Wei Huiting, Zhang Jiabao, Cui Kaiyin, Su Hao
Sport Science School, Beijing Sport University, Beijing, China.
Beijing Higher School Engineering Research Center of Sport Nutrition, Beijing, China.
Front Nutr. 2025 Aug 12;12:1575580. doi: 10.3389/fnut.2025.1575580. eCollection 2025.
This study aimed to assess the benefits of ≥8-week exercise interventions for stage sarcopenic obesity (SO) without complications.
Randomized controlled trials (RCTs) published from 2004 to July 2024 were searched in PubMed, Embase, Web of Science, the Cochrane Library, and EBSCO. Publication bias was assessed using funnel plots and Egger's test. The search strategy was prospectively registered in PROSPERO (ID number: CRD42024619070). Heterogeneity (I > 50%) was managed using random-effects models.
Fifteen parallel-group RCTs involving 623 elderly adults (aged ≥60 years) were included. Exercise significantly reduced BMI (MD = -1.35, < 0.0001), with combined exercise (CE) being the most effective (MD = -1.25, < 0.001). Body fat percentage decreased (MD = -0.52, < 0.00001) with CE outperforming resistance training (RT). No significant changes in fat mass or muscle mass were found (fat mass, = 0.19; appendicular skeletal muscle mass, = 0.88; and appendicular skeletal muscle mass index, = 0.86). Physical function (grip strength, gait speed, and the timed Up and Go test) improved significantly ( < 0.00001); RT and CE enhanced muscle strength, with RT being superior (MD = 3.43 vs. 2.64 for CE, both < 0.00001). Additionally, CE lowered insulin (MD = -1.73, < 0.05) and total cholesterol (MD = -0.38, < 0.05) levels, with marginal interleukin-6 reduction (MD = -0.51, = 0.08). Other metabolic and inflammatory markers (glucose, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, tumor necrosis factor-, and C-reactive protein) remained unchanged.
≥8-week exercise improves body composition in stage SO, with CE being the most effective for fat loss. Physical function improves with both RT and CE, and RT is better for muscle strength, while CE benefits metabolism and inflammation. We recommend that CE (≥3 times/week, 45 min/session) be used for high inflammation and RT (2-3 times/week, 60-80% of 1-RM) for low inflammation. Based on observed data trends, promoting a CE model of three aerobic exercises + two RT sessions weekly is advisable, with the intensity adjusted to 40-50% 1-RM for stage elderly patients. Future research needs large-sample, long-term RCTs with subgroup analyses and exercise-nutrition combinations.
The search strategy was prospectively registered in PROSPERO (ID number: CRD42024619070).
本研究旨在评估为期≥8周的运动干预对无并发症的II期肌肉减少性肥胖（SO）的益处。
在PubMed、Embase、Web of Science、Cochrane图书馆和EBSCO中检索2004年至2024年7月发表的随机对照试验（RCT）。使用漏斗图和Egger检验评估发表偏倚。检索策略已在PROSPERO（注册号：CRD42024619070）中预先注册。使用随机效应模型处理异质性（I²>50%）。
纳入了15项平行组RCT，涉及623名老年人（年龄≥60岁）。运动显著降低了体重指数（MD=-1.35，P<0.0001），其中联合运动（CE）最为有效（MD=-1.25，P<0.001）。体脂百分比下降（MD=-0.52，P<0.00001），CE优于阻力训练（RT）。未发现脂肪量或肌肉量有显著变化（脂肪量，P=0.19；四肢骨骼肌量，P=0.88；四肢骨骼肌量指数，P=0.86）。身体功能（握力、步速和定时起立行走测试）显著改善（P<0.00001）；RT和CE增强了肌肉力量，RT更优（CE的MD=2.64，RT的MD=3.43，两者P<0.00001）。此外，CE降低了胰岛素（MD=-1.73，P<0.05）和总胆固醇（MD=-0.38，P<0.05）水平，白细胞介素-6略有降低（MD=-0.51，P=0.08）。其他代谢和炎症标志物（葡萄糖、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、肿瘤坏死因子-α和C反应蛋白）保持不变。
为期≥8周的运动可改善II期SO的身体成分，CE对减脂最有效。RT和CE均可改善身体功能，RT对肌肉力量的提升更佳，而CE有益于代谢和炎症。我们建议，对于炎症较高的情况采用CE（每周≥3次，每次45分钟），对于炎症较低的情况采用RT（每周2-3次，1-RM的60-80%）。根据观察到的数据趋势，建议推广每周三次有氧运动+两次RT训练的CE模式，对于II期老年患者，强度调整为40-50%1-RM。未来的研究需要大样本、长期的RCT以及亚组分析和运动-营养组合研究。
检索策略已在PROSPERO中预先注册（注册号：CRD42024619070）。
