运动与 2 型糖尿病患者的胰岛素抵抗：系统评价和荟萃分析。
Exercise and insulin resistance in type 2 diabetes mellitus: A systematic review and meta-analysis.
机构信息
Department of Physiotherapy, School of Allied Health Sciences, Manipal Academy of Higher Education, 576104 Manipal, Karnataka, India.
Department of Medicine, Kasturba Medical College, 576104 Manipal, India.
出版信息
Ann Phys Rehabil Med. 2019 Mar;62(2):98-103. doi: 10.1016/j.rehab.2018.11.001. Epub 2018 Dec 13.
BACKGROUND
Insulin resistance is a determining factor in the pathophysiology of type 2 diabetes mellitus (T2DM). Exercise is known to improve insulin resistance, but a systematic review of the literature is lacking.
OBJECTIVE
This systematic review and meta-analysis focused on identifying evidence for the effectiveness of a structured exercise intervention program for insulin resistance in T2DM.
METHODS
We searched MEDLINE via PubMed, CINHAL, Scopus and Web of Science, and the Cochrane Central Register of Controlled Trials for reports of studies on fasting insulin, homeostatic model assessment for insulin resistance (Homa-IR), fasting blood sugar, glycated hemoglobin and body mass index in patients with T2DM and healthy controls that were published between 1990 and 2017. Data are reported as the standardized mean difference or mean difference with 95% confidence intervals (CIs).
RESULTS
Among 2242 records retrieved, only 11 full-text articles were available for meta-analysis. Data for 846 participants were analyzed, 440 in the intervention group, and 406 in the control group. The mean difference for fasting insulin level was-1.64 (95% CI; -3.38 to 0.10), Homa-Ir 0.14 (-1.48 to 1.76), fasting blood sugar-5.12 (-7.78 to-2.45), hemoglobin A1c 0.63 (-0.82 to 2.08) and body mass index-0.36 (-1.51 to 0.79).
CONCLUSION
The evidence highlights the effectiveness of a structured exercise intervention program for insulin resistance in T2DM with a moderate level 2 of evidence.
背景
胰岛素抵抗是 2 型糖尿病（T2DM）病理生理学的决定因素。运动被认为可以改善胰岛素抵抗，但缺乏系统的文献综述。
目的
本系统评价和荟萃分析主要关注确定结构化运动干预方案对 T2DM 胰岛素抵抗有效性的证据。
方法
我们通过 PubMed、CINHAL、Scopus 和 Web of Science 中的 MEDLINE 以及 Cochrane 对照试验中心注册库，检索了 1990 年至 2017 年期间发表的关于 T2DM 患者和健康对照组空腹胰岛素、稳态模型评估胰岛素抵抗（Homa-IR）、空腹血糖、糖化血红蛋白和体重指数的研究报告。数据以标准化均数差或均数差及其 95%置信区间（CI）报告。
结果
在 2242 条记录中，只有 11 篇全文文章可用于荟萃分析。对 846 名参与者的数据进行了分析，440 名在干预组，406 名在对照组。空腹胰岛素水平的平均差异为-1.64（95%CI；-3.38 至 0.10），Homa-Ir 为 0.14（-1.48 至 1.76），空腹血糖为-5.12（-7.78 至-2.45），糖化血红蛋白为 0.63（-0.82 至 2.08），体重指数为-0.36（-1.51 至 0.79）。
结论
证据强调了结构化运动干预方案对 T2DM 胰岛素抵抗的有效性，证据水平为 2 级。
Zotero 插件