运动对糖尿病肾病进展的影响：一项荟萃分析。

Effects of physical activity on the progression of diabetic nephropathy: a meta-analysis.

机构信息

National Clinical Research Center for Metabolic Diseases, Metabolic Syndrome Research Center, Key Laboratory of Diabetes Immunology, Ministry of Education and Department of Metabolism and Endocrinology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.

出版信息

Biosci Rep. 2021 Jan 29;41(1). doi: 10.1042/BSR20203624.

DOI:10.1042/BSR20203624

PMID:33289502

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7786348/

Abstract

BACKGROUND

Diabetic nephropathy (DN) is an important microvascular complication of diabetes. Physical activity (PA) is part of a healthy lifestyle for diabetic patients; however, the role of PA in DN has not been clarified. Our aim was to conduct a meta-analysis to explore the association between PA and DN risk.

METHODS

PubMed, Embase, Cochrane Library and Web of Science were systematically searched for articles examining PA in diabetic patients and its effect on renal function. Standardized mean differences (SMDs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. The study protocol is registered with PROSPERO (CRD42020191379).

RESULTS

A total of 38991 participants were identified from 18 studies. The results indicated that PA was associated with increases in the glomerular filtration rate (SMD = 0.01, 95% CI = [0.02-0.17]) and decreases in the urinary albumin creatinine ratio (SMD = -0.53, 95% CI: -0.72 to -0.34), rate of microalbuminuria (OR = 0.61, 95% CI = [0.46-0.81]), rate of acute kidney injury (OR = 0.02, 95% CI = [0.01-0.04]), rate of renal failure (OR = 0.71, 95% CI = [0.52-0.97]) and risk of DN in patients with Type 1 diabetes (OR = 0.67, 95% CI = [0.51-0.89]).

CONCLUSIONS

This meta-analysis indicated that PA is effective for improving DN and slowing its progression; however, more high-quality randomized controlled trials are required on this topic.

摘要

背景

糖尿病肾病（DN）是糖尿病的一种重要微血管并发症。对于糖尿病患者来说，体育活动（PA）是健康生活方式的一部分；然而，PA 对 DN 的作用尚未明确。我们旨在进行一项荟萃分析，以探讨 PA 与 DN 风险之间的关系。

方法

系统检索了 PubMed、Embase、Cochrane 图书馆和 Web of Science 中检查糖尿病患者 PA 及其对肾功能影响的文章。计算了标准化均数差（SMD）和比值比（OR）及其 95%置信区间（CI）。该研究方案已在 PROSPERO（CRD42020191379）注册。

结果

从 18 项研究中确定了 38991 名参与者。结果表明，PA 与肾小球滤过率增加（SMD=0.01，95%CI=[0.02-0.17]）和尿白蛋白肌酐比降低（SMD=-0.53，95%CI：-0.72 至-0.34）、微量白蛋白尿发生率（OR=0.61，95%CI=[0.46-0.81]）、急性肾损伤发生率（OR=0.02，95%CI=[0.01-0.04]）、肾衰竭发生率（OR=0.71，95%CI=[0.52-0.97]）和 1 型糖尿病患者 DN 风险（OR=0.67，95%CI=[0.51-0.89]）有关。