Mundbjerg L H, Stolberg C R, Bladbjerg E-M, Funch-Jensen P, Juhl C B, Gram B
Section of Endocrinology, Department of Medicine, Hospital of Southwest Jutland, Esbjerg, Denmark.
Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Clin Obes. 2018 Aug;8(4):227-235. doi: 10.1111/cob.12256. Epub 2018 Jun 12.
Obesity and physical inactivity are major health problems. Roux-en-Y gastric bypass (RYGB) surgery results in significant weight loss and reduces obesity-related morbidity and mortality. Physical activity lowers the risk of cardiovascular disease and premature death. The aims of this study were to elucidate the effects of RYGB followed by 6 months of supervised physical training on physical capacity. In a randomized controlled trial, 60 participants eligible for RYGB were randomized 6 months post-surgery to either two weekly physical training sessions for 26 weeks (INT) or a control group (CON). Aerobic capacity (VO max), muscle strength (MS) of the shoulder and hip and physical function were measured pre-surgery and 6, 12 and 24 months post-surgery. RYGB per se decreased MS in all tested muscle groups, had no effects on VO max but improved physical function. After the intervention, INT had a significant 0.33 L min increase in VO max compared to CON (95% CI: 0.07-0.57, P = 0.013). Furthermore, MS in the hip adductor increased significantly with 13 N (95% CI: 3.6-22.4, P = 0.007) and a between-group difference was found in the Stair Climb Test (0.46 repetitions [95% CI: 0.02-0.91, P = 0.042]). The effects were not maintained at follow-up. Supervised physical training following RYGB improved VO max, hip MS and physical function, but the positive effects were not maintained at follow-up. While activities of daily life may become easier as a result of RYGB, the observed extensive post-operative loss of MS requires more attention to increase the patient's physical capacity prospectively.
肥胖和缺乏身体活动是主要的健康问题。胃旁路手术（RYGB）可显著减轻体重，并降低与肥胖相关的发病率和死亡率。身体活动可降低心血管疾病和过早死亡的风险。本研究的目的是阐明RYGB联合6个月的监督性体育锻炼对身体能力的影响。在一项随机对照试验中，60名符合RYGB手术条件的参与者在术后6个月被随机分为两组，一组进行为期26周的每周两次体育锻炼（INT），另一组为对照组（CON）。在手术前以及术后6个月、12个月和24个月测量有氧能力（最大摄氧量）、肩部和髋部的肌肉力量（MS）以及身体功能。RYGB本身会降低所有测试肌肉群的MS，对最大摄氧量没有影响，但改善了身体功能。干预后，与CON组相比，INT组的最大摄氧量显著增加了0.33L/min（95%CI：0.07-0.57，P=0.013）。此外，髋内收肌的MS显著增加了13N（95%CI：3.6-22.4，P=0.007），并且在爬楼梯测试中发现两组之间存在差异（0.46次重复[95%CI：0.02-0.91，P=0.042]）。这些效果在随访时未得到维持。RYGB术后的监督性体育锻炼改善了最大摄氧量、髋部MS和身体功能，但积极效果在随访时未得到维持。虽然RYGB可能会使日常生活活动变得更容易，但观察到的术后广泛的MS丧失需要更多关注，以便前瞻性地提高患者的身体能力。
