非酒精性脂肪性肝病中改变久坐生活方式的代谢益处：一项随机对照试验的荟萃分析

Metabolic benefits of changing sedentary lifestyles in nonalcoholic fatty liver disease: a meta-analysis of randomized controlled trials.

作者信息

Ma Qianqian, Ye Junzhao, Shao Congxiang, Lin Yansong, Wu Tingfeng, Zhong Bihui

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-sen University, Yuexiu District, Guangzhou, China.

Department of Infectious Diseases, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.

出版信息

Ther Adv Endocrinol Metab. 2022 Sep 16;13:20420188221122426. doi: 10.1177/20420188221122426. eCollection 2022.

This study seeks to evaluate the effects of a reversal of sedentary lifestyles on the improvement of metabolic profiles in patients with NAFLD. The PubMed, Cochrane Library, Web of Science, and CNKI databases were searched up to May 15, 2021. Ten randomized controlled trials on changes in the sedentary lifestyle of patients with NAFLD were included in the analysis. Data from self-controlled case arms of randomized controlled trials investigating sedentary lifestyle alterations were extracted, and the effect size was reported as the MD and 95% CI. A total of 455 participants in 10 studies met the selection criteria. The results showed that changing a sedentary lifestyle can significantly improve ALT [MD = 4.35 (U/L), 95% CI: 0.53, 8.17], CHOL [MD = 0.31 (mmol/L), 95% CI: 0.19, 0.43], TG [MD = 0.22 (mmol/L), 95% CI: 0.10~~0.34], LDL-C [MD = 0.30 (mmol/L), 95% CI: 0.02, 0.57], fasting blood glucose [MD = 0.17 (mmol/L), 95% CI: 0.03, 0.31], insulin [MD = 3.23 (pmol/L), 95% CI: 1.37~~5.08], and HOMA-IR levels (MD = 0.39, 95% CI: 0.15, 0.63). Changing sedentary lifestyle can also significantly improve body mass index (BMI) [MD = 1.12 (kg/m), 95% CI: 0.66, 0.58], body fat (%) [MD = 0.34 (%), 95% CI: 0.13, 0.55] and VO levels [MD = -4.00 (mL/kg/min), 95% CI: -5.93, -2.06]. No differences in AST or GGT were noted before or after lifestyle changes. Altering a sedentary lifestyle to a lifestyle with regular exercise can slightly improve the levels of liver enzymes, blood lipids, blood glucose, insulin resistance, and body mass index in NAFLD patients.

本研究旨在评估改变久坐不动的生活方式对改善非酒精性脂肪性肝病（NAFLD）患者代谢状况的影响。检索了截至2021年5月15日的PubMed、Cochrane图书馆、Web of Science和中国知网数据库。纳入分析的有10项关于NAFLD患者久坐生活方式改变的随机对照试验。提取了调查久坐生活方式改变的随机对照试验中自我对照病例组的数据，效应量报告为均差（MD）和95%置信区间（CI）。10项研究中的455名参与者符合入选标准。结果显示，改变久坐生活方式可显著改善丙氨酸氨基转移酶（ALT）[MD = 4.35（U/L），95%CI：0.53，8.17]、总胆固醇（CHOL）[MD = 0.31（mmol/L），95%CI：0.19，0.43]、甘油三酯（TG）[MD = 0.22（mmol/L），95%CI：0.10~~0.34]、低密度脂蛋白胆固醇（LDL-C）[MD = 0.30（mmol/L），95%CI：0.02，0.57]、空腹血糖[MD = 0.17（mmol/L），95%CI：0.03，0.31]、胰岛素[MD = 3.23（pmol/L），95%CI：1.37~~5.08]以及稳态模型评估的胰岛素抵抗（HOMA-IR）水平（MD = 0.39，95%CI：0.15，0.63）。改变久坐生活方式还可显著改善体重指数（BMI）[MD = 1.12（kg/m²），95%CI：0.66，1.58]、体脂率（%）[MD = 0.34（%），95%CI：0.13，0.55]和最大摄氧量（VO₂）水平[MD = -4.00（mL/kg/min），95%CI：-5.93，-2.06]。生活方式改变前后天冬氨酸氨基转移酶（AST）或γ-谷氨酰转移酶（GGT）无差异。将久坐不动的生活方式改变为规律运动的生活方式可轻微改善NAFLD患者的肝酶、血脂、血糖、胰岛素抵抗和体重指数水平。