运动训练对代谢综合征患者临床结局的影响：系统评价和荟萃分析。

The effect of exercise training on clinical outcomes in patients with the metabolic syndrome: a systematic review and meta-analysis.

机构信息

School of Rural Medicine, University of New England, Armidale, NSW, 2351, Australia.

School of Science and Technology, University of New England, Armidale, NSW, 2351, Australia.

出版信息

Cardiovasc Diabetol. 2017 Aug 30;16(1):110. doi: 10.1186/s12933-017-0590-y.

DOI:10.1186/s12933-017-0590-y

PMID:28854979

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5577843/

Abstract

BACKGROUND

Purpose: to establish if exercise training improves clinical outcomes in people with metabolic syndrome (MetS). Registered with PROSPERO international prospective register of systematic reviews ( https://www.crd.york.ac.uk/PROSPERO/Identifier:CRD42017055491 ).

DATA SOURCES

studies were identified through a MEDLINE search strategy (1985 to Jan 12, 2017), Cochrane controlled trials registry, CINAHL and SPORTDiscus.

STUDY SELECTION

prospective randomized or controlled trials of exercise training in humans with metabolic syndrome, lasting 12 weeks or more.

RESULTS

We included 16 studies with 23 intervention groups; 77,000 patient-hours of exercise training. In analyses of aerobic exercise studies versus control: body mass index was significantly reduced, mean difference (MD) -0.29 (kg m) (95% CI -0.44, -0.15, p < 0.0001); body mass was significantly reduced, MD -1.16 kg (95% CI -1.83, -0.48, p = 0.0008); waist circumference was significantly reduced MD -1.37 cm (95% CI -2.02, -0.71, p < 0.0001), peak VO was significantly improved MD 3.00 mL kg min (95% CI 1.92, 4.08, p < 0.000001); systolic blood pressure and diastolic blood pressure were significantly reduced, MD -2.54 mmHg (95% CI -4.34, -0.75, p = 0.006), and, MD -2.27 mmHg (95% CI -3.47, -1.06, p = 0.0002) respectively; fasting blood glucose was significantly reduced MD -0.16 mmol L (95% CI -0.32, -0.01, p = 0.04); triglycerides were significantly reduced MD -0.21 mmol L (95% CI -0.29, -0.13, p < 0.00001); and low density lipoprotein was significantly reduced MD -0.03 mmol L (95% CI -0.05, -0.00, p = 0.02). In analyses of combined exercise versus control: waist circumference, MD -3.80 cm (95% CI -5.65, -1.95, p < 0.0001); peak VO MD 4.64 mL kg min (95% CI 2.42, 6.87, p < 0.0001); systolic blood pressure MD -3.79 mmHg (95% CI -6.18, -1.40, p = 0.002); and high density lipoprotein (HDL) MD 0.14 (95% CI 0.04, 0.25, p = 0.009) were all significantly improved. We found no significant differences between outcome measures between the two exercise interventions.

CONCLUSIONS

Exercise training improves body composition, cardiovascular, and, metabolic outcomes in people with metabolic syndrome. For some outcome measures, isolated aerobic exercise appears optimal.

摘要

背景

目的：确定运动训练是否能改善代谢综合征（MetS）患者的临床结局。在 PROSPERO 国际前瞻性系统评价注册中心（https://www.crd.york.ac.uk/PROSPERO/标识符：CRD42017055491）注册。

数据来源

通过 MEDLINE 搜索策略（1985 年至 2017 年 1 月 12 日）、Cochrane 对照试验注册库、CINAHL 和 SPORTDiscus 检索确定研究。

研究选择

在代谢综合征患者中进行的持续 12 周或以上的运动训练的前瞻性随机或对照试验。

结果

我们纳入了 16 项研究，共 23 个干预组；共有 77000 小时的运动训练。在有氧运动研究与对照组的分析中：体重指数显著降低，平均差值（MD）为-0.29（kg·m）（95%置信区间-0.44，-0.15，p<0.0001）；体重显著降低，MD 值为-1.16kg（95%置信区间-1.83，-0.48，p=0.0008）；腰围显著减小，MD 值为-1.37cm（95%置信区间-2.02，-0.71，p<0.0001）；峰值 VO 显著提高，MD 值为 3.00mL·kg·min（95%置信区间 1.92，4.08，p<0.000001）；收缩压和舒张压均显著降低，MD 值分别为-2.54mmHg（95%置信区间-4.34，-0.75，p=0.006）和-2.27mmHg（95%置信区间-3.47，-1.06，p=0.0002）；空腹血糖显著降低，MD 值为-0.16mmol·L（95%置信区间-0.32，-0.01，p=0.04）；甘油三酯显著降低，MD 值为-0.21mmol·L（95%置信区间-0.29，-0.13，p<0.00001）；低密度脂蛋白显著降低，MD 值为-0.03mmol·L（95%置信区间-0.05，-0.00，p=0.02）。在联合运动与对照组的分析中：腰围，MD 值为-3.80cm（95%置信区间-5.65，-1.95，p<0.0001）；峰值 VO MD 值为 4.64mL·kg·min（95%置信区间 2.42，6.87，p<0.0001）；收缩压 MD 值为-3.79mmHg（95%置信区间-6.18，-1.40，p=0.002）；高密度脂蛋白（HDL）MD 值为 0.14（95%置信区间 0.04，0.25，p=0.009）均显著提高。我们没有发现两种运动干预之间的结果测量值之间存在显著差异。