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阻力训练对2型糖尿病合并超重/肥胖患者心脏代谢健康相关指标的影响:一项随机对照试验的系统评价和荟萃分析

Impact of resistance training on cardiometabolic health-related indices in patients with type 2 diabetes and overweight/obesity: a systematic review and meta-analysis of randomised controlled trials.

作者信息

Al-Mhanna Sameer Badri, Franklin Barry A, Jakicic John M, Stamatakis Emmanuel, Pescatello Linda S, Riebe Deborah, Thompson Walter R, Skinner James, Colberg Sheri R, Alkhamees Nouf H, Bin Sheeha Bodor, Gülü Mehmet, Alghannam Abdullah F, Batrakoulis Alexios

机构信息

Center for Global Health Research, Saveetha Institute of Medical and Technical Sciences (Deemed to be University), Chennai, Tamil Nadu, India.

Department of Higher Studies, Al Qasim Green University, Al Qasim, Iraq.

出版信息

Br J Sports Med. 2025 May 2;59(10):733-746. doi: 10.1136/bjsports-2024-108947.

Abstract

OBJECTIVE

To evaluate the effects of resistance training on cardiometabolic health-related outcomes in patients with type 2 diabetes mellitus (T2DM) and overweight/obesity.

DESIGN

Systematic review and meta-analysis of randomised controlled trials (RCTs).

DATA SOURCES

PubMed, Web of Science, Scopus, Science Direct, Cochrane Library and Google Scholar databases were searched from inception up to May 2024. The search strategy included the following keywords: diabetes, resistance exercise and strength training.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

RCTs published in English comparing resistance training alone with non-exercising standard treatment. Participants were adults diagnosed with T2DM and concurrent overweight/obesity (body mass index (BMI) ≥25 kg/m).

RESULTS

A total of 18 RCTs qualified involving 1180 patients (48.6/51.4 female/male ratio; 63.3±7.0 years; 29.3±4.3 kg/m). Waist circumference (standardised mean differences (SMD) -0.85 cm, 95% CI -1.66 to -0.04), waist-to-hip ratio (SMD -0.72, 95% CI -1.30 to -0.15), high-density lipoprotein cholesterol (SMD +0.40 mg/dL, 95% CI 0.07 to -0.72), triglycerides (SMD -0.54 mg/dL, 95% CI -1.06 to -0.02), fasting blood glucose (SMD -0.65 mmol/L, 95% CI -1.19 to -0.12), fasting insulin (SMD -0.74 uIU/mL, 95% CI -1.12 to -0.36) and glycated haemoglobin (SMD -0.32%, 95% CI -0.63 to -0.01) improved compared with standard treatment. The risk of bias was low to unclear, and the quality of evidence was very low to moderate.

CONCLUSIONS

Resistance training as a standalone exercise intervention in the management and treatment of T2DM with concurrent overweight/obesity is associated with many cardiometabolic benefits when compared with standard treatment without exercise.

PROSPERO REGISTRATION NUMBER

CRD42022355612.

摘要

目的

评估抗阻训练对2型糖尿病(T2DM)合并超重/肥胖患者心脏代谢健康相关结局的影响。

设计

随机对照试验(RCT)的系统评价和荟萃分析。

数据来源

检索了PubMed、科学网、Scopus、Science Direct、Cochrane图书馆和谷歌学术数据库,检索时间从建库至2024年5月。检索策略包括以下关键词:糖尿病、抗阻运动和力量训练。

研究选择的纳入标准

以英文发表的RCT,比较单独抗阻训练与非运动标准治疗。参与者为诊断为T2DM并伴有超重/肥胖(体重指数(BMI)≥25 kg/m²)的成年人。

结果

共有18项RCT符合要求,涉及1180例患者(男女比例为48.6/51.4;年龄63.3±7.0岁;BMI 29.3±4.3 kg/m²)。与标准治疗相比,腰围(标准化均数差(SMD)-0.85 cm,95%CI -1.66至-0.04)、腰臀比(SMD -0.72,95%CI -1.30至-0.15)、高密度脂蛋白胆固醇(SMD +0.40 mg/dL,95%CI 0.07至0.72)、甘油三酯(SMD -0.54 mg/dL,95%CI -1.06至-0.02)、空腹血糖(SMD -0.65 mmol/L,95%CI -1.19至-0.12)、空腹胰岛素(SMD -0.74 uIU/mL,95%CI -1.12至-0.36)和糖化血红蛋白(SMD -0.32%,95%CI -0.63至-0.01)均有所改善。偏倚风险为低至不清楚,证据质量为极低至中等。

结论

与无运动的标准治疗相比,抗阻训练作为T2DM合并超重/肥胖管理和治疗中的单独运动干预措施,与许多心脏代谢益处相关。

PROSPERO注册号:CRD42022355612。

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