Sports and Exercise Medicine Division, Regional Center for the Therapeutic Prescription of Exercise in Chronic Disease, Department of Medicine, University of Padova, Veneto Region, Italy.
Department of Medicine, Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, University of Padova, Veneto Region, Italy.
Front Endocrinol (Lausanne). 2023 Jul 21;14:1147171. doi: 10.3389/fendo.2023.1147171. eCollection 2023.
Different approaches are used to classify obesity severity. The Edmonton Obesity Staging System (EOSS) considers medical, physical and psychological parameters. A new modified EOSS with a different functional evaluation method, measuring Cardiorespiratory Fitness (CRF), has been recently proposed, EOSS-CRF. Bariatric surgery (BS) is one of the most efficient treatments of obesity and all aspect of related disorders. No studies have yet applied EOSS-CRF after BS. Therefore, the aim of this study was to evaluate modifications in EOSS and EOSS-CRF before and after BS.
This observational study finally enrolled 72 patients affected by obesity. A multi-disciplinary assessment in order to evaluate eligibility to surgical treatment has been performed, including anamnesis, physical evaluation, anthropometric data measurement, biochemical blood exams and cardiopulmonary exercise testing. One year after BS the same protocol was applied. Patients have been classified according to EOSS and EOSS-CRF before and one year after BS.
After BS, patients categorized in classes associated to severe obesity (EOSS ≥ 2 or EOSS-CRF ≥ 2) reduced significantly. Using EOSS, patients without functional impairment were 61% before surgery and 69% after BS (p=0.383). Using EOSS-CRF, patients considered without functional impairment were only 9.7% before BS; this percentage significantly raised to 50% after BS (p<0.001). The impact of functional domains before and after BS is different in grading patients in EOSS and EOSS-CRF, respectively.
Improvements obtained after BS are adequately summarized by EOSS and EOSS-CRF. The EOSS-CRF grading method for functional impairment seems to better reflect the known amelioration obtained after BS. Objective measurements of CRF may provide additional value to classify severity of obesity, also in the follow-up after BS.
肥胖严重程度的分类方法有很多种。埃德蒙顿肥胖分期系统（EOSS）考虑了医学、身体和心理参数。最近提出了一种新的改良 EOSS，其功能评估方法不同，测量心肺功能（CRF），称为 EOSS-CRF。减重手术（BS）是肥胖及其相关疾病最有效的治疗方法之一。目前尚无研究在 BS 后应用 EOSS-CRF。因此，本研究旨在评估 BS 前后 EOSS 和 EOSS-CRF 的变化。
本观察性研究最终纳入 72 例肥胖患者。进行了多学科评估，以评估手术治疗的资格，包括病史、身体评估、人体测量数据测量、生化血液检查和心肺运动测试。BS 后 1 年应用相同方案。根据 EOSS 和 EOSS-CRF 将患者分类，分别在 BS 前和 BS 后 1 年进行分类。
BS 后，EOSS≥2 或 EOSS-CRF≥2 与严重肥胖相关的类别患者明显减少。使用 EOSS，术前无功能障碍的患者为 61%，术后为 69%（p=0.383）。使用 EOSS-CRF，术前无功能障碍的患者仅为 9.7%；BS 后这一比例显著上升至 50%（p<0.001）。BS 前后，功能域对 EOSS 和 EOSS-CRF 中患者分级的影响不同。
BS 后获得的改善被 EOSS 和 EOSS-CRF 充分总结。EOSS-CRF 对功能障碍的分级方法似乎更好地反映了 BS 后已知的改善。CRF 的客观测量可能为肥胖严重程度的分类提供额外的价值，也可用于 BS 后的随访。
