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运动干预后的胰岛素敏感性:健康成年人结局的系统评价和荟萃分析

Insulin Sensitivity Following Exercise Interventions: Systematic Review and Meta-Analysis of Outcomes Among Healthy Adults.

作者信息

Conn Vicki S, Koopman Richelle J, Ruppar Todd M, Phillips Lorraine J, Mehr David R, Hafdahl Adam R

机构信息

University of Missouri, Columbia, MO, USA

University of Missouri, Columbia, MO, USA.

出版信息

J Prim Care Community Health. 2014 Jul;5(3):211-22. doi: 10.1177/2150131913520328. Epub 2014 Jan 27.

Abstract

OBJECTIVE

Although exercise can improve insulin sensitivity, no adequate synthesis exists of exercise intervention studies with regard to their effect on insulin sensitivity. This comprehensive meta-analysis synthesized the insulin sensitivity outcomes of supervised exercise interventions.

METHOD

Extensive literature searching located published and unpublished intervention studies that measured insulin sensitivity outcomes. Eligible studies tested supervised exercise interventions among healthy adults. Primary study characteristics and results were coded. Random-effects meta-analyses of standardized mean differences included moderator analyses.

RESULTS

Data were synthesized across 2509 subjects (115 samples, 78 reports). The overall mean effect size for 2-group postintervention comparisons was 0.38 (95% confidence interval [CI] = 0.25-0.51, I (2) = 0%) and for 2-group pre-post comparisons was 0.43 (95% CI = 0.30-0.56, I (2) = 52%; higher mean insulin sensitivity for treatment than control subjects). The postintervention mean of 0.38 is consistent with treatment subjects ending studies with a mean fasting insulin of 6.8 mU/L if control participants' mean fasting insulin were 7.9 mU/L. Exploratory moderator analyses did not document different insulin sensitivity effect sizes across intervention characteristics or sample attributes.

CONCLUSION

This study documented that exercise is a valuable primary care and community health strategy for healthy adults to improve insulin sensitivity and lower the risk for diabetes conferred by insulin resistance.

摘要

目的

尽管运动可以提高胰岛素敏感性,但关于运动干预对胰岛素敏感性影响的研究尚无充分的综合分析。本项全面的荟萃分析综合了有监督运动干预对胰岛素敏感性的影响结果。

方法

通过广泛检索文献,查找已发表和未发表的测量胰岛素敏感性结果的干预性研究。符合条件的研究对健康成年人进行了有监督的运动干预测试。对主要研究特征和结果进行编码。对标准化均数差进行随机效应荟萃分析,包括调节因素分析。

结果

对2509名受试者(115个样本,78篇报告)的数据进行了综合分析。两组干预后比较的总体平均效应量为0.38(95%置信区间[CI]=0.25 - 0.51,I²=0%),两组干预前后比较的总体平均效应量为0.43(95%CI = 0.30 - 0.56,I²=52%;治疗组的胰岛素敏感性均值高于对照组)。如果对照组参与者的平均空腹胰岛素水平为7.9 mU/L,干预后的平均效应量0.38与治疗组受试者结束研究时的平均空腹胰岛素水平为6.8 mU/L一致。探索性调节因素分析未发现不同干预特征或样本属性的胰岛素敏感性效应量存在差异。

结论

本研究表明,运动是健康成年人提高胰岛素敏感性和降低胰岛素抵抗所致糖尿病风险的一项有价值的初级保健和社区健康策略。

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