2型糖尿病患者的运动训练与炎性脂肪因子：一项系统评价、荟萃分析和Meta回归分析
Exercise training and inflammatory adipokines in patients with type 2 diabetes: a systematic review, meta-analysis, and meta-regression.
作者信息
Pourkoshki Arezoo, Monazzami Amirabbas, Heydarpour Fatemeh, Yon Dong Keon, Smith Lee, Rahmati Masoud
机构信息
Department of Sport Physiology, Faculty of Sport Science, Razi University, Kermanshah, Iran.
Medical Biology Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
出版信息
Diabetol Metab Syndr. 2025 Jun 18;17(1):224. doi: 10.1186/s13098-025-01811-8.
BACKGROUND
Improvements in adipocytes levels can reduce the risk of diabetes and cardiovascular disease, indicating adipocytes to be a hopeful remedial target in type 2 diabetes mellitus (T2DM) and other related diseases. However, there is no consensus on the role of various exercise training on adipokines in T2DM and the results are contradictory. Therefore, this systematic review, meta-analysis, and meta-regression investigated the effects of different types of exercise training on some inflammatory adipokines concentrations in T2DM.
METHODS
A systematic search was conducted in PubMed/MEDLINE, Web of Science, Embase, Google Scholar, and Cochrane up to September 2024. Studies investigating the effects of exercise training on Resistin, apelin, visfatin, and vaspin were included. Meta-analysis was performed using a random-effect model (DerSimonian-Laird method) to calculate weighted means differences with 95% confidence intervals (CIs). The Cochrane Collaboration's tool was also used to asses risk of bias of studies.
RESULTS
Analysis of 36 studies (50 intervention arms, n = 1811) demonstrated that exercise training significantly decreased resistin (mean difference [MD]: -1.02 ng/ml, 95% CI -1.48 to -0.57, p < 0.0001) and visfatin (MD: -0.70 ng/ml, 95% CI -1.07 to -0.32, p = 0.0002) levels but had no significant effect on Apelin (MD: 0.02 ng/ml, 95% CI -0.04 to 0.08, p = 0.55) and vaspin (MD: 0.00 ng/ml, 95% CI -0.0 to 0.0, p = 0.69) levels compared to control in T2DM. Stronger effects were observed in combined training in men and more than 8 weeks of intervention. Meta-regression analysis also showed that there is a significant linear relation between changes in resistin with BMI changes but other variables were not observed to have significant linear relationships with changes of BMI, glucose, Insulin, and HOMA-IR.
CONCLUSIONS
Overall, aerobic and combined training decreased inflammatory adipokines with a positive supplementary effect for patient with T2DM.
REGISTRATION
PROSPERO registration no. CRD42024617538.
背景
脂肪细胞水平的改善可降低糖尿病和心血管疾病的风险，这表明脂肪细胞是2型糖尿病（T2DM）及其他相关疾病中一个有希望的治疗靶点。然而，关于各种运动训练对T2DM患者脂肪因子的作用尚无共识，且结果相互矛盾。因此，本系统评价、荟萃分析和荟萃回归研究了不同类型的运动训练对T2DM患者某些炎症性脂肪因子浓度的影响。
方法
截至2024年9月，在PubMed/MEDLINE、科学网、Embase、谷歌学术和考克兰系统评价数据库中进行了系统检索。纳入了研究运动训练对抵抗素、脂联素、内脂素和内脏脂肪素影响的研究。采用随机效应模型（DerSimonian-Laird法）进行荟萃分析，以计算加权平均差及95%置信区间（CI）。还使用了考克兰协作网的工具来评估研究的偏倚风险。
结果
对36项研究（50个干预组，n = 1811）的分析表明，与T2DM对照组相比，运动训练显著降低了抵抗素（平均差[MD]：-1.02 ng/ml，95%CI -1.48至-0.57，p < 0.0001）和内脂素（MD：-0.70 ng/ml，95%CI -1.07至-0.32，p = 0.0002）水平，但对脂联素（MD：0.02 ng/ml，95%CI -0.04至0.08，p = 0.55）和内脏脂肪素（MD：0.00 ng/ml，95%CI -0.0至0.0，p = 0.69）水平无显著影响。在男性的联合训练和超过8周的干预中观察到更强的效果。荟萃回归分析还表明，抵抗素变化与BMI变化之间存在显著的线性关系，但未观察到其他变量与BMI、血糖、胰岛素和HOMA-IR的变化有显著的线性关系。
结论
总体而言，有氧运动和联合训练可降低炎症性脂肪因子水平，对T2DM患者有积极的辅助作用。
注册信息
PROSPERO注册号CRD42024617538。
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