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Objective <p>Although exercise training is known to benefit cardiovascular health, its specific effects on cardiovascular parameters in patients after Metabolic and bariatric surgery remain unclear. This study aimed to synthesize the latest evidence through a systematic review and meta-analysis to evaluate the effectiveness of long-term exercise interventions (≥ 12 weeks) in improving cardiovascular health outcomes in postoperative patients, thereby providing a scientific basis for clinical rehabilitation.</p> Methods <p>Up to July 26, 2025, we systematically searched PubMed, Web of Science, EMBASE, Scopus, and the Cochrane Central Register of Controlled Trials for relevant randomized controlled trials (RCTs). The evaluated outcomes included body weight, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL), low-density lipoprotein (LDL), heart rate (HR), fat mass, lean mass, VO₂max/peak relative to body weight, and fasting insulin.</p> Results <p>A total of 17 studies involving 855 postoperative MBS patients were included. The interventions started at different postoperative time points, ranging from immediately after surgery to 12 months post-MBS.The duration of the intervention also varies, with the shortest being 12 weeks and the longest 52 weeks. The findings indicated that long-term exercise interventions significantly improved HDL (95% CI: 2.05 to 6.43, <i>P</i> = 0.0001); VO₂max/peak relative to body weight (95% CI: 1.91 to 5.68, <i>P</i> &lt; 0.00001), and was associated with a decrease in HR (95% CI: -11.70 to 0.04, <i>P</i> = 0.05, However, other metabolic indicators such as LDL, fat mass, lean mass, fasting insulin, and blood pressure did not reach statistical significance (LDL: MD = 3.60, 95% CI: -2.87 to 10.08, <i>P</i> = 0.28; fat mass: MD=-0.23, 95% CI: -1.75 to 1.28, <i>P</i> = 0.76; lean mass: MD=-0.12, 95% CI: -1.86 to 1.61, <i>P</i> = 0.89; fasting insulin: MD=-1.10, 95% CI: -2.30 to 0.10, <i>P</i> = 0.07; SBP: MD=-1.25, 95% CI: -4.01 to 1.51, <i>P</i> = 0.37; DBP: MD=-0.48, 95% CI: -2.39 to 1.42, <i>P</i> = 0.62).</p> Conclusion <p>Long-term exercise interventions demonstrate selective metabolic benefits in patients after bariatric surgery, with core advantages observed in enhanced cardiopulmonary function and HDL modulation. A non-significant trend toward lower insulin levels was observed, suggesting that exercise may be associated with favorable metabolic regulation; however, this finding should be interpreted cautiously and requires confirmation in adequately powered, dose–response studies with stratified intervention designs.</p>

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The Effects of Long-Term Exercise Intervention on Cardiovascular Health Outcomes in Patients after Metabolic and Bariatric Surgery: a Systematic Review and Meta-Analysis

  • 期刊论文

  • 发表日期：

    2026年3月27日

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  • Bingjie Zhai,
  • Qinzheng Liu,
  • Ni Dong,
  • Jun Xie

摘要

Objective

Although exercise training is known to benefit cardiovascular health, its specific effects on cardiovascular parameters in patients after Metabolic and bariatric surgery remain unclear. This study aimed to synthesize the latest evidence through a systematic review and meta-analysis to evaluate the effectiveness of long-term exercise interventions (≥ 12 weeks) in improving cardiovascular health outcomes in postoperative patients, thereby providing a scientific basis for clinical rehabilitation.

Methods

Up to July 26, 2025, we systematically searched PubMed, Web of Science, EMBASE, Scopus, and the Cochrane Central Register of Controlled Trials for relevant randomized controlled trials (RCTs). The evaluated outcomes included body weight, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein (HDL), low-density lipoprotein (LDL), heart rate (HR), fat mass, lean mass, VO₂max/peak relative to body weight, and fasting insulin.

Results

A total of 17 studies involving 855 postoperative MBS patients were included. The interventions started at different postoperative time points, ranging from immediately after surgery to 12 months post-MBS.The duration of the intervention also varies, with the shortest being 12 weeks and the longest 52 weeks. The findings indicated that long-term exercise interventions significantly improved HDL (95% CI: 2.05 to 6.43, P = 0.0001); VO₂max/peak relative to body weight (95% CI: 1.91 to 5.68, P < 0.00001), and was associated with a decrease in HR (95% CI: -11.70 to 0.04, P = 0.05, However, other metabolic indicators such as LDL, fat mass, lean mass, fasting insulin, and blood pressure did not reach statistical significance (LDL: MD = 3.60, 95% CI: -2.87 to 10.08, P = 0.28; fat mass: MD=-0.23, 95% CI: -1.75 to 1.28, P = 0.76; lean mass: MD=-0.12, 95% CI: -1.86 to 1.61, P = 0.89; fasting insulin: MD=-1.10, 95% CI: -2.30 to 0.10, P = 0.07; SBP: MD=-1.25, 95% CI: -4.01 to 1.51, P = 0.37; DBP: MD=-0.48, 95% CI: -2.39 to 1.42, P = 0.62).

Conclusion

Long-term exercise interventions demonstrate selective metabolic benefits in patients after bariatric surgery, with core advantages observed in enhanced cardiopulmonary function and HDL modulation. A non-significant trend toward lower insulin levels was observed, suggesting that exercise may be associated with favorable metabolic regulation; however, this finding should be interpreted cautiously and requires confirmation in adequately powered, dose–response studies with stratified intervention designs.