神经肌肉电刺激对血糖控制的影响：系统评价和荟萃分析。
Effects of neuromuscular electrical stimulation on glycemic control: a systematic review and meta-analysis.
机构信息
Metabolic, Nutrition, and Exercise Research (MiNER) Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States.
Muscle Molecular Physiology Laboratory, Department of Kinesiology, The University of Texas at El Paso, El Paso, TX, United States.
出版信息
Front Endocrinol (Lausanne). 2023 Jul 31;14:1222532. doi: 10.3389/fendo.2023.1222532. eCollection 2023.
BACKGROUND
Physical inactivity increases the risk for metabolic diseases such as obesity and type 2 diabetes. Neuromuscular electrical stimulation (NMES) is an effective method to induce muscle contraction, particularly for populations with physical impairments and/or metabolic diseases. However, its effectiveness to improve glycemic control is unclear. This review aimed to determine the effectiveness of NMES on glycemic control.
METHODS
Electronic search consisted of MEDLINE (PubMed), EMBASE, Cochrane Library, Google Scholar, and Web of Science to identify studies that investigated the effects of NMES on glycemic control for this systematic review. The meta-analysis consists of the studies designed as randomized controlled trials. Effect sizes were calculated as the standardized mean difference (SMD) and meta-analysis was conducted using a random-effects model.
RESULTS
Thirty-five studies met the inclusion criteria for systematic review and of those, nine qualified for the meta-analysis. Existing evidence suggested that NMES effectively improves glycemic control predominantly in middle-aged and elderly population with type 2 diabetes, obesity, and spinal cord injury. The meta-analysis is comprised of 180 participants and reported that NMES intervention lowered fasting blood glucose (SMD: 0.48; 95% CI: 0.17 to 0.78; p=0.002; I²=0%). Additional analysis using the primary measures reported by each study to indicate glycemic control (i.e., OGTT, HOMA-IR, and fasting glucose) also confirmed a significant effect of NMES on improving glycemic control (SMD: 0.41; 95% CI, 0.09 to 0.72; p=0.01; I²=11%). NMES protocol varied across studies and requires standardization.
CONCLUSION
NMES could be considered as a therapeutic strategy to improve glycemic control in populations with physical impairments and/or metabolic disorders.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42020192491.
背景
身体活动不足会增加代谢疾病的风险，如肥胖和 2 型糖尿病。神经肌肉电刺激（NMES）是一种有效的诱导肌肉收缩的方法，特别是对于身体功能障碍和/或代谢疾病的人群。然而，其改善血糖控制的效果尚不清楚。本综述旨在确定 NMES 对血糖控制的有效性。
方法
电子检索包括 MEDLINE（PubMed）、EMBASE、Cochrane 图书馆、谷歌学术和 Web of Science，以确定研究 NMES 对血糖控制影响的研究。荟萃分析包括设计为随机对照试验的研究。效应大小计算为标准化均数差（SMD），并使用随机效应模型进行荟萃分析。
结果
35 项研究符合系统评价的纳入标准，其中 9 项符合荟萃分析的标准。现有证据表明，NMES 主要能有效改善 2 型糖尿病、肥胖和脊髓损伤中老年人群的血糖控制。荟萃分析包括 180 名参与者，报告 NMES 干预降低了空腹血糖（SMD：0.48；95%CI：0.17 至 0.78；p=0.002；I²=0%）。使用每个研究报告的主要措施（即 OGTT、HOMA-IR 和空腹血糖）进行的额外分析也证实了 NMES 对改善血糖控制的显著效果（SMD：0.41；95%CI，0.09 至 0.72；p=0.01；I²=11%）。NMES 方案在研究之间存在差异，需要标准化。
结论
NMES 可以被视为改善身体功能障碍和/或代谢紊乱人群血糖控制的一种治疗策略。
系统评价注册
https://www.crd.york.ac.uk/prospero/，标识符 CRD42020192491。
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