A multidimensional analysis of the longitudinal effects of roux en y gastric bypass on fatigue: An association with visceral obesity
A multidimensional analysis of the longitudinal effects of roux en y gastric bypass on fatigue: An association with visceral obesity
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DOI：
10.1016/j.physbeh.2019.112612
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发表时间：
2019-10-01
影响因子：
2.9
通讯作者：
Musselman, Dominique
中科院分区：
文献类型：
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作者：
Gletsu-Miller, Nana;Shevni, Neeta;Musselman, Dominique
背景和目的：严重肥胖与疲劳有关，然而，减肥手术后体重减轻对疲劳的特定维度的影响尚不清楚。在对接受Roux-en-y胃分流术(RYGB)的女性进行的前瞻性队列研究的二次分析中，我们探索了疲劳的多个维度与改善肥胖、胰岛素抵抗和炎症的关系。方法：在RYBG前、术后1个月和6个月，使用经过验证的自我报告的多维度疲劳量表评估疲劳维度。采用排气量描记、计算机体层摄影、糖耐量试验和酶联免疫分析等方法，测定肥胖患者的总肥胖度、腹部内脏脂肪(VAT)和皮下脂肪(SAT)，胰岛素敏感性(SI)和胰岛素抵抗指数(HOMA)，以及血浆瘦素、C反应蛋白(CRP)和白细胞介素6(IL-6)浓度。结果：在基线时，大多数女性参与者(N=19，体重指数，46.5 kg/m(2)，年龄37.2岁)都经历了更高水平的疲劳。6个月后，体力(-43%)、活动减少(-43%)、动力减少(-38%)、一般(-31%；所有P<；.005)和精神(-18%，p<；.05)疲劳感改善，同时肥胖、炎症和胰岛素抵抗的标记物减少。增值税的降低与精神疲劳的改善有关(Beta，0.447+/-0.203，p=0.045)，与其他肥胖指标、IL-6浓度或Si值无关。结论：在RYGB治疗后的6个月内，疲劳改善，尤其是体力疲劳。精神疲劳的减少与内脏肥胖症的减少密切相关。然而，这些特定疲劳维度变化背后的生物机制仍然不确定。
Background and objectives: Severe obesity is associated with fatigue, however, the effects of weight loss after bariatric surgery on particular dimensions of fatigue are unknown. In a secondary analysis of a prospective cohort study of women undergoing roux-en-y gastric bypass (RYGB) we explored relationships among multiple dimensions of fatigue and improving adiposity, insulin resistance and inflammationMethods: Before, and 1 and 6 months after RYBG, dimensions of fatigue were assessed using the validated, self-report, Multidimensional Fatigue Inventory. Total, abdominal visceral (VAT) and subcutaneous (SAT) adiposity, insulin sensitivity (Si and HOMA) and plasma concentrations of leptin, C-reactive protein (CRP) and interleukin-6 (Il-6) were measured using air displacement plethysmography, computed tomography, glucose tolerance testing and enzyme-linked immnunoassay. Associations were assessed using Spearman correlations and linear regression.Results: At baseline, the majority of our female participants (N = 19, body mass index, 46.5 kg/m(2), age 37.2 years) were experiencing elevated levels of fatigue. By 6 months, dimensions of physical (-43%), reduced activity ( -43%), reduced motivation (-38%), general (-31%; all p < .005), and mental (-18%, p < .05) fatigue improved, concomitant with decreases in markers of adiposity, inflammation and insulin resistance. The decrease in VAT was associated with improvement in mental fatigue (beta, 0.447 +/- 0.203, p = .045), independent of other indices of adiposity, IL-6 concentrations, or Si.Conclusions: In the 6 months after RYGB, fatigue improved, especially physical fatigue. Decreases in mental fatigue were strongly associated with decreases in visceral adiposity. Nevertheless, the biologic mechanisms underlying changes in these specific fatigue dimensions remain undetermined.