超重和肥胖儿童及青少年的运动与BMI z评分：随机试验的系统评价和网状Meta分析
Exercise and BMI z-score in Overweight and Obese Children and Adolescents: A Systematic Review and Network Meta-Analysis of Randomized Trials.
作者信息
Kelley George A, Kelley Kristi S, Pate Russell R
机构信息
Department of Biostatistics, West Virginia University, Morgantown, West Virginia, United States.
Exercise Science, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States.
出版信息
J Evid Based Med. 2017 May;10(2):108-128. doi: 10.1111/jebm.12228.
AIM
Examine the effects of selected types of exercise (aerobic, strength training, both) on BMI z-score in overweight and obese children and adolescents.
METHODS
Randomized exercise intervention trials ≥ 4 weeks were included. Studies were retrieved by searching six electronic databases, cross-referencing and expert review. Dual selection and abstraction occurred. Risk of bias and confidence in cumulative evidence were assessed. Network meta-analysis was performed using multivariate random-effects meta-regression models while surface under the cumulative ranking curves were used to calculate a hierarchy of exercise treatments. The number needed to treat (NNT) and percentile improvement (U ) were also calculated.
RESULTS
Thirty-four studies representing 2,239 participants were included. Median exercise occurred 3 times per week, 50 minutes per session over a 12-week period. Statistically significant reductions in BMI z-score were found for aerobic exercise and combined aerobic and strength exercise, but not strength training alone (M±SD, 95% CI: aerobic, -0.10, -0.15 to -0.05; aerobic and strength, -0.11, -0.19 to -0.03; strength, 0.04, -0.07 to 0.15). Combined aerobic and strength training was ranked best, followed by aerobic exercise and strength training. The NNT was 2 for both aerobic exercise and combined aerobic exercise and strength training. Percentile improvements were 28.8% for aerobic exercise and 31.5% for combined aerobic exercise and strength training. Confidence in effect estimates was ranked as low for aerobic exercise and very low for combined aerobic and strength training as well as strength training.
CONCLUSIONS
Aerobic exercise and combined aerobic exercise and strength training are associated with reductions in BMI z-score.
目的
研究特定类型的运动（有氧运动、力量训练、两者结合）对超重和肥胖儿童及青少年体重指数（BMI）z评分的影响。
方法
纳入持续时间≥4周的随机运动干预试验。通过检索六个电子数据库、交叉引用和专家评审来获取研究。进行双重筛选和提取。评估偏倚风险和累积证据的可信度。使用多变量随机效应荟萃回归模型进行网络荟萃分析，同时使用累积排名曲线下的面积来计算运动治疗的等级。还计算了治疗所需人数（NNT）和百分位数改善情况（U）。
结果
纳入了34项研究，共2239名参与者。运动中位数为每周3次，每次50分钟，为期12周。有氧运动以及有氧运动与力量训练相结合可使BMI z评分有统计学意义的降低，但单独的力量训练则无此效果（均值±标准差，95%置信区间：有氧运动，-0.10，-0.15至-0.05；有氧运动与力量训练相结合，-0.11，-0.19至-0.03；力量训练，0.04，-0.07至0.15）。有氧运动与力量训练相结合排名最佳，其次是有氧运动和力量训练。有氧运动以及有氧运动与力量训练相结合的NNT均为2。有氧运动的百分位数改善为28.8%，有氧运动与力量训练相结合的百分位数改善为31.5%。有氧运动效果估计的可信度为低，有氧运动与力量训练相结合以及力量训练的可信度为极低。
结论
有氧运动以及有氧运动与力量训练相结合与BMI z评分降低有关。
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