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体育活动对2型糖尿病成年患者合并抑郁症的管理效果:一项系统评价与荟萃分析

Effectiveness of physical activity in managing co-morbid depression in adults with type 2 diabetes mellitus: A systematic review and meta-analysis.

作者信息

Arsh Aatik, Afaq Saima, Carswell Claire, Bhatti Mujeeb Masud, Ullah Irfan, Siddiqi Najma

机构信息

Department of Health Sciences, University of York, United Kingdom; Institute of Physical Medicine & Rehabilitation, Khyber Medical University, Pakistan.

Institute of Public Health, Khyber Medical University, Pakistan.

出版信息

J Affect Disord. 2023 May 15;329:448-459. doi: 10.1016/j.jad.2023.02.122. Epub 2023 Mar 1.

Abstract

BACKGROUND

Physical activity may be effective in alleviating depressive symptoms and improving glycaemic control; however, evidence to guide practice is limited. The current review was conducted to assess the effects of physical activity on depression and glycaemic control in people with type 2 diabetes mellitus.

METHODS

Randomized controlled clinical trials, from the earliest record to October 2021, which recruited adults with the diagnosis of type 2 diabetes mellitus and compared physical activity with no interventions or usual care for the management of depression were included. The outcomes were change in depression severity and glycaemic control.

RESULTS

In 17 trials, including 1362 participants, physical activity was effective in reducing the severity of depressive symptoms (SMD = -057; 95%CI = -0.80, -0.34). However, physical activity did not have a significant effect in improving markers of glycaemic control (SMD = -0.18; 95%CI = -0.46, 0.10).

LIMITATIONS

There was substantial heterogeneity in the included studies. Furthermore, risk of bias assessment showed that most of the included studies were of low quality.

CONCLUSIONS

Physical activity can effectively reduce the severity of depressive symptoms, nonetheless, it appears that physical activity is not significantly effective in improving glycaemic control in adults who have both type 2 diabetes mellitus and depressive symptoms. The latter finding is surprising, however, given the limited evidence on which this is based, future research on the effectiveness of physical activity for depression in this population should include high quality trials with glycaemic control as an outcome.

摘要

背景

体育活动可能对缓解抑郁症状和改善血糖控制有效;然而,指导实践的证据有限。本综述旨在评估体育活动对2型糖尿病患者抑郁和血糖控制的影响。

方法

纳入从最早记录到2021年10月的随机对照临床试验,这些试验招募了诊断为2型糖尿病的成年人,并比较了体育活动与无干预措施或常规护理对抑郁症管理的效果。结局指标为抑郁严重程度和血糖控制的变化。

结果

在17项试验中,包括1362名参与者,体育活动能有效降低抑郁症状的严重程度(标准化均数差= -0.57;95%置信区间= -0.80,-0.34)。然而,体育活动在改善血糖控制指标方面没有显著效果(标准化均数差= -0.18;95%置信区间= -0.46,0.10)。

局限性

纳入研究存在显著异质性。此外,偏倚风险评估显示,大多数纳入研究质量较低。

结论

体育活动能有效降低抑郁症状的严重程度,尽管如此,体育活动似乎对改善同时患有糖尿病和抑郁症状的成年人的血糖控制效果不显著。后一项发现令人惊讶,然而,鉴于此结论所依据的证据有限,未来关于体育活动对该人群抑郁有效性的研究应包括以血糖控制为结局指标的高质量试验。

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