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运动干预对糖尿病前期患者脂联素、瘦素及其他炎症标志物水平的影响:一项随机对照试验的系统评价和荟萃分析。

Effect of physical activity promotion on adiponectin, leptin and other inflammatory markers in prediabetes: a systematic review and meta-analysis of randomized controlled trials.

机构信息

Department of Physiotherapy, Centre for Diabetic Foot Care and Research, Manipal College of Health Professions, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.

Independent Systematic Reviewer, Luton, Bedfordshire, UK.

出版信息

Acta Diabetol. 2021 Apr;58(4):419-429. doi: 10.1007/s00592-020-01626-1. Epub 2020 Nov 19.

Abstract

AIMS

Inflammatory stage in prediabetes is associated with increase in level of adipokines and pro-inflammatory cytokines. Physical activity promotion considered as a first-line therapeutic strategy to treat prediabetes. We have conducted the systematic review and meta-analysis to strengthen the evidence on the impact of physical activity promotion on inflammatory markers in prediabetes.

METHODS

Studies were identified using electronic search and manual search techniques by choosing keywords for prediabetes, physical activity and inflammatory marker. Randomized controlled trials on individuals diagnosed with prediabetes and provided intervention in the form of physical activity were included in this review. Adiponectin, leptin, C-reactive protein, interleukin-6 and tumour necrosis factor-α were the considered outcome measures.

RESULTS

Our search retrieved 1,688 citations, 31 full-text articles assessed for eligibility of inclusion. Nine studies satisfied the pre-specified criteria for inclusion. Meta-analysis found that physical activity with or without dietary or lifestyle modification reduces level of leptin (MD-2.11 ng/mL, 95% CI -3.81 - -0.42) and interleukin-6 (MD -0.15 pg/mL, 95% CI -0.25--0.04). It has no effect on level of adiponectin (MD 0.26 µg/mL, 95% CI -0.42- 0.93), C-reactive protein (MD -0.05 mg/L, 95% CI -0.33-0.23) and tumour necrosis factor-α (MD 0.67 pg/mL, 95% CI -2.56-3.89).

CONCLUSIONS

This review suggests that physical activity promotion with dietary and lifestyle modification may reduce the level of leptin and interleukin-6 but are uncertain if there is any effect on levels of adiponectin, C-reactive protein and tumour necrosis factor-α in the individuals with prediabetes.

摘要

目的

糖尿病前期的炎症期与脂肪因子和促炎细胞因子水平的升高有关。促进身体活动被认为是治疗糖尿病前期的一线治疗策略。我们进行了系统评价和荟萃分析,以加强关于促进身体活动对糖尿病前期炎症标志物影响的证据。

方法

通过选择糖尿病前期、身体活动和炎症标志物的关键词,使用电子搜索和手动搜索技术来识别研究。本综述纳入了诊断为糖尿病前期并以身体活动形式提供干预的个体的随机对照试验。考虑的结果测量指标为脂联素、瘦素、C 反应蛋白、白细胞介素-6 和肿瘤坏死因子-α。

结果

我们的搜索共检索到 1688 条引文,对 31 篇全文文章进行了纳入标准评估。9 项研究符合纳入标准。荟萃分析发现,无论是否结合饮食或生活方式改变,身体活动均可降低瘦素水平(MD-2.11ng/mL,95%CI-3.81 至-0.42)和白细胞介素-6 水平(MD-0.15pg/mL,95%CI-0.25 至-0.04)。它对脂联素水平(MD0.26μg/mL,95%CI-0.42 至 0.93)、C 反应蛋白水平(MD-0.05mg/L,95%CI-0.33 至 0.23)和肿瘤坏死因子-α水平(MD0.67pg/mL,95%CI-2.56 至 3.89)没有影响。

结论

本综述表明,结合饮食和生活方式改变的身体活动促进可能会降低瘦素和白细胞介素-6 的水平,但不确定其对糖尿病前期个体脂联素、C 反应蛋白和肿瘤坏死因子-α水平是否有任何影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/543e/8053655/8e3fdeb2b6e3/592_2020_1626_Fig1_HTML.jpg

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