School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
School of Nursing, Peking University, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Department of Neurology, Peking University First Hospital, 8 Xishiku Street, Xicheng District, Beijing 100034, China.
Exp Gerontol. 2021 Aug;151:111424. doi: 10.1016/j.exger.2021.111424. Epub 2021 May 26.
To summarize the biomarkers for evaluating the effects of exercise interventions in patients with cognitive impairment associated with aging, as well as their responses to exercise interventions.
A systematic review and meta-analysis METHODS: We systematically searched different electronic database, including PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, PsycINFO, SPORTDiscus up to April 2020. Clinical controlled trials with exercise interventions in patients with cognitive impairment were included. The main outcomes included all the biomarkers used to evaluate the effects of exercise interventions. If data for certain biomarkers was enough (more than 2 studies), meta-analyses would be performed to estimate the effect sizes by calculating the standard mean differences (SMDs) and 95% confidence intervals (CIs).
Finally, we included 33 articles from 26 trials. The biomarkers included neurotrophic factors, inflammatory factors, oxidative stress markers, neuropathological hallmarks, metabolic biomarkers and genotypes. The meta-analyses indicated that exercise significantly decreased the levels of IL-6 (SMD = -0.45; 95% CI: -0.72, -0.18) and low-density lipoprotein (SMD = -0.26; 95% CI: -0.50, -0.01). Subgroup analyses showed that aerobic exercise also could decrease the levels of TNF-α (SMD = -1.21; 95% CI: -2.29, -0.14). There were some important cognition-related biomarkers which were rarely measured, such as Aβ, tau and IGF-1.
Regular exercise showed positive effects on reducing inflammation and regulating lipid metabolism. But the available evidence is limited and more studies with different exercise interventions should be conducted to test the effects of exercise on other important cognition-related biomarkers in patients with cognitive dysfunction.
总结评估与衰老相关的认知障碍患者运动干预效果的生物标志物,以及他们对运动干预的反应。
系统评价和荟萃分析。
我们系统地检索了不同的电子数据库,包括 PubMed、Cochrane 对照试验中心注册库、Embase、Web of Science、PsycINFO、SPORTDiscus,截至 2020 年 4 月。纳入了有运动干预的认知障碍患者的临床对照试验。主要结局包括用于评估运动干预效果的所有生物标志物。如果某些生物标志物的数据足够(超过 2 项研究),则进行荟萃分析,通过计算标准均数差(SMD)和 95%置信区间(CI)来估计效应大小。
最终我们纳入了 26 项试验的 33 篇文章。生物标志物包括神经生长因子、炎性因子、氧化应激标志物、神经病理学标志物、代谢生物标志物和基因型。荟萃分析表明,运动显著降低了 IL-6(SMD=-0.45;95%CI:-0.72,-0.18)和低密度脂蛋白(SMD=-0.26;95%CI:-0.50,-0.01)的水平。亚组分析表明,有氧运动还可以降低 TNF-α(SMD=-1.21;95%CI:-2.29,-0.14)的水平。还有一些重要的与认知相关的生物标志物很少被测量,如 Aβ、tau 和 IGF-1。
定期运动对减轻炎症和调节脂质代谢有积极作用。但是,现有的证据有限,需要更多不同运动干预的研究来检验运动对认知功能障碍患者其他重要与认知相关的生物标志物的影响。