da Costa Tavares Bezerra Michelle, Medeiros de Almeida Camila, Falcão Leal Paulo Roberto, Bouskela Eliete, Fleiuss de Farias Maria Lucia, Madeira Miguel, Grutter Lopes Karynne, Kraemer-Aguiar Luiz Guilherme
Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
Obesity Unit, Multiuser Clinical Research Center (CePeM), Hospital Universitário Pedro Ernesto, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
Obes Surg. 2025 Jul 15. doi: 10.1007/s11695-025-08043-9.
Roux-en-Y gastric bypass (RYGB) is well-established for its effectiveness in promoting weight loss and improving metabolic health, but its effects on muscle mass, strength, physical function, and quality of life (QoL) remain unclear. This study aimed to compare and explore the associations between muscle mass, muscle strength, physical function, and QoL indicators in patients who underwent RYGB and in matched non-surgical controls.
This cross-sectional study included 39 patients post-RYGB (92.3% females, aged 39 ± 5 years, and BMI of 42.2 ± 3.8 kg/m) and 21 BMI-, age-, and gender-matched non-surgical controls. Between-group comparisons, using unpaired Student t-test or Mann-Whitney test, were performed for appendicular skeletal muscle mass index (ASM index), handgrip strength (HGS), timed Up and Go Test (TUG), biochemical parameters, and 36-Item Short-Form Health Survey (SF-36).
Compared to controls, patients who underwent RYGB showed similar ASM index (7.13 [6.65-7.85] vs. 7.41 [6.84-8.18] kg/m; p = 0.36), HGS (32 ± 9.3 vs. 29.9 ± 7.1 kg; p = 0.17), and TUG (5.80 ± 0.74 vs. 6.27 ± 0.92; p = 0.08), and lower scores in most of QoL indicators (physical functioning, physical/emotional role limitations, bodily pain, social functioning, and mental health; p ≤ 0.01). Weight loss showed moderate negative correlations with both the ASM index and HGS (r = - 0.32 to - 0.55; p ≤ 0.04). In contrast, time since surgery demonstrated a moderate positive correlation with TUG (rho = 0.43, p < 0.001).
Muscle health appears to be preserved following RYGB. However, the observed impairments in QoL indicators highlight the need for post-surgical care to extend beyond weight loss and metabolic improvements, addressing both physical and psychological well-being.
Roux-en-Y胃旁路术（RYGB）在促进体重减轻和改善代谢健康方面的有效性已得到充分证实，但其对肌肉质量、力量、身体功能和生活质量（QoL）的影响仍不明确。本研究旨在比较并探讨接受RYGB手术的患者与匹配的非手术对照组在肌肉质量、肌肉力量、身体功能和生活质量指标之间的关联。
这项横断面研究纳入了39例接受RYGB手术后的患者（女性占92.3%，年龄39±5岁，BMI为42.2±3.8kg/m²）以及21例BMI、年龄和性别匹配的非手术对照组。采用不成对学生t检验或曼-惠特尼检验对两组进行比较，指标包括四肢骨骼肌质量指数（ASM指数）、握力（HGS）、计时起立行走测试（TUG）、生化参数以及36项简短健康调查问卷（SF-36）。
与对照组相比，接受RYGB手术的患者ASM指数（7.13[6.65-7.85] vs. 7.41[6.84-8.18]kg/m²；p=0.36）、HGS（32±9.3 vs. 29.9±7.1kg；p=0.17）和TUG（5.80±0.74 vs. 6.27±0.92；p=0.08）相似，而在大多数生活质量指标（身体功能、身体/情感角色限制、身体疼痛、社会功能和心理健康；p≤0.01）上得分较低。体重减轻与ASM指数和HGS均呈中度负相关（r=-0.32至-0.55；p≤0.04）。相反，术后时间与TUG呈中度正相关（rho=0.43，p<0.001）。
RYGB术后肌肉健康似乎得以保留。然而，观察到的生活质量指标受损情况凸显了术后护理需要超越体重减轻和代谢改善，关注身体和心理健康。
