生活方式干预促进身体活动对2型糖尿病患者身体活动及糖化血红蛋白的影响：一项系统评价与Meta分析

Effects of Lifestyle Interventions to Promote Physical Activity on Physical Activity and Glycated Hemoglobin in Patients with Type 2 Diabetes: a Systematic Review and Meta-Analysis.

作者信息

Hohberg Vivien, Lichtenstein Eric, Kreppke Jan-Niklas, Zanitti Cedrine, Streckmann Fiona, Gerber Markus, Faude Oliver

机构信息

Department of Sport, Exercise and Health, University of Basel, Gross Allee 6, 4052, Basel, Switzerland.

Institute of Movement and Neurosciences, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933, Cologne, Germany.

出版信息

Sports Med. 2025 Mar 13. doi: 10.1007/s40279-025-02184-8.

DOI:10.1007/s40279-025-02184-8

PMID:40080359

Abstract

BACKGROUND

Numerous studies have explored the impact of controlled exercise interventions in type 2 diabetes, as physical activity can positively influence its progression. However, our understanding of how broader lifestyle interventions can effectively promote physical activity in practical real-world scenarios remains limited.

OBJECTIVE

This systematic review and meta-analysis aimed to investigate the potential of lifestyle interventions targeting the promotion of physical activity on physical activity outcomes and glycated hemoglobin (HbA1c), providing a comprehensive understanding of both behavioral and clinical impacts.

METHODS

We performed a systematic review and meta-analysis, searching three databases and examined the study design, structure, and content of the lifestyle interventions. We assessed physical activity and HbA1c as endpoints and performed a multivariate meta-regression to explore physical activity's impact on HbA1c.

RESULTS

This review incorporated 13 studies (n = 5301 patients), with heterogeneity in intervention designs, components, and durations. Lifestyle interventions showed a slight increase in physical activity, equivalent to an average of 9.0 min more total physical activity per day (95% confidence interval 5.8, 12.2) and 1.7 min more moderate-to-vigorous physical activity per day (95% confidence interval 1.1, 2.3), irrespective of objective (e.g., accelerometers) or subjective measurement (e.g., questionnaires) method. However, HbA1c reduction through these interventions was minimal 0.09% (95% confidence interval - 0.20, 0.03). The effect of physical activity was - 0.04 (standard error = 0.05, 95% confidence interval - 0.15, 0.06), suggesting that physical activity does not act as a moderator for changes in HbA1c.

CONCLUSIONS

Lifestyle interventions effectively increase physical activity but have limited impact on HbA1c compared to controls. The role of physical activity as a moderator for changes in HbA1c remains uncertain. Further research is needed to enhance the efficacy of these interventions in reducing HbA1c in individuals with type 2 diabetes.

摘要

背景

许多研究探讨了有控制的运动干预对2型糖尿病的影响，因为体育活动可对其病情发展产生积极影响。然而，我们对于更广泛的生活方式干预如何在实际现实场景中有效促进体育活动的了解仍然有限。

目的

本系统评价和荟萃分析旨在研究以促进体育活动为目标的生活方式干预对体育活动结果和糖化血红蛋白（HbA1c）的潜在影响，全面了解其行为和临床影响。

方法

我们进行了一项系统评价和荟萃分析，检索了三个数据库，并审查了生活方式干预的研究设计、结构和内容。我们将体育活动和HbA1c作为终点指标，并进行多变量荟萃回归以探讨体育活动对HbA1c的影响。

结果

本评价纳入了13项研究（n = 5301例患者），干预设计、组成部分和持续时间存在异质性。生活方式干预使体育活动略有增加，相当于每天总体育活动平均增加9.0分钟（95%置信区间5.8，12.2），每天中度至剧烈体育活动增加1.7分钟（95%置信区间1.1，2.3），无论采用客观（如加速度计）或主观测量（如问卷调查）方法。然而，通过这些干预使HbA1c降低幅度极小，为0.09%（95%置信区间−0.20，0.03）。体育活动的效应为−0.04（标准误 = 0.05，95%置信区间−0.15，0.06），表明体育活动并非HbA1c变化的调节因素。