Leonardo Santos Lopes da Silva, Bandeirantes Avenue nº 3900, University Campus - Monte Alegre, Ribeirao Preto-SP, Brazil. Zip code: 14030-680 Contact: +55 17 98154-4151,
J Nutr Health Aging. 2023;27(11):1076-1090. doi: 10.1007/s12603-023-2018-6.
To carry out a systematic review and meta-analysis to verify the effects of different exercise training types on body composition and physical performance in older adults with sarcopenic obesity (SO).
Systematic review and meta-analysis.
Older adults (≥60 years).
Database searches were performed in MEDLINE (via PubMed), EMBASE, Cochrane Library, Web of Science, SCOPUS, and LILACS on January 10th, 2023. We included: randomized and/or controlled clinical trials; physical exercise as an intervention; analysis of body composition and/or muscle function; and sarcopenic obesity diagnosis. We used the Risk of Bias 2 tool and PEDro scale. The GRADE certainty of evidence was also performed.
Fourteen studies were included in the systematic review and nine studies in the meta-analysis. A decrease in body fat (%) favoring the exercise group was identified (SMD: -0.34 [95% CI: -0.53 to -0.16]; p=0.0003) (GRADE: ⊕⊕⊕◯ Moderate). Only resistance training showed fat reduction (SMD: -0.27 [95% CI: -0.48 to -0.06]; p=0.01). Increases in upper (SMD: 0.41 [95% CI: 0.04 to 0.78]; p=0.03) (GRADE: ⊕⊕◯◯ Low) and lower (SMD: 0.80 [95% CI: 0.22 to 1.39]; p=0.007) (GRADE: ⊕⊕⊕⊕ High) limb strength was identified with exercise. Chair stand test showed increases with exercise (SMD: 0.73 [95% CI: 0.40 to 1.07]; p<0.0001) (GRADE: ⊕⊕⊕⊕ High), especially for resistance training (SMD: 0.62 [95% CI: 0.21 to 1.02]; p=0.003) and combined training (SMD: 0.99 [95% CI: 0.40 to 1.57]; p=0.0005). The PEDro scale for the studies in our review ranged from 3 to 8 (mean = 5.8 (1.6)), meaning fair methodological quality, and most studies were overall judged with at least low/some concerns in terms of risk of bias.
Overall, moderate to high certainty of evidence was found for body fat, lower limb strength, and chair stand test. On the other hand, low certainty of evidence was found for upper limb strength. Resistance, combined, and aerobic training evoked divergent results between the variables analyzed. Although promising, our results should be considered sparingly, but may guide additional exercise recommendations to improve specific health parameters in older adults with SO.
系统回顾和荟萃分析验证不同运动训练类型对伴有肌肉减少症肥胖（SO）的老年人身体成分和身体表现的影响。
系统回顾和荟萃分析。
老年人（≥60 岁）。
于 2023 年 1 月 10 日在 MEDLINE（通过 PubMed）、EMBASE、Cochrane 图书馆、Web of Science、SCOPUS 和 LILACS 进行数据库检索。我们纳入了：随机和/或对照临床试验；作为干预措施的身体运动；身体成分和/或肌肉功能分析；以及肌肉减少症肥胖症的诊断。我们使用了风险偏倚 2 工具和 PEDro 量表。还进行了证据确定性的 GRADE 分级。
系统综述纳入了 14 项研究，荟萃分析纳入了 9 项研究。发现运动组的体脂（%）减少（SMD：-0.34 [95%CI：-0.53 至-0.16]；p=0.0003）（GRADE：⊕⊕⊕◯ 中等）。只有抗阻训练显示出脂肪减少（SMD：-0.27 [95%CI：-0.48 至-0.06]；p=0.01）。上肢（SMD：0.41 [95%CI：0.04 至 0.78]；p=0.03）和下肢（SMD：0.80 [95%CI：0.22 至 1.39]；p=0.007）的力量增加被发现与运动有关。坐立起身测试显示运动后有增加（SMD：0.73 [95%CI：0.40 至 1.07]；p<0.0001）（GRADE：⊕⊕⊕⊕ 高），特别是抗阻训练（SMD：0.62 [95%CI：0.21 至 1.02]；p=0.003）和组合训练（SMD：0.99 [95%CI：0.40 至 1.57]；p=0.0005）。我们综述中研究的 PEDro 量表范围为 3 至 8（平均值=5.8（1.6）），这意味着方法学质量为中等，并且大多数研究在偏倚风险方面总体上被评为至少有低度/一些关注。
总的来说，身体脂肪、下肢力量和坐立起身测试的证据确定性为中等至高度。另一方面，上肢力量的证据确定性为低度。抗阻、组合和有氧训练在分析的变量之间产生了不同的结果。尽管有希望，但我们的结果应谨慎考虑，但可能为改善伴有肌肉减少症肥胖的老年人的特定健康参数提供额外的运动建议。
