Lean Mass Loss and Altered Muscular Aerobic Capacity after Bariatric Surgery
Lean Mass Loss and Altered Muscular Aerobic Capacity after Bariatric Surgery
复制标题
减肥手术后瘦体重的减少和肌肉有氧能力的改变
作者：
N. Zhou;Corentin Scoubeau;K. Forton;P. Loi;J. Closset;G. Deboeck;J. Moraine;M. Klass;V. Faoro
简介：接受减肥手术的患者在减肥手术后没有改善他们的有氧能力或峰值摄氧量（VO 2 peak），有些人仍然抱怨虚弱和/或呼吸困难。我们研究了这一假设，即术后肌肉限制可能会影响运动的缓解反应，通过评估术后肌肉质量，力量和肌肉有氧能力的变化，测量的第一缓解阈值（VT）。研究方法：13名肥胖患者在减肥手术前和手术后6个月被转诊到我们大学的运动实验室，并按性别、年龄和身高与正常体重的健康受试者相匹配。所有受试者都接受了临床检查、血液采样、通过双能X射线吸收测定法进行的身体成分评估、呼吸和肢体肌肉力量评估以及在自行车测力计上进行的心肺运动测试。结果：减肥手术导致34%的脂肪量、43%的内脏脂肪组织和12%的瘦体重（LM）减少（p < 0.001）。绝对握力、股四头肌或呼吸肌力量未受影响，而股四头肌/握力相对于LM增加（p < 0.05）。绝对VO 2 peak或VO 2 peak/LM没有改善，术后第一个VT降低（1.4 ± 0.3 vs. 1.1 ± 0.4 L min−1，p < 0.05），与运动LM（LM腿）相关（R = 0.84，p < 0.001）。结论：虽然减肥手术有许多有益的效果，绝对VO 2峰值并没有改善，体重减轻引起的LM减少与肌肉有氧能力的改变有关，如早期VT触发早期运动过度通气所反映的。
Introduction: Patients undergoing weight loss surgery do not improve their aerobic capacity or peak oxygen uptake (VO2peak) after bariatric surgery and some still complain about asthenia and/or breathlessness. We investigated the hypothesis that a post-surgery muscular limitation could impact the ventilatory response to exercise by evaluating the post-surgery changes in muscle mass, strength, and muscular aerobic capacity, measured by the first ventilatory threshold (VT). Methods: Thirteen patients with obesity were referred to our university exercise laboratory before and 6 months after bariatric surgery and were matched by sex, age, and height to healthy subjects with normal weight. All subjects underwent a clinical examination, blood sampling, and body composition assessment by dual-energy X-ray absorptiometry, respiratory and limb muscle strength assessments, and cardiopulmonary exercise testing on a cyclo-ergometer. Results: Bariatric surgery resulted in a loss of 34% fat mass, 43% visceral adipose tissue, and 12% lean mass (LM) (p < 0.001). Absolute handgrip, quadriceps, or respiratory muscle strength remained unaffected, while quadriceps/handgrip strength relative to LM increased (p < 0.05). Absolute VO2peak or VO2peak/LM did not improve and the first VT was decreased after surgery (1.4 ± 0.3 vs. 1.1 ± 0.4 L min−1, p < 0.05) and correlated to the exercising LM (LM legs) (R = 0.84, p < 0.001). Conclusions: Although bariatric surgery has numerous beneficial effects, absolute VO2peak does not improve and the weight loss-induced LM reduction is associated to an altered muscular aerobic capacity, as reflected by an early VT triggering early exercise hyperventilation.