King Wendy C, Hinerman Amanda S, White Gretchen E, Courcoulas Anita P, Saad Mohammed A Bu, Belle Steven H
Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
General and Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
Ann Surg. 2022 Apr 1;275(4):718-726. doi: 10.1097/SLA.0000000000004456.
To examine associations of objectively-measured physical activity (PA) with changes in weight after roux-en-Y gastric bypass (RYGB) over 7 years.
The contribution of free-living PA to surgery-induced weight loss and subsequent weight regain is not well understood.
Participants of a multi-center prospective cohort study of bariatric surgery were followed annually ≥7 years. Of 807 participants who underwent RYGB and were given an activity monitor, 649 (80%) had sufficient data for this report (78% female; median age 47 years; median body mass index 46 kg/m2). Mean daily steps, hours/day in SB and minutes/week in moderate-to-vigorous physical activity (MVPA) were determined at each assessment. Mixed models tested associations between PA measures and weight outcomes, controlling for sociodemographics, health status, and eating behaviors.
Across follow-up, mean pre to postsurgery changes in PA were small, and mean postsurgery PA level was below PA recommendations for health (eg, 101 MVPA min/week 7 years postsurgery versus the ≥150 MVPA min/week recommendation). There was a dose-response association between more steps, less SB and more MVPA with greater weight loss. Steps and SB, but not MVPA, were also associated with weight regain. For example, participants in the highest versus lowest steps quartile lost 2.9% (95% confidence interval, 1.8-4.1) more of their presurgery weight and regained 5.4% (95% confidence interval, 2.4-8.3) less of their maximum weight lost across follow-up.
Despite only small increases in objectively-measured PA level after RYGB, PA level was independently associated with weight outcomes of bariatric surgery throughout 7 years of follow-up.
Reprints will not be available from the authors.
研究在7年时间里，客观测量的身体活动（PA）与Roux-en-Y胃旁路术（RYGB）后体重变化之间的关联。
自由生活状态下的PA对手术引起的体重减轻及随后的体重反弹的作用尚未得到充分理解。
对一项多中心前瞻性肥胖症手术队列研究的参与者进行了≥7年的年度随访。在807例行RYGB并配备了活动监测器的参与者中，649人（80%）有足够数据用于本报告（78%为女性；中位年龄47岁；中位体重指数46kg/m²）。每次评估时测定每日平均步数、久坐行为的小时数/天以及中度至剧烈身体活动（MVPA）的分钟数/周。混合模型检验了PA测量值与体重结果之间的关联，并对社会人口统计学、健康状况和饮食行为进行了控制。
在整个随访期间，PA的术前至术后平均变化较小，术后PA水平低于健康方面的PA建议值（例如，术后7年MVPA为101分钟/周，而建议值为≥150分钟/周）。步数越多、久坐行为越少以及MVPA越多与体重减轻幅度越大之间存在剂量反应关系。步数和久坐行为与体重反弹有关，但MVPA无关。例如，最高步数四分位数组与最低步数四分位数组相比，术后体重较术前多减轻了2.9%（95%置信区间，1.8 - 4.1），随访期间最大体重减轻后的反弹量少了5.4%（95%置信区间，2.4 - 8.3）。
尽管RYGB术后客观测量的PA水平仅略有增加，但在7年的随访期间，PA水平与肥胖症手术的体重结果独立相关。
作者不提供重印本。
