联合运动对 2 型糖尿病合并超重/肥胖人群的疗效：系统评价和荟萃分析。

Effectiveness of combined exercise in people with type 2 diabetes and concurrent overweight/obesity: a systematic review and meta-analysis.

机构信息

Department of Endocrinology and Metabolism, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China.

School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong, China.

出版信息

BMJ Open. 2021 Oct 6;11(10):e046252. doi: 10.1136/bmjopen-2020-046252.

OBJECTIVE

To synthesise the available scientific evidence on the effects of combined exercise on glycaemic control, weight loss, insulin sensitivity, blood pressure and serum lipids among patients with type 2 diabetes (T2D) and concurrent overweight/obesity.

DESIGN AND SAMPLE

PubMed, EMBASE, Web of Science, the Cochrane library, WANFANG, CNKI, SinoMed, OpenGrey and ClinicalTrials.gov were searched from inception through April 2020 to identify randomised controlled trials (RCTs) that reported the effects of combined exercise in individuals with T2D and concurrent overweight/obesity.

METHODS

Quality assessment was performed using the Cochrane Collaboration's risk of bias tool. The mean difference (MD) with its corresponding 95% CI was used to estimate the effect size. Meta-analysis was performed using Review Manager V.5.3.

RESULTS

A total of 10 RCTs with 978 participants were included in the meta-analysis. Pooled results demonstrated that combined exercise significantly reduced haemoglobin A1c (MD=-0.16%, 95% CI: -0.28 to -0.05, p=0.006); body mass index (MD=-0.98 kg/m, 95% CI: -1.41 to -0.56, p<0.001); homeostasis model assessment of insulin resistance (MD=-1.19, 95% CI: -1.93 to -0.46, p=0.001); serum insulin (MD=-2.18 μIU/mL, 95% CI: -2.99 to -1.37, p<0.001) and diastolic blood pressure (MD=-3.24 mm Hg, 95% CI: -5.32 to -1.16, p=0.002).

CONCLUSIONS

Combined exercise exerted significant effects in improving glycaemic control, influencing weight loss and enhancing insulin sensitivity among patients with T2D and concurrent overweight/obesity.

目的

综合现有科学证据，评估 2 型糖尿病（T2D）合并超重/肥胖患者联合运动对血糖控制、体重减轻、胰岛素敏感性、血压和血清脂质的影响。

设计和样本

从建库至 2020 年 4 月，通过 PubMed、EMBASE、Web of Science、Cochrane 图书馆、万方、中国知网、中国生物医学文献服务系统、OpenGrey 和 ClinicalTrials.gov 检索随机对照试验（RCT），以评估 T2D 合并超重/肥胖患者联合运动的效果。

方法

使用 Cochrane 协作风险偏倚工具评估质量。使用均数差（MD）及其 95%置信区间（CI）来估计效应量。使用 Review Manager V.5.3 进行荟萃分析。

结果

共纳入 10 项 RCT 共计 978 名参与者。汇总结果显示，联合运动可显著降低糖化血红蛋白（MD=-0.16%，95%CI：-0.28 至-0.05，p=0.006）、体重指数（MD=-0.98kg/m，95%CI：-1.41 至-0.56，p<0.001）、稳态模型评估的胰岛素抵抗（MD=-1.19，95%CI：-1.93 至-0.46，p=0.001）、血清胰岛素（MD=-2.18μIU/mL，95%CI：-2.99 至-1.37，p<0.001）和舒张压（MD=-3.24mmHg，95%CI：-5.32 至-1.16，p=0.002）。