Department of Medicine, Section of Endocrinology, Hospital of Southwest Jutland, Denmark; Department of Regional Health Research, University of Southern, Denmark; OPEN, Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark.
Department of Medicine, Section of Endocrinology, Hospital of Southwest Jutland, Denmark; Department of Regional Health Research, University of Southern, Denmark; OPEN, Odense Patient Data Explorative Network, Odense University Hospital, Odense, Denmark.
Atherosclerosis. 2018 Jun;273:37-44. doi: 10.1016/j.atherosclerosis.2018.04.002. Epub 2018 Apr 6.
Obesity and physical inactivity are both associated with low-grade inflammation and endothelial dysfunction. Bariatric surgery improves markers of inflammation and endothelial function, but it is unknown if physical training after bariatric surgery can improve these markers even further. Therefore, we aimed to investigate the effects of Roux-en-Y gastric bypass (RYGB) followed by physical training on markers of low-grade inflammation and endothelial function.
Sixty patients approved for RYGB underwent examinations pre-surgery, 6, 12, and 24 months post-surgery. Six months post-surgery, they were randomized 1:1 to an intervention group or a control group. The interventions consisted of two weekly sessions of supervised moderate intensity physical training for a period of 26 weeks. Fasting blood samples were analyzed for concentrations of interleukin 6 (IL-6), C-reactive protein (CRP), intercellular adhesion molecule 1 (ICAM-1), tissue-type plasminogen activator antigen (t-PA:Ag) and von Willebrand factor (vWF).
RYGB markedly improved markers of inflammation (IL-6, CRP) (p < 0.001) and endothelial function (ICAM-1, t-PA:Ag, vWF) (p < 0.05), and the improvements were sustained 24 months post-surgery (p < 0.01), except for the effects on vWF. We found no correlations between the changes in weight or BMI and the changes in markers of inflammation and endothelial function, except that the change in vWF was found to be inversely correlated with the changes in weight and BMI. We observed no effects of supervised physical training on markers on inflammation or endothelial function (p>0.1 for all).
RYGB causes substantial and sustained favorable effects on markers of inflammation and endothelial function. Supervised physical training after RYGB did not cause additional improvements.
肥胖症和身体活动不足均与低度炎症和内皮功能障碍相关。减重手术可改善炎症和内皮功能的标志物，但尚不清楚减重手术后的身体训练是否能进一步改善这些标志物。因此，我们旨在研究 Roux-en-Y 胃旁路术（RYGB）联合身体训练对低度炎症和内皮功能标志物的影响。
60 名经批准接受 RYGB 的患者在术前、术后 6、12 和 24 个月进行了检查。术后 6 个月，他们被随机分为干预组和对照组，1:1 比例分配。干预措施包括为期 26 周、每周两次的监督性中等强度身体训练。空腹血样用于分析白细胞介素 6（IL-6）、C 反应蛋白（CRP）、细胞间黏附分子 1（ICAM-1）、组织型纤溶酶原激活物抗原（t-PA：Ag）和血管性血友病因子（vWF）的浓度。
RYGB 显著改善了炎症标志物（IL-6、CRP）（p<0.001）和内皮功能标志物（ICAM-1、t-PA：Ag、vWF）（p<0.05），并且这种改善在术后 24 个月仍持续存在（p<0.01），除了对 vWF 的影响。我们发现体重或 BMI 的变化与炎症和内皮功能标志物的变化之间没有相关性，除了 vWF 的变化与体重和 BMI 的变化呈反比相关。我们观察到监督性身体训练对炎症或内皮功能标志物没有影响（所有 p 值均>0.1）。
RYGB 对炎症和内皮功能标志物产生实质性和持续的有利影响。RYGB 后的监督性身体训练不会产生额外的改善。
