Roux-en-Y 胃旁路手术后 7 年期间身体活动与抑郁症状和健康相关生活质量变化的相关性：一项多中心前瞻性队列研究。
Associations Between Physical Activity and Changes in Depressive Symptoms and Health-related Quality of Life Across 7 Years After Roux-en-Y Gastric Bypass Surgery: A Multicenter Prospective Cohort Study.
机构信息
Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania.
General and internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
出版信息
Ann Surg. 2022 Dec 1;276(6):e777-e783. doi: 10.1097/SLA.0000000000004652. Epub 2020 Nov 24.
OBJECTIVE
To examine associations of objectively-measured free-living physical activity (PA) with changes in depressive symptoms and mental and physical health-related quality of life (HRQoL) over 7 years after Roux-en-Y gastric bypass surgery (RYGB).
BACKGROUND
The contributions of PA to improvements in mental and physical health after RYGB, independent of weight loss, are unclear.
METHODS
Adults undergoing RYGB in a US multi-center cohort study wore an activity monitor and completed the Beck depression inventory (BDI) and 36-Item Short Form Health Survey (SF-36) annually ≤7 years (N = 646; 78% female, median age 47 years, median body mass index 46kg/m 2 ). Linear mixed models estimated associations of quartiles of steps, sedentary behavior (SB), and moderate-to-vigorous intensity physical activity (MVPA), respectively, with pre-to-post-surgery changes in the BDI and SF-36 mental component summary and physical component summary scores, respectively, over 1-7 years post-surgery, with adjustment for sex, age, race, pre-surgerybody mass index, the respective pre-surgery score, treatment for depression (time-varying) and pre-to-post-surgery weight change (time-varying).
RESULTS
There were dose-response associations between steps, SB (inverse) and MVPA quartiles, respectively, with improvements in each score. Across follow-up, mean improvements in the BDI, Mental Component Summary and physical component summary scores, were 1.9 [95% confidence interval (CI), 1.0-2.8], 3.1 (95% CI, 1.5-4.7), and 4.0 (95% CI, 2.7-5.4) points higher, respectively, in the highest versus lowest steps quartile.
CONCLUSION
Among adults who underwent RYGB, multiple objective PA measures were associated with decreases in depressive symptoms and improvements in mental and physical HRQoL throughout 7 years, independent of weight loss, indicating PA is a modifiable behavior to augment outcomes.
目的
研究在 Roux-en-Y 胃旁路手术后 7 年内，通过客观测量的自由生活体力活动（PA）与抑郁症状变化以及心理健康和身体健康相关生活质量（HRQoL）变化之间的关联。
背景
PA 对 RYGB 后心理健康和身体健康的改善的贡献，独立于体重减轻，尚不清楚。
方法
在美国多中心队列研究中，接受 RYGB 的成年人佩戴活动监测器，并每年完成贝克抑郁量表（BDI）和 36 项简短健康调查（SF-36），随访时间≤7 年（N=646；78%为女性，中位年龄 47 岁，中位体重指数 46kg/m2）。线性混合模型估计了步骤、久坐行为（SB）和中等到剧烈强度体力活动（MVPA）的四分位数，分别与手术前后 BDI 和 SF-36 心理成分综合评分和身体成分综合评分的变化相关，调整了性别、年龄、种族、术前体重指数、术前得分、抑郁治疗（时变）和手术前后体重变化（时变）。
结果
在 1-7 年的随访中，分别与步骤、SB（反）和 MVPA 四分位数之间存在剂量反应关系，与每个评分的改善相关。在整个随访过程中，BDI、心理成分综合评分和身体成分综合评分的平均改善分别为 1.9[95%置信区间（CI），1.0-2.8]、3.1（95%CI，1.5-4.7）和 4.0（95%CI，2.7-5.4）分更高，分别在最高与最低步骤四分位组之间。
结论
在接受 RYGB 的成年人中，多种客观 PA 测量指标与抑郁症状的减轻以及心理健康和身体健康 HRQoL 的改善相关，与体重减轻无关，这表明 PA 是一种可改变的行为，可以增强治疗效果。
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