减重手术后身体活动量增加可改善体重减轻和心肺功能适应性。
Increase in Physical Activity After Bariatric Surgery Demonstrates Improvement in Weight Loss and Cardiorespiratory Fitness.
机构信息
Nederlandse Obesitas Kliniek (Dutch Obesity Clinic), Postbus 601, 3700AP, Zeist, The Netherlands.
Medtronic, Minneapolis, MN, USA.
出版信息
Obes Surg. 2018 Dec;28(12):3950-3957. doi: 10.1007/s11695-018-3439-x.
BACKGROUND
Low cardiorespiratory fitness is strongly associated with cardiovascular diseases and mortality. Although increased physical activity can improve cardiorespiratory fitness, this relationship has not been examined in a large bariatric population undergoing perioperative care focusing on long-term lifestyle change.
OBJECTIVES
To evaluate changes in physical activity, weight loss, and cardiorespiratory fitness up to 24 months after bariatric surgery, and to evaluate the relationships of change in physical activity with weight loss and change in cardiorespiratory fitness.
MATERIALS AND METHODS
Four thousand seven hundred eighty-five patients who underwent primary Roux-en-Y gastric bypass or sleeve gastrectomy between January 2012 and December 2014 were included. Physical activity was assessed by the Baecke questionnaire (work, leisure, and sport activity) and cardiorespiratory fitness, defined as VOmax relative to fat-free mass (VOmax/FFM), was assessed by the Åstrand test.
RESULTS
Twenty-four months postoperative, significant improvements were seen in sport and leisure activity assessments (n = 3548, P < 0.001), weight loss (n = 3695, P < 0.001), and VOmax/FFM (n = 1852, P < 0.001). Furthermore, regression analysis showed that change in leisure activity was positively associated with weight loss (n = 3535, ß = 1.352, P < 0.001) and change in sport activity was positively associated with change in VOmax/FFM (n = 1743, ß = 1.730, P < 0.001).
CONCLUSION
Bariatric surgery complemented by a comprehensive bariatric care program can lead to improvement in physical activity, as well as weight loss and improvement in cardiorespiratory fitness. The positive associations of change in leisure activity with weight loss and change in sport activity with cardiorespiratory fitness suggest that bariatric care programs can enhance postoperative outcomes by improving the patient's physical activity.
背景
心肺适能较低与心血管疾病和死亡率密切相关。尽管增加身体活动可以提高心肺适能，但在关注长期生活方式改变的围手术期护理中，这种关系尚未在大量接受减重手术的人群中进行过研究。
目的
评估减重手术后 24 个月内身体活动、体重减轻和心肺适能的变化，并评估身体活动变化与体重减轻和心肺适能变化的关系。
材料和方法
共纳入 2012 年 1 月至 2014 年 12 月期间接受原发性 Roux-en-Y 胃旁路术或袖状胃切除术的 4785 例患者。身体活动通过 Baecke 问卷（工作、休闲和运动活动）进行评估，心肺适能定义为最大摄氧量与去脂体重的比值（VOmax/FFM），通过 Åstrand 测试进行评估。
结果
术后 24 个月，运动和休闲活动评估（n=3548，P<0.001）、体重减轻（n=3695，P<0.001）和 VOmax/FFM（n=1852，P<0.001）均有显著改善。此外，回归分析显示，休闲活动的变化与体重减轻呈正相关（n=3535，β=1.352，P<0.001），运动活动的变化与 VOmax/FFM 的变化呈正相关（n=1743，β=1.730，P<0.001）。
结论
减重手术辅以全面的减重护理方案可改善身体活动，减轻体重，提高心肺适能。休闲活动变化与体重减轻以及运动活动变化与心肺适能改善之间的正相关关系表明，减重护理方案可以通过提高患者的身体活动来增强术后效果。
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