Osaka Metropolitan University, Osaka,Japan.
Faculty of Sport Sciences, Waseda University, Tokorozawa,Japan.
Int J Sport Nutr Exerc Metab. 2023 Apr 19;33(4):209-221. doi: 10.1123/ijsnem.2022-0217. Print 2023 Jul 1.
An increase in visceral fat is associated with an increase in insulin resistance, so reducing body fat mass through exercise may help alleviate type 2 diabetes mellitus (T2DM). The current meta-analysis evaluated the effect of changes in body fat via an intervention of regular exercise on hemoglobin A1c (HbA1c) in patients with T2DM. The inclusion criteria were randomized controlled trials involving adults with T2DM, intervention involving exercise alone, an overall duration of intervention ≥12 weeks, and reporting HbA1c and body fat mass. The mean differences (MDs) were defined as the MD between the exercise group and the control group, and the MDs in HbA1c (in percentage) and body fat mass (in kilograms) were calculated. All MDs in HbA1c were pooled as overall effects. A meta-regression analysis was performed to evaluate the relationship between the MD in the body fat mass (in kilograms) and the MD in HbA1c. Twenty studies (1,134 subjects) were analyzed. The pooled MD in HbA1c (in percentage) decreased significantly (-0.4; 95% confidence interval [-0.5, -0.3]) but contained significant heterogeneity (Q = 52.7, p < .01; I2 = 41.6%). A meta-regression analysis showed that a decrease in the MD in body fat mass was significantly associated with a decrease in the MD in HbA1c (R2 = 80.0%) and heterogeneity decreased (Q = 27.3, p = .61; I2 = 11.9%), and a reduction in body fat mass of 1 kg was estimated to decrease the HbA1c (%) by approximately 0.2. The current study suggested that a decrease in HbA1c due to regular exercise depends on a reduction in body fat mass in patients with T2DM.
内脏脂肪的增加与胰岛素抵抗的增加有关，因此通过运动减少体脂肪量可能有助于缓解 2 型糖尿病（T2DM）。本荟萃分析评估了通过定期运动干预对 T2DM 患者的血红蛋白 A1c（HbA1c）的体脂肪量变化的影响。纳入标准为涉及 T2DM 成人的随机对照试验，干预措施仅为运动，干预总时长≥12 周，以及报告 HbA1c 和体脂肪量。平均差异（MD）定义为运动组与对照组之间的 MD，HbA1c（百分比）和体脂肪量（千克）的 MD 计算得出。HbA1c 的所有 MD 均汇总为总体效应。进行了荟萃回归分析，以评估体脂肪量 MD（千克）与 HbA1c MD 之间的关系。分析了 20 项研究（1134 名受试者）。HbA1c（百分比）的汇总 MD 显著降低（-0.4；95%置信区间[-0.5，-0.3]），但存在显著异质性（Q = 52.7，p <.01；I2 = 41.6%）。荟萃回归分析显示，体脂肪量 MD 的降低与 HbA1c MD 的降低显著相关（R2 = 80.0%），异质性降低（Q = 27.3，p =.61；I2 = 11.9%），体脂肪量每减少 1 公斤，HbA1c（%）估计降低约 0.2。本研究表明，T2DM 患者定期运动导致的 HbA1c 降低取决于体脂肪量的减少。
