Abstract
Objective: We aimed to compare the effect of Roux-en-Y gastric bypass surgery (RYGBP) with intensive lifestyle intervention (ILI) on blood gases and lung function in morbidly obese subjects.
Design: One year non-randomized controlled clinical trial (ClinicalTrials.gov identifier NCT00273104).
Methods: 139 morbidly obese subjects, (103 women); mean (SD) age 44 (11) years, mean (SD) body mass index 45.1 (5.6) kg/m2, mean (SD) weight 131.8 (21.2) kg treated with either RYGBP (n=76) or ILI (n=63), were included. Blood gases and lung function tests were registered before and after treatment.
Results: Mean (SD) 1-year weight loss was 30 (8)% and 8 (9)%, and mean pO2 increased 1.4 (1.5) kPa and 0.8 (1.5) kPa in the RYGBP- and ILI-group, respectively (all P<0.001). Mean pCO2 decreased by 0.16 (0.4) kPa in the ILI-group (P=0.005), and 0.04 (0.5) kPa in the RYGBP-group (P=0.511).
Mean ERV increased from 44 (32)% to 89 (39)% of predicted value (P<0.001) in the RYGBP-group, while there was no significant change in the ILI- group. We also found significantly improved mean values for FVC, FEV1, DLCO/VA, TLC, IC and RV in the RYGB group (all P<0.001, data not shown). In the lifestyle group there were significant changes in mean TLC and RV (P<0.001), DLCO/VA (P=0.010) and FVC (P=0.049).There were no significant changes in mean DLCO in either group.
There were significant between-group changes for mean FVC, FEV1, DLCO/VA, IC and ERV (all P<0.001), TLC (P=0.007) and pO2 (P=0.032).
Conclusion: Blood gases and lung function improved in both treatment groups. However, the greatest effects were in the RYGP group.
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