Al-Mhanna Sameer Badri, Alghannam Abdullah F, Alkhamees Nouf H, Sheeha Bodor Bin, Omar Norsuhana, Albalawi Hani, Gülü Mehmet, Canli Umut, Afolabi Hafeez Abiola, Abubakar Bishir Daku, Badicu Georgian, Ahmad Rozaziana, Grivas Gerasimos V, Batrakoulis Alexios
Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.
PeerJ. 2025 Jun 11;13:e19537. doi: 10.7717/peerj.19537. eCollection 2025.
The potential advantages of concurrent aerobic and resistance training (CART) for enhancing cardiometabolic health-related outcomes appear to surpass the outcomes of engaging in aerobic or resistance training alone. The present study aimed to synthesize the available scientific evidence on the effects of CART on body composition, lipid metabolism, and physical function in patients with type 2 diabetes and overweight/obesity.
PubMed, Scopus, ScienceDirect, Cochrane Library, and Google Scholar were searched from inception to August 7, 2024. The review focused on randomized controlled trials and controlled clinical trials of CART. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the reliability of evidence. A random-effects model was used and data were analyzed using standardized mean differences (SMD) and 95% confidence intervals (CI).
A total of 22,878 studies were retrieved; only 20 studies were included, and data were extracted from 1,289 participants (57.0 ± 7.0 years; 31.1 ± 4.6 kg/m) who met the eligibility criteria. CART group significantly reduced body fat percentage (SMD -0.42, 95% CI [-0.70 to -0.15]), low-density lipoprotein-cholesterol (SMD -0.32, 95% CI [-0.62 to -0.02]), triglycerides (SMD -0.48, 95% CI [-0.71 to -0.24]), total cholesterol (SMD -0.35, 95% CI [-0.58 to -0.12]), and fasting blood glucose levels compared to standard treatment (non-exercising controls). CART significantly increased high-density lipoprotein-cholesterol (SMD 0.44, 95% CI [0.05-0.82]) and improved physical function (cardiorespiratory fitness: SMD 78.78, 95% CI [46.30-111.25]; muscular fitness: SMD 5.19, 95% CI [1.80-8.59]) compared to standard treatment. There were no significant differences in body mass, waist-to-hip ratio, fat mass, and lean body mass between CART and standard treatment. An uncertain risk of bias and poor quality of evidence were observed in the eligible studies.
The present results indicate clear evidence that CART has a beneficial role in the improvement of several cardiometabolic health-related parameters in patients with type 2 diabetes and concomitant overweight/obesity. More trials with robust methodological design are needed to investigate the dose-response effects, training parameters formation, and potential mechanisms.
有氧运动与抗阻训练相结合（CART）在改善心脏代谢健康相关指标方面的潜在优势似乎超过单纯进行有氧运动或抗阻训练的效果。本研究旨在综合现有科学证据，探讨CART对2型糖尿病合并超重/肥胖患者身体成分、脂质代谢和身体功能的影响。
检索了PubMed、Scopus、ScienceDirect、Cochrane图书馆和谷歌学术数据库，检索时间范围从建库至2024年8月7日。本综述聚焦于CART的随机对照试验和对照临床试验。采用Cochrane偏倚风险工具评估符合条件的研究，并使用GRADE方法评估证据的可靠性。采用随机效应模型，使用标准化均数差（SMD）和95%置信区间（CI）分析数据。
共检索到22878项研究；仅纳入20项研究，并从1289名符合纳入标准的参与者（年龄57.0±7.0岁；体重指数31.1±4.6kg/m²）中提取数据。与标准治疗（非运动对照组）相比，CART组显著降低了体脂百分比（SMD -0.42，95%CI[-0.70至-0.15]）、低密度脂蛋白胆固醇（SMD -0.32，95%CI[-0.62至-0.02]）、甘油三酯（SMD -0.48，95%CI[-0.71至-0.24]）、总胆固醇（SMD -0.35，95%CI[-0.58至-0.12]）和空腹血糖水平。与标准治疗相比，CART显著提高了高密度脂蛋白胆固醇（SMD 0.44，95%CI[0.05 - 0.82]），并改善了身体功能（心肺适能：SMD 78.78，95%CI[46.30 - 111.25]；肌肉适能：SMD 5.19，95%CI[1.80 - 8.59]）。CART组与标准治疗组在体重、腰臀比、脂肪量和去脂体重方面无显著差异。在符合条件的研究中观察到偏倚风险不确定且证据质量较差。
目前的结果表明，有明确证据显示CART对改善2型糖尿病合并超重/肥胖患者的多个心脏代谢健康相关参数具有有益作用。需要更多方法设计严谨的试验来研究剂量反应效应、训练参数构成和潜在机制。
