Gilbertson Nicole M, Eichner Natalie Z M, Khurshid Mahnoor, Rexrode Elizabeth A, Kranz Sibylle, Weltman Arthur, Hallowell Peter T, Malin Steven K
Department of Kinesiology, University of Virginia, Charlottesville, VA, United States.
Department of Surgery, University of Virginia, Charlottesville, VA, United States.
Front Physiol. 2020 Aug 26;11:1018. doi: 10.3389/fphys.2020.01018. eCollection 2020.
Examine the effect of aerobic exercise (EX) combined with standard medical care (SC) (EX + SC) compared to SC alone on cardiometabolic health and quality of life in relation to surgical outcomes.
Patients receiving bariatric surgery were match-paired to 30 days of pre-operative SC ( = 7, 1 male, 39.0 ± 5.3 years, body mass index 46.4 ± 3.0 kg/m; low calorie diet) or EX + SC ( = 7, 0 males, 45.6 ± 4.8 years, body mass index 43.9 ± 4.2 kg/m; walking 30 min/day, 5 days/week, 65-85% HR ). Body mass, waist circumference, cardiorespiratory fitness (VOpeak), high sensitivity C-reactive protein (hs-CRP), cytokeratin 18 (CK18), weight related quality of life (QoL), and a 120 min mixed meal tolerance test (MMTT) was performed to assess arterial stiffness via augmentation index normalized to a heart rate of 75 beats per minute (AIx@75), whole-body insulin sensitivity, and glucose total area under the curve (tAUC) pre- and post-intervention (∼2 days prior to surgery). Length of hospital stay (admission to discharge) was recorded.
EX + SC had a greater effect for decreased intake of total calories ( = 0.14; ES = 0.86) compared to SC, but no change in body weight or waist circumference was observed in either group. EX + SC had a greater effect for increased VOpeak ( = 0.24; ES = 0.91) and decreased hs-CRP ( = 0.31; ES = 0.69) compared to SC. EX + SC reduced circulating CK18 ( = 0.05; ES = 3.05) and improved QoL ( = 0.02) compared to SC. Although EX + SC had no statistical effect on arterial stiffness compared to SC, we observed a modest effect size for AIx@75 tAUC ( = 0.36; ES = 0.52). EX + SC had a significantly shorter length of hospital stay ( = 0.05; ES = 1.38) than SC, and a shorter length of hospital stay was associated with decreased sugar intake ( = 0.55, = 0.04). Decreased AIx@75 tAUC significantly correlated with improved whole-body insulin sensitivity ( = -0.59, = 0.03) and glucose tAUC ( = 0.57, = 0.04).
EX with SC for 30 days prior to bariatric surgery may be important for cardiometabolic health, quality of life, and surgical outcomes in the bariatric patient.
研究与单纯标准医疗护理(SC)相比,有氧运动(EX)联合标准医疗护理(EX + SC)对代谢性健康和生活质量以及手术结局的影响。
接受减肥手术的患者被匹配为两组,一组接受术前30天的标准医疗护理(n = 7,1名男性,39.0 ± 5.3岁,体重指数46.4 ± 3.0 kg/m²;低热量饮食),另一组接受EX + SC(n = 7,0名男性,45.6 ± 4.8岁,体重指数43.9 ± 4.2 kg/m²;每天步行30分钟,每周5天,心率为65 - 85%)。测量体重、腰围、心肺适能(VO₂峰值)、高敏C反应蛋白(hs-CRP)、细胞角蛋白18(CK18)、与体重相关的生活质量(QoL),并进行120分钟的混合餐耐量试验(MMTT),以通过校正到每分钟75次心跳的增强指数(AIx@75)评估动脉僵硬度、全身胰岛素敏感性以及干预前后(手术前约2天)葡萄糖曲线下总面积(tAUC)。记录住院时间(入院到出院)。
与SC相比,EX + SC在减少总热量摄入方面效果更显著(p = 0.14;效应量ES = 0.86),但两组的体重和腰围均无变化。与SC相比,EX + SC在增加VO₂峰值(p = 0.24;效应量ES = 0.91)和降低hs-CRP(p = 0.31;效应量ES = 0.69)方面效果更显著。与SC相比,EX + SC降低了循环CK18水平(p = 0.05;效应量ES = 3.05)并改善了QoL(p = 0.02)。虽然与SC相比,EX + SC对动脉僵硬度无统计学影响,但我们观察到AIx@75 tAUC有适度的效应量(p = 0.36;效应量ES = 0.52)。EX + SC的住院时间显著短于SC(p = 0.