Department of Kinesiology, Michigan State University, East Lansing, MI.
Department of Rehabilitation Sciences, Faculty of Movement and Rehabilitation Sciences, KU Leuven, Leuven, BELGIUM.
Med Sci Sports Exerc. 2021 Jul 1;53(7):1345-1355. doi: 10.1249/MSS.0000000000002596.
Cardiorespiratory fitness (CRF) is an independent predictor of mortality, and females typically achieve smaller improvements in CRF than males after exercise-based cardiac rehabilitation. High-intensity interval training (HIIT) has been shown to produce superior improvements in CRF than traditional cardiac rehabilitation, but the sex differences are unknown. The purpose of this systematic review and meta-analysis was to evaluate sex differences for changes in CRF and cardiometabolic health indicators after HIIT in adults with coronary artery disease (CAD).
A systemic search of five electronic databases for studies examining the effect of HIIT on measured CRF and cardiometabolic health indicators in adults with CAD was performed. Data (published and unpublished) from 14 studies were included in the meta-analyses with approximately eightfold greater male than female participation (n = 836 vs n = 103). Males with CAD achieved a near-significant absolute improvement in CRF (mean difference [MD] = 1.07, 95% confidence interval [CI] = -0.08 to 2.23 mL·kg-1⋅min-1, P = 0.07) after HIIT when compared with control; there were insufficient data to conduct such an analysis in females. Significantly smaller improvements in CRF were experienced by females than males (MD = -1.10, 95% CI = -2.08 to -0.12 mL·kg-1⋅min-1, P = 0.03); there was no sex difference for the relative (percentage) change in CRF after HIIT. Females achieved significantly smaller reductions in body mass index (MD = -0.25, 95% CI = -0.03 to -0.47 kg·m-2, P = 0.02) and fasting blood glucose (MD = -0.38, 95% CI = -0.05 to -0.72, P = 0.03); no sex differences were observed for other cardiometabolic health indicators.
There are no sex differences for relative improvements in CRF after HIIT; however, females are greatly underrepresented in trials. Future studies should increase female participation and perform sex-based analyses to determine sex-specific outcomes following HIIT.
心肺适能（CRF）是死亡率的独立预测因素，女性在接受基于运动的心脏康复后，CRF 的改善通常比男性小。高强度间歇训练（HIIT）已被证明比传统心脏康复更能显著改善 CRF，但性别差异尚不清楚。本系统评价和荟萃分析的目的是评估 HIIT 对冠心病（CAD）成人 CRF 和心血管代谢健康指标的影响的性别差异。
对五项电子数据库进行了系统性检索，以寻找研究 HIIT 对 CAD 成人测量的 CRF 和心血管代谢健康指标影响的研究。荟萃分析纳入了 14 项研究的数据（已发表和未发表），男性参与者约为女性的八倍（n = 836 对 n = 103）。与对照组相比，CAD 男性在接受 HIIT 后 CRF 几乎有显著的绝对改善（平均差异 [MD] = 1.07，95%置信区间 [CI] = -0.08 至 2.23 毫升·千克-1·分钟-1，P = 0.07）；没有足够的数据对女性进行此类分析。女性经历的 CRF 改善明显小于男性（MD = -1.10，95% CI = -2.08 至 -0.12 毫升·千克-1·分钟-1，P = 0.03）；HIIT 后 CRF 的相对（百分比）变化没有性别差异。女性的体重指数（MD = -0.25，95% CI = -0.03 至 -0.47 千克·米-2，P = 0.02）和空腹血糖（MD = -0.38，95% CI = -0.05 至 -0.72，P = 0.03）显著降低；其他心血管代谢健康指标没有观察到性别差异。
HIIT 后 CRF 的相对改善没有性别差异；然而，女性在试验中的代表性严重不足。未来的研究应该增加女性的参与，并进行基于性别的分析，以确定 HIIT 后特定性别的结果。
