Snowling Neil J, Hopkins Will G
Division of Sport and Recreation, Auckland University of Technology, Private Bag 92006, Auckland, New Zealand.
Diabetes Care. 2006 Nov;29(11):2518-27. doi: 10.2337/dc06-1317.
We sought to meta-analyze the effects of different modes of exercise training on measures of glucose control and other risk factors for complications of diabetes.
The 27 qualifying studies were controlled trials providing, for each measure, 4-18 estimates for the effect of aerobic training, 2-7 for resistance training, and 1-5 for combined training, with 1,003 type 2 diabetic patients (age 55 +/- 7 years [mean +/- between-study SD]) over 5-104 weeks. The meta-analytic mixed model included main-effect covariates to control for between-study differences in disease severity, sex, total training time, training intensity, and dietary cointervention (13 studies). To interpret magnitudes, effects were standardized after meta-analysis using composite baseline between-subject SD.
Differences among the effects of aerobic, resistance, and combined training on HbA(1c) (A1C) were trivial; for training lasting >/=12 weeks, the overall effect was a small beneficial reduction (A1C 0.8 +/- 0.3% [mean +/- 90% confidence limit]). There were generally small to moderate benefits for other measures of glucose control. For other risk factors, there were either small benefits or effects were trivial or unclear, although combined training was generally superior to aerobic and resistance training. Effects of covariates were generally trivial or unclear, but there were small additional benefits of exercise on glucose control with increased disease severity.
All forms of exercise training produce small benefits in the main measure of glucose control: A1C. The effects are similar to those of dietary, drug, and insulin treatments. The clinical importance of combining these treatments needs further research.
我们试图对不同运动训练模式对血糖控制指标及糖尿病并发症其他危险因素的影响进行荟萃分析。
27项符合条件的研究为对照试验，针对每项指标，有氧训练效果有4 - 18项估计值，抗阻训练有2 - 7项，联合训练有1 - 5项，涉及1003例2型糖尿病患者（年龄55±7岁[均值±研究间标准差]），训练时间为5 - 104周。荟萃分析混合模型纳入主效应协变量，以控制研究间在疾病严重程度、性别、总训练时间、训练强度和饮食协同干预方面的差异（13项研究）。为解释效应大小，在荟萃分析后使用受试者间综合基线标准差对效应进行标准化。
有氧训练、抗阻训练和联合训练对糖化血红蛋白（HbA1c）（A1C）的影响差异微不足道；对于持续≥12周的训练，总体效应是糖化血红蛋白有小幅有益降低（A1C降低0.8±0.3%[均值±90%置信区间]）。对其他血糖控制指标通常有小到中度的益处。对于其他危险因素，要么有小的益处，要么效应微不足道或不明确，不过联合训练总体上优于有氧训练和抗阻训练。协变量的效应通常微不足道或不明确，但随着疾病严重程度增加，运动对血糖控制有小的额外益处。
所有形式的运动训练在血糖控制的主要指标糖化血红蛋白（A1C）方面都产生了小的益处。这些效应与饮食、药物和胰岛素治疗的效应相似。联合这些治疗的临床重要性需要进一步研究。
