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在中老年肥胖患者中,训练干预可降低瘦素水平:一项荟萃分析。

In middle-aged and old obese patients, training intervention reduces leptin level: A meta-analysis.

作者信息

Rostás Ildikó, Pótó László, Mátrai Péter, Hegyi Péter, Tenk Judit, Garami András, Illés Anita, Solymár Margit, Pétervári Erika, Szűcs Ákos, Párniczky Andrea, Pécsi Dániel, Rumbus Zoltán, Zsiborás Csaba, Füredi Nóra, Balaskó Márta

机构信息

Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary.

Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary.

出版信息

PLoS One. 2017 Aug 15;12(8):e0182801. doi: 10.1371/journal.pone.0182801. eCollection 2017.

Abstract

BACKGROUND

Leptin is one of the major adipokines in obesity that indicates the severity of fat accumulation. It is also an important etiological factor of consequent cardiometabolic and autoimmune disorders. Aging has been demonstrated to aggravate obesity and to induce leptin resistance and hyperleptinemia. Hyperleptinemia, on the other hand, may promote the development of age-related abnormalities. While major weight loss has been demonstrated to ameliorate hyperleptinemia, obese people show a poor tendency to achieve lasting success in this field. The question arises whether training intervention per se is able to reduce the level of this adipokine.

OBJECTIVES

We aimed to review the literature on the effects of training intervention on peripheral leptin level in obesity during aging, in order to evaluate the independent efficacy of this method. In the studies that were included in our analysis, changes of adiponectin levels (when present) were also evaluated.

DATA SOURCES

3481 records were identified through searching of PubMed, Embase and Cochrane Library Database. Altogether 19 articles were suitable for analyses.

STUDY ELIGIBILITY CRITERIA

Empirical research papers were eligible provided that they reported data of middle-aged or older (above 45 years of age) overweight or obese (body mass index above 25) individuals and included physical training intervention or at least fitness status of groups together with corresponding blood leptin values.

STATISTICAL METHODS

We used random effect models in each of the meta-analyses calculating with the DerSimonian and Laird weighting methods. I-squared indicator and Q test were performed to assess heterogeneity. To assess publication bias Egger's test was applied. In case of significant publication bias, the Duval and Tweedie's trim and fill algorithm was used.

RESULTS

Training intervention leads to a decrease in leptin level of middle-aged or older, overweight or obese male and female groups, even without major weight loss, indicated by unchanged serum adiponectin levels. Resistance training appears to be more efficient in reducing blood leptin level than aerobic training alone.

CONCLUSIONS

Physical training, especially resistance training successfully reduces hyperleptinemia even without diet or major weight loss.

摘要

背景

瘦素是肥胖症中的主要脂肪因子之一,可指示脂肪堆积的严重程度。它也是后续发生心脏代谢和自身免疫性疾病的重要病因。衰老已被证明会加重肥胖,并诱导瘦素抵抗和高瘦素血症。另一方面,高瘦素血症可能会促进与年龄相关的异常情况的发展。虽然已证明大幅减重可改善高瘦素血症,但肥胖者在这方面取得持久成功的倾向较差。问题在于训练干预本身是否能够降低这种脂肪因子的水平。

目的

我们旨在综述有关训练干预对衰老过程中肥胖症患者外周瘦素水平影响的文献,以评估该方法的独立疗效。在我们分析纳入的研究中,还评估了脂联素水平(如有)的变化。

数据来源

通过检索PubMed、Embase和Cochrane图书馆数据库,共识别出3481条记录。总共19篇文章适合进行分析。

研究入选标准

实证研究论文符合条件,前提是它们报告了中年或老年(45岁以上)超重或肥胖(体重指数高于25)个体的数据,并包括体育训练干预或至少各群体的健康状况以及相应的血液瘦素值。

统计方法

我们在每个荟萃分析中使用随机效应模型,采用DerSimonian和Laird加权方法进行计算。进行I²指标和Q检验以评估异质性。应用Egger检验评估发表偏倚。如果存在显著的发表偏倚,则使用Duval和Tweedie的修剪和填充算法。

结果

训练干预导致中年或老年超重或肥胖男性和女性群体的瘦素水平降低,即使没有大幅减重,血清脂联素水平未变也表明了这一点。抗阻训练在降低血液瘦素水平方面似乎比单纯的有氧训练更有效。

结论

体育训练,尤其是抗阻训练,即使不节食或大幅减重也能成功降低高瘦素血症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/23bf/5557366/83aaeee9b567/pone.0182801.g001.jpg

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