Ancín-Osés Arantxa, Izquierdo Mikel, Cuesta Manuel J, Sáez de Asteasu Mikel L
Navarrabiomed, Hospital Universitario de Navarra (HUN), https://ror.org/02z0cah89Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Spain.
CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain.
Eur Psychiatry. 2025 Jul 18;68(1):e101. doi: 10.1192/j.eurpsy.2025.10064.
Physical exercise improves mental and physical health of individuals with severe mental illness (SMI); however, its impact on metabolic syndrome remains unclear.
To evaluate the effects of exercise interventions on metabolic syndrome components in individuals with SMI and explore interactions between exercise and antipsychotic medications on metabolic outcomes.
Following PRISMA guidelines, we systematically searched PubMed, CINAHL, Web of Science, and APA PsycINFO through October 10, 2023, for randomized controlled trials (RCTs) assessing the effects of exercise on waist circumference, blood pressure, glucose, triglycerides, and HDL cholesterol in SMI. Risk of bias was evaluated using the Cochrane RoB-2 tool. Data were pooled using random-effects models in Comprehensive Meta-Analysis and JASP.
Ten RCTs ( = 773; mean age 39.9 ± 7.36 years; 38.7% female; 71.5% schizophrenia spectrum disorders) met inclusion criteria. Pooled analyses revealed no significant effects of exercise on waist circumference (SMD = 0.206, 95% CI [-0.118, 0.530], = 0.171), systolic blood pressure (SMD = 0.194, 95% CI [-0.115, 0.504], = 0.219), diastolic blood pressure (SMD = -0.21, 95% CI [-0.854, 0.434], = 0.522), HDL (SMD = 0.157, 95% CI [-0.36, 0.674], = 0.551), triglycerides (SMD = -0.041, 95% CI [-0.461, 0.38], = 0.849), or glucose (SMD = -0.071, 95% CI [-0.213, 0.071], = 0.326). Heterogeneity was moderate to high.
Exercise interventions did not significantly improve metabolic syndrome components in SMI. Future trials must prioritize tailored regimens, adjunctive therapies, and rigorous control of medication effects.
体育锻炼可改善重症精神疾病（SMI）患者的身心健康；然而，其对代谢综合征的影响仍不明确。
评估运动干预对SMI患者代谢综合征各组分的影响，并探讨运动与抗精神病药物对代谢结果的相互作用。
遵循PRISMA指南，我们系统检索了截至2023年10月10日的PubMed、CINAHL、Web of Science和APA PsycINFO，以查找评估运动对SMI患者腰围、血压、血糖、甘油三酯和高密度脂蛋白胆固醇影响的随机对照试验（RCT）。使用Cochrane RoB-2工具评估偏倚风险。在Comprehensive Meta-Analysis和JASP中使用随机效应模型合并数据。
10项RCT（n = 773；平均年龄39.9 ± 7.36岁；38.7%为女性；71.5%为精神分裂症谱系障碍）符合纳入标准。汇总分析显示，运动对腰围（标准化均数差[SMD]=0.206，95%可信区间[-0.118, 0.530]，P = 0.171）、收缩压（SMD = 0.194，95%可信区间[-0.115, 0.504]，P = 0.219）、舒张压（SMD = -0.21，95%可信区间[-0.854, 0.434]，P = 0.522）、高密度脂蛋白（SMD = 0.157，95%可信区间[-0.36, 0.674]，P = 0.551）、甘油三酯（SMD = -0.041，95%可信区间[-0.461, 0.38]，P = 0.849）或血糖（SMD = -0.071，95%可信区间[-0.213, 0.071]，P = 0.326）均无显著影响。异质性为中度到高度。
运动干预并未显著改善SMI患者的代谢综合征组分。未来的试验必须优先考虑量身定制的方案、辅助治疗以及对药物效应的严格控制。
