Li Daxin, Chen Ping
Department of Physical Education, Ocean University of China-Laoshan Campus, Qingdao 266100, China.
Children (Basel). 2021 Nov 18;8(11):1062. doi: 10.3390/children8111062.
Obesity has become increasingly prevalent in adolescents due to unhealthy diet habits, sedentary behavior and a lack of physical activities. This study aims to assess the effects of different exercise modalities in the treatment of cardiometabolic risk factors (CRF) in obese adolescents with sedentary behavior.
A systematic search was conducted using databases (PubMed, Embase, Cochrane library, Web of Science, CNKI and VIP database) from the earliest available date to August 2021. Nineteen randomized controlled trials (RCTs) with 704 participants were included. The included studies were evaluated for methodological quality by the Cochrane bias risk assessment tool, and a statistical analysis was performed by the Review Manage 5.3 and Stata 15.1 software.
The results of the meta-analysis showed that exercise could significantly improve obese adolescents' body mass index (BMI) (MD = -1.99, 95% CI: -2.81 to -1.17, < 0.00001), low density liptein cholesterol (LDL-C) (SMD = -0.98, 95% CI: -1.58 to -0.37, = 0.002), triglyceride (TG) (SMD = -0.93, 95% CI: -1.72 to -0.14, = 0.02), total cholesterol (TC) (SMD = -1.00, 95% CI: -1.73 to -0.26, = 0.008), peak oxygen uptake (VOpeak) (MD = 3.27, 95% CI: 1.52 to 5.02, = 0.0003) and homeostatic model assessment insulin resistance (HOMA-IR) (SMD = -2.07, 95% CI: -3.3 to -0.84, = 0.001). However, there was no statistically significant difference in high-density liptein cholesterol (HDL-C) (SMD = 0.40, 95% CI: -0.28 to 1.08, = 0.25).
Exercise can effectively improve cardiometabolic risk factors in obese adolescents with sedentary behavior. For obese adolescents who want to lose weight and improve cardiorespiratory fitness, combined aerobic and resistance training and high-intensity interval training are optimal choices. For obese adolescents with high blood lipids, aerobic training can be regarded as a primary exercise modality to reduce the high risk of cardiovascular diseases; For obese adolescents with insulin resistance, combined aerobic and resistance training can be considered to reduce the high risk of diabetes. It is hoped that more high-quality studies will further expand the meta-analysis results and demonstrate the optimal exercise frequency and treatment intensity of cardiometabolic risk factors in obese adolescents with sedentary behavior in the future.
由于不健康的饮食习惯、久坐不动的行为以及缺乏体育活动，肥胖在青少年中越来越普遍。本研究旨在评估不同运动方式对久坐不动的肥胖青少年心血管代谢危险因素（CRF）的治疗效果。
使用数据库（PubMed、Embase、Cochrane图书馆、Web of Science、中国知网和维普数据库）从最早可用日期至2021年8月进行系统检索。纳入了19项随机对照试验（RCT），共704名参与者。采用Cochrane偏倚风险评估工具对纳入研究的方法学质量进行评估，并使用Review Manage 5.3和Stata 15.1软件进行统计分析。
荟萃分析结果显示，运动可显著改善肥胖青少年的体重指数（BMI）（MD = -1.99，95%CI：-2.81至-1.17，<0.00001）、低密度脂蛋白胆固醇（LDL-C）（SMD = -0.98，95%CI：-1.58至-0.37，=0.002）、甘油三酯（TG）（SMD = -0.93，95%CI：-1.72至-0.14，=0.02）、总胆固醇（TC）（SMD = -1.00，95%CI：-1.73至-0.26，=0.008）、峰值摄氧量（VOpeak）（MD = 3.27，95%CI：1.52至5.02，=0.0003）和稳态模型评估胰岛素抵抗（HOMA-IR）（SMD = -2.07，95%CI：-3.3至-0.84，=0.001）。然而，高密度脂蛋白胆固醇（HDL-C）没有统计学显著差异（SMD = 0.40，95%CI：-0.28至1.08，=0.25）。
运动可以有效改善久坐不动的肥胖青少年的心血管代谢危险因素。对于想要减肥并提高心肺适能的肥胖青少年，有氧和抗阻训练相结合以及高强度间歇训练是最佳选择。对于血脂高的肥胖青少年，有氧训练可被视为降低心血管疾病高风险的主要运动方式；对于有胰岛素抵抗的肥胖青少年，可考虑有氧和抗阻训练相结合以降低糖尿病的高风险。希望未来有更多高质量研究进一步扩展荟萃分析结果，并证明久坐不动的肥胖青少年心血管代谢危险因素的最佳运动频率和治疗强度。
