减重手术对体力活动影响的荟萃分析。

Meta-analysis of the effect of bariatric surgery on physical activity.

机构信息

Department of Upper GI and Bariatric Surgery, Luton and Dunstable University Hospital, Luton, United Kingdom.

出版信息

Surg Obes Relat Dis. 2019 Sep;15(9):1620-1631. doi: 10.1016/j.soard.2019.06.014. Epub 2019 Jun 20.

DOI:10.1016/j.soard.2019.06.014

PMID:31358394

Abstract

BACKGROUND

Obesity leads to impairment of physical activity as measured by an inability to perform activities of daily living. Literature on the effect of bariatric surgery on physical activity is conflicting.

OBJECTIVE

The aim of this study was to perform a meta-analysis of the effect of bariatric surgery on physical activity from studies employing objective measurement and self-reporting of physical activity before and after bariatric surgery.

METHODS

Bibliographic databases were searched systematically for relevant literature until December 31, 2018. Studies employing objective and self-reported measurement of physical activity were included. Study quality was assessed using Risk of Bias in Nonrandomized Studies - of Interventions tool. Meta-analysis was performed using random effects model and presented as standardized mean difference (SMD) with 95% confidence intervals (CI).

RESULTS

Twenty studies identified 5886 patients suitable for the analysis. Physical activity showed significant improvement at 0-6 months (SMD: .50; 95% CI: .25-.76; P = .0001), >6-12 months (SMD: .58; 95% CI: .26-.91; P = .0004), and >12-36 months (SMD: .82; 95% CI: .27-1.36; P = .004) after bariatric surgery. Self-reported assessment after bariatric surgery showed significant improvement at 0-6 months (SMD: .65; 95% CI: .29-1.01; P = .0004), >6 to 12 months (SMD: .53; 95% CI: .18-.88; P = .003), and >12-36 months (SMD: .51; 95% CI: .46-.55; P < .00001). Objective assessment after bariatric surgery did not show improvement at 0-6 months (SMD: .31; 95%CI:-.05-.66; P = .09), but showed significant improvement at >6-12 months (SMD: .85; 95% CI:-.07-1.62; P = .03), and >12-36 months (SMD: 1.99; 95% CI: 1.13-2.86; P < .00001) after bariatric surgery.

CONCLUSIONS

Bariatric surgery improves physical activity significantly in a population with obesity up to 3 years after surgery. Objective measurement of physical activity does not show significant improvement within 6 months of bariatric surgery but begins to improve at >6 months. Self-reported measurement of physical activity begins to show improvement within 6 months of a bariatric procedure.

摘要

背景

肥胖会导致身体活动能力受损，表现在无法完成日常生活活动。关于减重手术对身体活动影响的文献存在争议。

目的

本研究旨在对采用客观测量和减重手术前后自我报告的身体活动来评估减重手术对身体活动影响的研究进行荟萃分析。

方法

系统检索文献数据库，以获取截至 2018 年 12 月 31 日有关的文献。纳入采用客观和自我报告测量身体活动的研究。使用干预措施的非随机研究偏倚风险工具评估研究质量。采用随机效应模型进行荟萃分析，并以标准化均数差（SMD）及其 95%置信区间（CI）表示。

结果

共确定了 20 项研究，有 5886 例患者适合进行分析。身体活动在减重手术后 0-6 个月（SMD：.50；95%CI：.25-.76；P =.0001）、>6-12 个月（SMD：.58；95%CI：.26-.91；P =.0004）和>12-36 个月（SMD：.82；95%CI：.27-1.36；P =.004）时显著改善。减重手术后的自我报告评估在 0-6 个月（SMD：.65；95%CI：.29-1.01；P =.0004）、>6-12 个月（SMD：.53；95%CI：.18-.88；P =.003）和>12-36 个月（SMD：.51；95%CI：.46-.55；P <.00001）时显示出显著改善。减重手术后的客观评估在 0-6 个月时没有显示出改善（SMD：.31；95%CI：-.05-.66；P =.09），但在>6-12 个月（SMD：.85；95%CI：-.07-1.62；P =.03）和>12-36 个月（SMD：1.99；95%CI：1.13-2.86；P <.00001）时显示出显著改善。