Ibacache-Saavedra Paulina, Jerez-Mayorga Daniel, Carretero-Ruiz Alejandro, Miranda-Fuentes Claudia, Cano-Cappellacci Marcelo, Artero Enrique G
Exercise and Rehabilitation Sciences Laboratory, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile.
Department of Education and SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almeria, Spain.
Obes Rev. 2022 Mar;23(3):e13408. doi: 10.1111/obr.13408. Epub 2021 Dec 19.
Although bariatric surgery (BS) is recognized as an effective strategy for body weight loss, its impact on cardiorespiratory fitness (CRF) is still unclear. We aimed to examine postoperative changes in CRF (VO ) and its relationship with weight loss among adults undergoing BS. We systematically searched the WoS, PubMed, MEDLINE, and Scopus databases. Observational and intervention studies were selected reporting the presurgery and postsurgery CRF, measured by breath-by-breath VO or its estimation. Eleven articles (312 patients) revealed that BS leads to a reduction in absolute VO in the short term (effect size, ES = -0.539; 95%CI = -0.708, -0.369; p < 0.001), and those patients who suffered a more significant decrease in BMI after BS also had a greater loss of absolute VO . However, VO relative to body weight increased after surgery (ES = 0.658; 95%CI = 0.473, 0.842; p < 0.001). An insufficient number of studies were found investigating medium and long-term changes in CRF after BS. This study provides moderate-quality evidence that the weight loss induced by BS can reduce CRF in the short term, which represents a therapeutic target to optimize BS outcomes. More high-quality studies are needed to evaluate the impact of BS on VO in the short, medium, and long term including normalized values for fat-free mass.
尽管减肥手术被认为是一种有效的体重减轻策略，但其对心肺适能（CRF）的影响仍不明确。我们旨在研究接受减肥手术的成年人术后心肺适能（VO ）的变化及其与体重减轻的关系。我们系统检索了Web of Science、PubMed、MEDLINE和Scopus数据库。选择了报告术前和术后心肺适能的观察性和干预性研究，通过逐次呼吸VO 测量或其估算值进行测量。11篇文章（312例患者）显示，减肥手术在短期内会导致绝对VO 降低（效应量，ES = -0.539；95%置信区间 = -0.708，-0.369；p < 0.001），并且减肥手术后BMI下降更显著的患者绝对VO 的损失也更大。然而，术后相对于体重的VO 增加了（ES = 0.658；95%置信区间 = 0.473，0.842；p < 0.001）。发现研究减肥手术后心肺适能中长期变化的研究数量不足。本研究提供了中等质量的证据，表明减肥手术引起的体重减轻在短期内会降低心肺适能，这是优化减肥手术效果的一个治疗靶点。需要更多高质量的研究来评估减肥手术在短期、中期和长期对VO 的影响，包括去脂体重的标准化值。
