Purpose
This study was undertaken to investigate cardiorespiratory fitness and its correlation with preoperative evaluations, including body composition parameters, cardiorespiratory responses, laboratory findings, co-morbidities, and self-reported questionnaires in patients with morbid obesity scheduled for laparoscopic sleeve gastrectomy.
Materials and Methods
In this retrospective cross-sectional study, we assessed a total of 38 patients (13 males and 25 females, average age 34.9±10.9) who were waiting for laparoscopic sleeve gastrectomy. All participants conducted a symptom-limited cardiopulmonary exercise stress test. Measured cardiopulmonary responses included peak values of oxygen consumption (VO2), metabolic equivalents (METs), respiratory exchange ratio (RER), heart rate (HR), rate pressure product (RPP), age-predicted HR percentage and age-predicted VO2. Besides, body composition variables using bioimpedance analysis, laboratory findings such as hemoglobin A1c, lipid-profile and inflammatory markers, and co-morbidities such as hypertension, diabetes mellitus, dyslipidemia, chronic musculoskeletal pain, and metabolic syndrome were analyzed.
Twenty-two of 38 patients completed self-reported questionnaires, including Beck-Depression-Inventory (BDI), Hamilton Depression Rating Scale (HDRS), Short-Form Health Survey (SF-36), and McMaster Asthma Quality of Life (MAQOL).
Results
The average Body-Mass-Index (BMI) and body fat percentage were 39.8±5.7 〖kg∙m〗^(-2) and 46.2±6.1 %, respectively. In the cardiorespiratory responses, 〖VO〗_(2,peak), ME〖Ts〗_peak, 〖RER〗_peak, 〖HR〗_peak, 〖RPP〗_peak, age-predicted HR and 〖VO〗_(2,max) percentages were 18.6±3.8 〖mL∙min〗^(-1)∙kg^(-1), 5.3±1.1, 1.1±0.1 min^(-1), 32414.4±6695.8 〖mm∙Hg〗^(-1) 〖∙min〗^(-1), 85.2±8.8 % and 76.1±14.8 %, respectively.
The simple linear regression analysis revealed that BMI (p = 0.026), body fat percentage (p = 0.001), 〖HR〗_peak (p = 0.018), 〖RPP〗_peak (p = 0.067), metabolic syndrome (p = 0.096), triglyceride (p = 0.065), Erythrocyte Sedimentation Rate (ESR) (p = 0.007), and the total scores of BDI (p = 0.043), HRDS (p = 0.025), SF-36 (p = 0.006) and MAQOL (p = 0.007) were significantly associated with the 〖VO〗_(2,peak),. The multiple linear regression analysis showed that body fat percentage (p <0.001) and the total score of SF-36 (p < 0.001) remained significantly.
Conclusion
We found the variable values of cardiorespiratory fitness in patients with morbid obesity waiting for the laparoscopic sleeve gastrectomy. Moreover, our study revealed that the peak aerobic exercise capacity was significantly associated with several pre-operative parameters such as body fat composition, self-reported quality of life in those patients. |
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Table 1. Demograhpic and disease-related characteristics of the subjects (n = 38) / 주석: Values are presented as mean±standard deviation or numbed (%). BMI, body mass index
Table 2. Pre-operative evaluation parameters and cardiopulmonary fitness indexes of the subjects (n = 38) / 주석 : Values are presented as mean±standard deviation or numbed (%). MET, metabolic equivalents; RER, respiratory exchange ratio; HR, heart rate; SBP, systolic blood pressure; DBP, diastolic blood pressure; RPP, rate pressure product; HDL-C, high density lipoprotein-cholesterol; LDL-C, low density lipoprotein-cholesterol; ESR, erythrocyte sediment rate; CRP, c-reactive protein; BDI, beck-depression-inventoy; HRDS, hamilton depression rating scale; SF-36, Short Form Health Survery; MAQOL, McMaster Asthma Quality of Life
Table 3. Simple linear regression analysis of pre-operative parameters with peak aerobic exercise capacity (VO2 peak) (n=22) / 주석: * denotes p < 0.15, ** denotes p < 0.05 B, Beta coefficient
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