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单独运动或联合饮食补充剂对伴有肌肉减少性肥胖的社区居住老年人人体测量学和身体表现测量的影响:随机对照试验的荟萃分析。

Effect of exercise alone or combined with dietary supplements on anthropometric and physical performance measures in community-dwelling elderly people with sarcopenic obesity: A meta-analysis of randomized controlled trials.

机构信息

Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain.

Department of Psychiatry, Miguel Servet University Hospital, Zaragoza, Spain.

出版信息

Maturitas. 2018 Oct;116:24-35. doi: 10.1016/j.maturitas.2018.07.007. Epub 2018 Jul 19.

DOI:10.1016/j.maturitas.2018.07.007
PMID:30244776
Abstract

OBJECTIVE

To evaluate the effect of exercise (EXE) alone or exercise combined with dietary supplements (EXE-SUPPL) on body composition and physical performance in subjects 60 years and older with sarcopenic obesity.

METHODS

A systematic review was carried out of studies identified through five search engines up to April 15, 2018. We searched for randomized controlled trials (RCTs) evaluating EXE or EXE-SUPPL in elderly individuals with sarcopenic obesity for at least six weeks. Primary outcomes were percentage of body fat mass, appendicular skeletal muscle mass, and hand grip strength. Random effects meta-analyses with the inverse variance method were used to evaluate the effects of interventions on outcomes. Effects were expressed as mean differences (MD) and their 95% confidence intervals (CI). Risk of bias was assessed with the Cochrane tool.

RESULTS

Nine papers reporting seven RCTs (with a total of 558 participants) were included in the review. EXE alone and EXE-SUPPL increased grip strength (MD 1.30 kg; 95% CI 0.58-2.01), gait speed (MD 0.05 m/s; 95% CI 0.03-0.07) and appendicular skeletal muscle mass (MD 0.40 kg; 95% CI 0.18-0.63). EXE alone and EXE-SUPPL reduced waist circumference (MD -1,40 cm; 95% CI -1.99 to -0.81), total fat mass (MD -1,77 kg; 95% CI -2.49 to -1.04), and trunk fat mass (MD -0.82 kg; 95% CI -1.22 to -0.42).

CONCLUSION

EXE alone and EXE-SUPPL improved muscle-related outcomes and reduced fat-related outcomes in subjects with sarcopenic obesity. There is a need for better-designed RCTs with systematic assessment of both different exercise regimes and dietary supplements in sarcopenic obese subjects.

摘要

目的

评估单纯运动(EXE)或运动联合饮食补充剂(EXE-SUPPL)对 60 岁及以上伴有肌肉减少性肥胖的受试者身体成分和身体表现的影响。

方法

系统检索了截至 2018 年 4 月 15 日的五个搜索引擎中的研究,寻找评估 EXE 或 EXE-SUPPL 治疗伴肌肉减少性肥胖的老年人至少 6 周的随机对照试验(RCT)。主要结局为体脂肪百分比、四肢骨骼肌量和手握力。采用逆方差法进行随机效应荟萃分析,以评估干预对结局的影响。效应表示为均数差值(MD)及其 95%置信区间(CI)。采用 Cochrane 工具评估偏倚风险。

结果

共纳入 9 篇文献报道的 7 项 RCT(共 558 名参与者)。单纯运动和运动联合饮食补充剂均可增加握力(MD 1.30kg;95%CI 0.58-2.01)、步速(MD 0.05m/s;95%CI 0.03-0.07)和四肢骨骼肌量(MD 0.40kg;95%CI 0.18-0.63)。单纯运动和运动联合饮食补充剂均可减少腰围(MD-1.40cm;95%CI-1.99 至-0.81)、总脂肪量(MD-1.77kg;95%CI-2.49 至-1.04)和躯干脂肪量(MD-0.82kg;95%CI-1.22 至-0.42)。

结论

单纯运动和运动联合饮食补充剂可改善伴肌肉减少性肥胖患者的肌肉相关结局,并减少脂肪相关结局。需要更好设计的 RCT,系统评估不同的运动方案和饮食补充剂在伴肌肉减少性肥胖患者中的作用。

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