33.3 kg, respectively). Self-reported physical activity was significantly increased, and pain associated with movement was reduced.
In adolescents with obesity, Roux-en-Y gastric bypass improved VOmax more than could be explained by fat mass loss alone. In combination with improved functional capacity and body composition, these results suggest that surgery in adolescence might add specific benefits of importance for future health.
在青少年病态肥胖手术研究（AMOS）中，我们之前已展示了Roux-en-Y胃旁路手术后2年的良好结果。本研究的目的是描述AMOS研究斯德哥尔摩子集中心肺适能、身体成分和功能能力的2年结果。
纳入41名青少年（10名男性，31名女性，年龄14 - 18岁，体重指数35 - 69kg·m）。除人体测量外，参与者在基线、术后1年和2年进行了次极量自行车测试、6分钟步行测试、双能X线吸收法和简短访谈。
术后1年观察到每千克体重最大摄氧量（VOmax）相对改善（+62%），每千克去脂体重相对改善（+21%），以及步行距离相对改善（+13%），且术后2年持续存在。尽管去脂体重减少（-15%），但全组绝对VOmax保持不变（+8%，p =无显著性差异），非吸烟者显著增加。体重和脂肪量显著降低（分别为-45.4和-33.3kg）。自我报告的身体活动显著增加，与运动相关的疼痛减轻。
在肥胖青少年中，Roux-en-Y胃旁路手术对VOmax的改善超过仅由脂肪量减少所能解释的程度。结合功能能力和身体成分的改善，这些结果表明青春期手术可能为未来健康带来重要的特定益处。
