Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas.
Surg Obes Relat Dis. 2019 May;15(5):794-803. doi: 10.1016/j.soard.2018.12.018. Epub 2018 Dec 22.
The association between obesity and asthma is well-established. Some evidence suggests that weight loss may improve asthma outcomes; however, the effect of bariatric surgery on pulmonary function in asthmatic patients remains inconclusive. This systematic review and meta-analysis of observational studies assessed the impact of bariatric surgery on patients with asthma.
To investigate the effect of bariatric surgery on pulmonary function in patients with asthma.
Systematic review and meta-analysis of published studies.
A comprehensive search of the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted. The sole inclusion criterion was published studies that evaluated the effects of bariatric surgery on pulmonary function in asthmatic patients. The outcomes of interest were forced expiratory volume in 1 second (FEV), forced vital capacity (FVC), and FEV/FVC. A meta-analysis of studies comparing pre- and postsurgery spirometric measures, and of studies comparing surgery and control groups was performed.
From 25 full-text articles, 6 observational studies met the inclusion criteria and were included in this meta-analysis based on the random-effects model. A significant increase in FEV and FVC was observed after bariatric surgery among studies without a control group (mean difference: .21 L, 95% confidence interval: .07-.35 for FEV, and mean difference: .34 L, 95% confidence interval: .14-.53 for FVC). There was no significant change in FEV/FVC after bariatric surgery compared with control.
FEV and FVC were both found to be significantly improved after bariatric surgery; however, no significant postsurgical improvement was observed for FEV/FVC.
肥胖与哮喘之间存在关联。有证据表明，减肥可能改善哮喘结局；然而，减重手术对哮喘患者肺功能的影响仍存在争议。本系统评价和观察性研究的荟萃分析评估了减重手术对哮喘患者的影响。
研究减重手术对哮喘患者肺功能的影响。
已发表研究的系统评价和荟萃分析。
对 MEDLINE、EMBASE 和 Cochrane 对照试验中心注册库（CENTRAL）数据库进行全面检索。唯一的纳入标准是评估减重手术对哮喘患者肺功能影响的已发表研究。主要结局指标为 1 秒用力呼气容积（FEV）、用力肺活量（FVC）和 FEV/FVC。对比较手术前后肺活量测定值的研究和比较手术组与对照组的研究进行了荟萃分析。
从 25 篇全文文章中，有 6 项观察性研究符合纳入标准，并根据随机效应模型纳入本荟萃分析。在没有对照组的研究中，减重手术后 FEV 和 FVC 显著增加（平均差异：.21 L，95%置信区间：.07-.35 为 FEV；平均差异：.34 L，95%置信区间：.14-.53 为 FVC）。与对照组相比，减重手术后 FEV/FVC 无显著变化。
减重手术后 FEV 和 FVC 均显著改善，但 FEV/FVC 术后无显著改善。
