Effects of bariatric surgery on inspiratory muscle strength

Pouwels, Sjaak; Kools-Aarts, Marieke; Said, M.; Teijink, Joep A.W.; Smeenk, Frank W.J.M.; Nienhuijs, Simon W.

doi:10.1186/s40064-015-1088-2

Cited by 9 publications

(6 citation statements)

References 35 publications

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“…The present results show no difference in MIP and MEP between the pre- and post-surgery conditions and compared to healthy subjects with normal weight. Previous studies showed conflicting results with either unchanged [28], increased [29], or reduced [30] respiratory muscle strength 6 months after bariatric surgery. Type II errors, male/female equilibrium, initial BMI, FM distribution, and loss may account for discrepancies between studies.…”

Section: Discussionmentioning

confidence: 99%

Lean Mass Loss and Altered Muscular Aerobic Capacity after Bariatric Surgery

Zhou¹,

Scoubeau²,

Forton³

et al. 2022

Obes Facts

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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.

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Section: Discussionmentioning

confidence: 99%

Lean Mass Loss and Altered Muscular Aerobic Capacity after Bariatric Surgery

Zhou¹,

Scoubeau²,

Forton³

et al. 2022

Obes Facts

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“…No significant differences between both groups (standard and additional supplementation) were found which suggests that different cholecalciferol supplementation regimen seem to have a little impact on the outcomes. Multiple studies have shown that the SWRT is a reliable indicator for the assessment of cardiopulmonary fitness [19,20,21,22]. The study of Goncalves et al [20] showed that female gender, older age and lower heart rate before the test are the determinants of not reaching maximal effort.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Physical Fitness after Bariatric Surgery and Its Association with Protein Intake and Type of Cholecalciferol Supplementation

et al. 2019

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: Background: Several studies showed that there is a relationship between vitamin and mineral status and muscle strength. In particular this is the case for handgrip strength (HS) and vitamin D deficiency. In bariatric surgery there is a risk of decrease in muscle strength after surgery and also vitamin and mineral deficiencies are not uncommon. The aim of this study is to assess the effect of low vitamin 25 (OH) cholecalciferol levels, high dose cholecalciferol supplementation regime and protein intake on physical fitness, measured using handgrip strength (HS) and the shuttle walk run test (SWRT). Methods: For this retrospective study, 100 patients who have had bariatric surgery were included. Group A (n = 50) used 800 IU oral cholecalciferol per day. Group B (n = 50) used 800 IU oral cholecalciferol daily and 50,000 IU liquid cholecalciferol monthly lifelong. Both groups were matched on common variables. To measure physical fitness, we used the HS manometer of Jamar and the Shuttle Walk Run Test (SWRT) to assess physical capacity. Results: No significant differences in HS and SWRT outcomes were found between patients with serum 25 (OH) cholecalciferol < 75 nmol/L or >75 nmol/L. The postoperative HS is significantly influenced by protein intake (p = 0.017) and no significant influence was seen in outcomes of the SWRT (p = 0.447). Conclusion: We have found that serum 25 (OH) cholecalciferol and different cholecalciferol supplementation regimes do not have a significant effect on HS and SWRT before, three and 6 months after surgery. It seems that protein intake plays a more important role in maintaining adequate muscle strength.

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“…12,13 Researchers have reported impaired maximal inspiratory pressure, a clinical marker of inspiratory (diaphragm) muscle strength, in individuals with obesity. [14][15][16][17][18][19] This finding suggests that diaphragm weakness may be a relevant therapeutic target for attenuating dyspnea and improving exercise capacity in this patient population. Preliminary data show improvements in exercise performance and tolerance when individuals with obesity undergo respiratory muscle unloading 20 or training.…”

Section: Introductionmentioning

confidence: 91%

Cardiac and respiratory muscle responses to dietary N-acetylcysteine in rats consuming a high-saturated fat, high-sucrose diet

Hahn

et al. 2021

Preprint

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BACKGROUND: Exertional dyspnea is a significant clinical concern in individuals with overweight or obesity. The pathophysiology of dyspnea is multifactorial and complex. Previous data suggest that diaphragm and cardiac abnormalities should be considered as likely contributors to obesity-related exertional dyspnea. Additionally, oxidative stress is a causative factor in the general etiology of obesity as well as skeletal and cardiac muscle pathology. Thus, this preclinical study aimed to define diaphragm and cardiac morphological and functional alterations following an obesogenic diet in rats and the therapeutic potential of an antioxidant supplement, N-acetylcysteine (NAC). METHODS: Male Wistar rats (~7 weeks old) consumed ad libitum either lean (20% protein, 70% carbohydrate, 10% fat) or high-saturated fat, high-sucrose (HFHS, 20% protein, 35% carbohydrate, 45% fat) diets for ~22 weeks. Rats receiving HFHS diet were randomized to drink control water or water with NAC (2 mg/ml) for the last eight weeks of the dietary intervention: Lean, HFHS, and HFHS+NAC (n = 8 per group). We evaluated diaphragm bundles (in vitro function and histology) and hearts (weights and echocardiography) for all groups. RESULTS: Final body weights of HFHS rats, but not HFHS+NAC rats, were significantly higher than Lean controls. Neither HFHS diet nor NAC supplementation affected diaphragm specific force (N/cm2), peak power (W/kg), or morphology. In cardiac muscle, right and left ventricle weights (normalized to tibia length) of HFHS rats were greater than those of Lean controls and HFHS+NAC rats. Cardiac functional abnormalities were also present in HFHS rats, with left ventricular fractional shortening (%) and posterior wall maximal shortening velocity (cm/s) increasing compared to Lean controls, but HFHS+NAC rats did not demonstrate these markers of hypercontractility. HFHS rats showed an elevated deceleration rate of early transmitral diastolic velocity (E/DT) consistent with diastolic dysfunction, but NAC eliminated this effect. CONCLUSION: Our data suggest that an HFHS diet does not compromise diaphragm muscle morphology or in vitro function, suggesting other possible contributors to breathing abnormalities in obesity (e.g., neuromuscular transmission abnormalities). However, an HFHS diet resulted in cardiac hypertrophy, hypercontractility, and diastolic dysfunction. Supplementation with NAC did not affect diaphragm morphology or function but attenuated cardiac abnormalities in the HFHS diet. Our findings support future studies testing NAC supplementation in clinical trials of humans with obesity.

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Effects of bariatric surgery on inspiratory muscle strength

Cited by 9 publications

References 35 publications

Lean Mass Loss and Altered Muscular Aerobic Capacity after Bariatric Surgery

Lean Mass Loss and Altered Muscular Aerobic Capacity after Bariatric Surgery

Assessment of Physical Fitness after Bariatric Surgery and Its Association with Protein Intake and Type of Cholecalciferol Supplementation

Cardiac and respiratory muscle responses to dietary N-acetylcysteine in rats consuming a high-saturated fat, high-sucrose diet

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