Colonetti Tamy, Grande Antonio Jose, Amaral Marcos Cruz, Colonetti Laura, Uggioni Maria Laura, da Rosa Maria Inês, Hernandez Adrian V, Tse Gary, Liu Tong, Nerlekar Nitesh, Biondi-Zoccai Giuseppe, Neto Mansueto Gomes, Durães André Rodrigues, Pontes-Neto Octávio, Resende Elmiro Santos, Roever Leonardo
Laboratory of Biomedicine Translational, Postgraduate Program in Health Sciences,, Universidade do Extremo Sul Catarinense (UNESC),, Criciúma, Santa Catarina, Brazil.
Laboratory of Evidence-Based Health, Medical Course, Universidade Estadual de Mato Grosso do Sul (UEMS), Campo Grande, MS, Brazil.
Heart Fail Rev. 2021 Nov;26(6):1399-1411. doi: 10.1007/s10741-020-09965-5.
According to previous epidemiological studies, we can reduce the thickness of epicardial fat and improve cardiovascular risk factors through exercise, and the changes may depend on the form of exercise. We systemically reviewed published studies that evaluated exercise intervention on epicardial adipose tissue (EAT) levels. We included randomized controlled trials (RCTs) comparing one exercise with another exercise or diet for the treatment to reduce EAT. We used fixed effects models for meta-analyses; effects of exercise on outcomes were described as mean differences (MD) or standardized difference of means (SMD) was used, their 95% confidence intervals (CI). Five RCTs were included (n = 299), 156 in exercise group and 143 in the control. In comparison to the control group, exercise significantly reduced EAT (SMD - 0.57, 95%CI - 0.97 to - 0.18) and waist circumference (MD - 2.95 cm, 95%CI - 4.93 to - 0.97). Exercise did not have an effect on BMI (MD - 0.23 kg/m, 95%CI - 0.73 to 0.27), weight (MD - 0.06 kg, 95%CI - 1.46 to 1.34), or HDL (SMD 0.26, 95%CI - 0.06 to 0.57).VO was significantly increased by exercise (SMD 1.58, 95%CI 1.17 to 1.99). Risk of bias was high for 3 studies, and GRADE quality of evidence was very low to moderate. Exercise reduced epicardial adipose tissue and waist circumference, and did not have effect on weight, BMI, or HDL. Newer trials with better design and methods are necessary to improve the quality of the evidence. PROSPERO registration number (CRD42018096581).
根据以往的流行病学研究，我们可以通过运动减少心外膜脂肪厚度并改善心血管危险因素，且这些变化可能取决于运动形式。我们系统回顾了已发表的评估运动干预对心外膜脂肪组织（EAT）水平影响的研究。我们纳入了比较一种运动与另一种运动或饮食对降低EAT治疗效果的随机对照试验（RCT）。我们使用固定效应模型进行荟萃分析；运动对结果的影响以均值差异（MD）或标准化均值差异（SMD）表示，并给出其95%置信区间（CI）。共纳入5项RCT（n = 299），运动组156例，对照组143例。与对照组相比，运动显著降低了EAT（SMD -0.57，95%CI -0.97至-0.18）和腰围（MD -2.95 cm，95%CI -4.93至-0.97）。运动对体重指数（MD -0.23 kg/m，95%CI -0.73至0.27）、体重（MD -0.06 kg，95%CI -1.46至1.34）或高密度脂蛋白（SMD 0.26，95%CI -0.06至0.57）没有影响。运动显著增加了最大摄氧量（SMD 1.58，95%CI 1.17至1.99）。3项研究的偏倚风险较高，GRADE证据质量为极低至中等。运动减少了心外膜脂肪组织和腰围，对体重、体重指数或高密度脂蛋白没有影响。需要设计和方法更好的新试验来提高证据质量。PROSPERO注册号（CRD42018096581）。
