运动训练对超重或肥胖儿童和青少年胰岛素抵抗的影响:系统评价和荟萃分析。

The effects of exercise training on insulin resistance in children and adolescents with overweight or obesity: a systematic review and meta-analysis.

机构信息

Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.

Department of Cancer Research Center, Shahid Beheshti of Medical Sciences, Tehran, Iran.

出版信息

Front Endocrinol (Lausanne). 2023 Aug 10;14:1178376. doi: 10.3389/fendo.2023.1178376. eCollection 2023.

Abstract

AIM

The aim of present meta-analysis was to determine the effects of exercise training (Exe) on insulin resistance (IR) and body weight in children and adolescents with overweight or obesity.

METHODS

PubMed, Web of Science, and Scopus were searched for original articles, published through October 2022 that included exercise versus control interventions on fasting glucose, insulin, HOMA-IR, and body weight outcomes in children and adolescents with overweight or obesity. Standardized mean differences (SMD) for fasting insulin, and weighted mean differences (WMD) for fasting glucose, HOMA-IR, body weight (BW), and 95% confidence intervals were determined using random effects models.

RESULTS

Thirty-five studies comprising 1,550 children and adolescents with overweight and obesity were included in the present meta-analysis. Exercise training reduced fasting glucose (WMD=-2.52 mg/dL, p=0.001), fasting insulin (SMD=-0.77, p=0.001), HOMA-IR (WMD=-0.82, p=0.001), and BW (WMD=-1.51 kg, p=0.001), as compared to a control. Subgroup analyses showed that biological sex, intervention duration, type of exercise training, BMI percentile, and health status (with or without diagnosed condition), were sources of heterogeneity.

CONCLUSION

Exercise training is effective for lowering fasting glucose, fasting insulin, HOMA-IR, and BW in children and adolescents with overweight or obesity and could provide an important strategy for controlling IR and related factors. With clear evidence for the effectiveness of exercise interventions in this vulnerable population, it is important to determine effective approaches for increasing exercise training in children and adolescents with overweight or obesity.

摘要

目的

本荟萃分析的目的是确定运动训练(Exe)对超重或肥胖儿童和青少年胰岛素抵抗(IR)和体重的影响。

方法

检索了 PubMed、Web of Science 和 Scopus,以获取截至 2022 年 10 月发表的关于超重或肥胖儿童和青少年进行空腹血糖、胰岛素、HOMA-IR 和体重干预的对照试验的原始文章。使用随机效应模型确定空腹胰岛素的标准化均数差(SMD)和空腹血糖、HOMA-IR、体重(BW)的加权均数差(WMD)及 95%置信区间。

结果

本荟萃分析共纳入 35 项研究,包括 1550 名超重和肥胖的儿童和青少年。与对照组相比,运动训练降低了空腹血糖(WMD=-2.52mg/dL,p=0.001)、空腹胰岛素(SMD=-0.77,p=0.001)、HOMA-IR(WMD=-0.82,p=0.001)和 BW(WMD=-1.51kg,p=0.001)。亚组分析表明,生物性别、干预持续时间、运动训练类型、BMI 百分位数和健康状况(有无诊断)是异质性的来源。

结论

运动训练对降低超重或肥胖儿童和青少年的空腹血糖、空腹胰岛素、HOMA-IR 和 BW 是有效的,可为控制 IR 及相关因素提供重要策略。鉴于运动干预对这一脆弱人群的有效性有明确证据,确定增加超重或肥胖儿童和青少年运动训练的有效方法非常重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1700/10450243/bed6ae6af65d/fendo-14-1178376-g001.jpg

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