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运动对慢性肾脏病患者炎症标志物和营养指标的影响:一项系统评价和荟萃分析

Effects of exercise on markers of inflammation and indicators of nutrition in patients with chronic kidney disease: a systematic review and meta-analysis.

作者信息

Wu Lihua, Liu Yu, Wu Ling, Yang Ju, Jiang Ting, Li Mingquan

机构信息

Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, No. 39 Shi-er-qiao Road, Chengdu, 610072, Sichuan Province, People's Republic of China.

出版信息

Int Urol Nephrol. 2022 Apr;54(4):815-826. doi: 10.1007/s11255-021-02949-w. Epub 2021 Jul 13.

Abstract

PURPOSE

This meta-analysis aimed to reveal the effects of exercise training on markers of inflammation and indicators of nutrition in non-dialysis-dependent patients with chronic kidney disease (NDD-CKD).

METHODS

We searched the MEDLINE, EMBASE, CENTRAL, Web of Science, CINAHL, CNKI, WANFANE, VIP, and CBM databases, from their inception up to October 2020 to identify randomized controlled trials that examined the effects of exercise training on inflammation and nutrition in NDD-CKD patients. A total of 16 trials, comprising 724 patients, were included in the analysis.

RESULTS

The BMI (P = 0.005) and waist circumference (P = 0.004) decreased significantly after exercise training in NDD-CKD patients. Similarly, IL-6 (P = 0.03) decreased after exercise training in NDD-CKD patients. However, serum albumin level, body fat, CRP and hs-CRP were not different between patients who received exercise training and those who received usual care. Furthermore, BMI (P = 0.009), body weight (P = 0.009), and waist circumference (P = 0.010) were decreased in overweight patients (BMI ≧ 25 kg/m). Moreover, BMI (P = 0.003), body weight (P = 0.005), and waist circumference (P = 0.007) reduced when the length of intervention exceeded 48 weeks. Subgroup analyses revealed no significant alteration of serum albumin, body fat, CRP, or hs-CRP, when studies were divided based on BMI or intervention duration.

CONCLUSION

Overall, these findings suggest that exercise training may improve inflammation status in NDD-CKD patients, and enhance weight loss in obese adult CKD patients.

REGISTRATION NUMBER

INPLASY2020100025.

摘要

目的

本荟萃分析旨在揭示运动训练对非透析依赖型慢性肾脏病(NDD-CKD)患者炎症标志物和营养指标的影响。

方法

我们检索了MEDLINE、EMBASE、CENTRAL、Web of Science、CINAHL、CNKI、万方数据、维普资讯和中国生物医学文献数据库,检索时间从建库至2020年10月,以确定研究运动训练对NDD-CKD患者炎症和营养影响的随机对照试验。共有16项试验、724例患者纳入分析。

结果

NDD-CKD患者运动训练后,体重指数(P = 0.005)和腰围(P = 0.004)显著降低。同样,NDD-CKD患者运动训练后白细胞介素-6(IL-6)水平降低(P = 0.03)。然而,接受运动训练的患者与接受常规护理的患者之间,血清白蛋白水平、体脂、C反应蛋白(CRP)和超敏C反应蛋白(hs-CRP)并无差异。此外,超重患者(体重指数≥25kg/m²)的体重指数(P = 0.009)、体重(P = 0.009)和腰围(P = 0.010)降低。而且,干预时间超过48周时,体重指数(P = 0.003)、体重(P = 0.005)和腰围(P = 0.007)下降。亚组分析显示,根据体重指数或干预持续时间对研究进行分组时,血清白蛋白、体脂、CRP或hs-CRP无显著变化。

结论

总体而言,这些研究结果表明,运动训练可能改善NDD-CKD患者的炎症状态,并促进肥胖成年CKD患者减重。

注册号

INPLASY2020100025

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