Graduate Institute of Integration of Traditional Chinese Medicine with Western Nursing, National Taipei University of Nursing and Health Sciences, No. 365, Minte Road, Taipei, Taiwan, ROC..
Department of Nursing, National Taipei University of Nursing and Health Sciences, No. 365, Minte Road, Taipei, Taiwan, ROC..
Appl Nurs Res. 2018 Apr;40:90-98. doi: 10.1016/j.apnr.2017.12.011. Epub 2017 Dec 19.
Menopause has been considered as an aggravating factor for developing cardiovascular diseases and the metabolic syndromes for women. Exercise might be an effective intervention for reducing such threats.
The purpose of this study was to evaluate the exercise effects on body composition, cardiovascular risk factors, and bone mineral density of menopausal women.
Two reviewers did a complete search of five electronic database (Medline, PubMed, Cochrane Central Register of Controlled Trials, CINAHL, and the Chinese Electronic Periodical Service) records up to January 31, 2014. Randomized controlled trials (RCTs) that compared female menopausal participants with exercises, and those without exercise or with placebo were included. Risk of bias was classified based on the Cochrane Collaboration tool, the meta-analysis was conducted using Comprehensive Meta-Analysis Version 2.2. The study selection, data extraction, and validation were performed independently by the 2 reviewers.
A total of 17 RCTs with 792 participants were included for meta-analysis. Among the eight RCTs (247 participants), a moderate effect size of exercise on body fat was found (SMD=-0.34, 95% CI: -0.60 to -0.08). In five RCTs (195 participants), a moderate effect size of exercise on waist circumference (SMD=-0.39, 95% CI: -0.68 to -0.09), in seven RCTs (162 participants), a moderate effect size on triglyceride level (SMD=-0.37, 95% CI: -0.62 to -0.11), and in five RCTs (311 participants), a moderate effect size on bone mineral density (SMD=0.38, 95% CI: 0.08-0.68). Subgroup analysis revealed a significant effect of aerobic exercise on body fat (SMD=-0.29, 95% CI: -0.53 to -0.06), and a short-term exercise on body fat (SMD=-0.50, 95% CI: -0.89 to -0.11) and on triglycerides (SMD=-0.42, 95% CI: -0.79 to -0.04). The trials included in this meta-analysis were small and some had methodologic limitations.
This study provides evidences to clinical practice for menopause women that exercise, compared with nonexercise or placebo exerted significant benefits on body fat, waist circumference, triglyceride level, and lumbar spine bone mineral density. Particularly, aerobic exercise did help menopausal women improve their body fat. A short-term exercise intervention had a benefit on not only body fat but also triglyceride level. However, well-designed, well-executed RCTs, and a detailed long-term clinical research should be needed in the future.
绝经被认为是女性罹患心血管疾病和代谢综合征的一个加重因素。运动可能是一种降低这些威胁的有效干预措施。
本研究旨在评估运动对绝经后妇女身体成分、心血管风险因素和骨密度的影响。
两位审查员对截至 2014 年 1 月 31 日的五个电子数据库（医学文献在线数据库、PubMed、Cochrane 对照试验中心注册库、CINAHL 和中国电子期刊服务）的记录进行了全面检索。纳入了比较女性更年期参与者接受运动与不运动或安慰剂的随机对照试验（RCT）。基于 Cochrane 协作工具对偏倚风险进行分类，使用 Comprehensive Meta-Analysis Version 2.2 进行荟萃分析。研究选择、数据提取和验证由两位审查员独立进行。
共有 17 项 RCT 纳入 792 名参与者进行荟萃分析。在 8 项 RCT（247 名参与者）中，运动对体脂的影响有中等效应量（SMD=-0.34，95%CI：-0.60 至 -0.08）。在 5 项 RCT（195 名参与者）中，运动对腰围（SMD=-0.39，95%CI：-0.68 至 -0.09）有中等效应量，在 7 项 RCT（162 名参与者）中，运动对甘油三酯水平（SMD=-0.37，95%CI：-0.62 至 -0.11）有中等效应量，在 5 项 RCT（311 名参与者）中，运动对骨密度（SMD=0.38，95%CI：0.08-0.68）有中等效应量。亚组分析显示，有氧运动对体脂（SMD=-0.29，95%CI：-0.53 至 -0.06）和短期运动对体脂（SMD=-0.50，95%CI：-0.89 至 -0.11）和甘油三酯（SMD=-0.42，95%CI：-0.79 至 -0.04）均有显著影响。纳入本荟萃分析的试验规模较小，部分存在方法学局限性。
本研究为临床实践中绝经后女性提供了证据，运动与不运动或安慰剂相比，对体脂、腰围、甘油三酯水平和腰椎骨密度有显著益处。特别是，有氧运动有助于绝经后女性改善体脂。短期运动干预不仅对体脂，而且对甘油三酯水平都有获益。然而，未来需要进行设计良好、执行良好的 RCT 和详细的长期临床研究。
