循证研究

运动对2型糖尿病患者血脂影响的网状Meta分析

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  • 1.郑州大学护理学院,河南郑州市 450001
    2.社区健康维护系统河南省工程实验室,河南郑州市 450001
陈影(1994-),女,汉族,河南信阳市人,硕士研究生,主要研究方向:心血管疾病。

收稿日期: 2018-05-30

  修回日期: 2018-08-09

  网络出版日期: 2019-07-23

基金资助

河南省国际科技合作计划项目(No. 144300510056)

Effect of Exercise on Blood Lipid for Patients with Type 2 Diabetes: A Network Meta-analysis

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  • 1.Nursing College of Zhengzhou University, Zhengzhou, Henan 450001, China
    2.Community Health Maintenance System Henan Engineering Laboratory, Zhengzhou, Henan 450001, China

Received date: 2018-05-30

  Revised date: 2018-08-09

  Online published: 2019-07-23

Supported by

Supported by Foundation:Henan International Science and Technology Program (No. 144300510056)

摘要

目的 采用网状Meta分析方法评价有氧运动、抗阻运动和有氧结合抗阻运动(联合运动)对2型糖尿病患者血脂的影响,以制定运动处方。 方法 检索PubMed、Ovid、Web of Science、Cochrane Library、Springer Link、Science Direct、中国知网、万方和中国生物医学文献数据库,并追溯参考文献作为补充,筛选三种运动方式对2型糖尿病患者血脂影响的随机对照试验,对所纳入研究进行方法学质量评价,应用R-Studio软件、Stata 14.0软件和Review Manager 5.3软件进行统计学分析。 结果 最终纳入21个随机对照试验,共1735例2型糖尿病患者。根据敏感性分析剔除2篇质量较差文献后,与对照组相比,三种运动方式均能显著降低2型糖尿病患者空腹血糖、总胆固醇水平、甘油三酯水平、低密度脂蛋白水平,提高高密度脂蛋白水平,同质性较好。等级概率图显示,在降低空腹血糖、总胆固醇水平、甘油三酯水平,提高高密度脂蛋白水平方面,联合运动效果最好;在降低低密度脂蛋白水平方面,有氧运动效果最好。 结论 联合运动是改善空腹血糖、总胆固醇水平、甘油三酯水平、高密度脂蛋白最优运动方式,有氧运动是改善低密度脂蛋白水平的最佳运动方式。

本文引用格式

陈影, 张爽, 余珍, 潘利妞, 张伟宏 . 运动对2型糖尿病患者血脂影响的网状Meta分析[J]. 中国康复理论与实践, 2019 , 25(7) : 849 -858 . DOI: 10.3969/j.issn.1006-9771.2019.07.022

Abstract

Objective To evaluate the effects of aerobic exercise, resistance exercise, and aerobic combined resistance exercise (combined exercise) on blood lipids for patients with type 2 diabetes with network meta-analysis, to develop exercise prescription. Methods Randomized controlled trials (RCTs) about the above exercises for blood lipid in patients with type 2 diabetes were searched in databases of PubMed, Ovid, Web of Science, Cochrane Library, Springer Link, Science Direct, CNKI, Wanfang data and CBM, and were supplied by retrospective references. After evaluating the methodological quality of the RCTs, the data were analyzed with R-Studio, Stata 14.0 and Review Manager 5.3. Results A total of 21 RCTs were recalled, with 1735 patients. Two poor quality literatures were excluded based on sensitivity analysis. Compared with the control group, all three kinds of exercise significantly reduced the level of fasting glucose, total cholesterol, triglyceride, low density lipoprotein, increased the level of high density lipoprotein, with good homogeneity. Rank probability graph showed that the combined exercise was the best for fasting glucose, total cholesterol triglyceride and high density lipoprotein, while aerobic exercise was the best for low density lipoprotein. Conclusion It is the best to select the combined exercise to improve fasting glucose, total cholesterol, triglycerides and high density lipoprotein, and aerobic exercise for low density lipoprotein.

参考文献

1 AssociationA D. Standards of Medical Care in Diabetes-2017: summary of revisions [J]. Diabetes Care, 2017, 40(Suppl 1): S4.
2 马丽媛,吴亚哲,王文,等.《中国心血管病报告2017》要点解读[J]. 中国心血管杂志, 2018, 23(1): 3-6.
3 张健,李蕾,邓一洁,等. 我国糖尿病的流行现状和危险因素分析[J]. 世界最新医学信息文摘, 2018, 18(16): 94-96.
4 International Diabetes Federation. Interim results of first-ever global survey show people with type 2 diabetes underestimated their cardiovascular risk [DB/OL]. (2017-12-06). http://www.idf.org.
5 International Diabetes Federation. Taking Diabetes to Heart-Global IDF survey on CVD risk awareness among people with diabetes [DB/OL]. (2017-12-06). http://www.idf.org/takingdiabetes2heart.
6 方英,戴莉敏,刘媛,等. 2型糖尿病合并脑血管疾病病人足部危险因素筛查及护理现状分析[J]. 护理研究, 2016, 30(5): 560-563.
7 于晨昕. 糖尿病患者运动干预效果的国内研究现状[J]. 体育世界(学术版), 2018(4): 194-195.
8 戴霞,楼青青,陈青云,等. 联合抗阻-有氧运动对糖尿病前期人群胰岛素抵抗的影响[J]. 护士进修杂志, 2015, 30(19): 1731-1733.
9 麻晓君,戴霞,陆丽荣,等. 有氧运动和抗阻运动对糖调节受损患者空腹血糖及胰岛素抵抗的影响研究[J]. 中国全科医学, 2017, 20(29): 3584-3589.
10 季红,楼青青,张玉梅,等. 抗阻运动对糖尿病前期患者作用效果的研究[J]. 现代医药卫生, 2017, 33(8): 1136-1138.
11 李荣娟,李锋. 不同运动方式对2型老年男性糖尿病患者血糖、血脂等指标的影响研究[J]. 广州体育学院学报, 2017, 37(2): 99-101.
12 汪亚群,楼青青,嵇加佳,等. 抗阻运动对糖尿病前期患者糖脂代谢的影响[J]. 中华物理医学与康复杂志, 2015, 37(4): 294-297.
13 王一书,殷显德,王海峰,等. 抗阻运动对老年2型糖尿病患者糖脂代谢的临床研究[J]. 中国实验诊断学, 2016, 20(5): 733-735.
14 钟锦均,杨琦. 持续有氧体育锻炼对2型糖尿病患者相关指数的影响[J]. 临床合理用药杂志, 2017, 10(3): 155-156.
15 陆丽荣,戴霞,陈青云,等. 联合抗阻-有氧运动对糖尿病前期人群代谢指标的影响[J]. 护理研究, 2016, 33(10): 1230-1233.
16 理同新. 不同运动干预对2型糖尿病患者血液生化指标的影响[J]. 山东体育科技, 2014, 36(6): 81-84.
17 朱黎霞. 抗阻力运动结合有氧运动对2型糖尿病患者生理指标的影响分析[J]. 糖尿病新世界, 2015, 35(21): 67-69.
18 JorgeM L, OliveiraV N, ResendeN M, et al. The effects of aerobic resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus [J]. Metab Clin Exp, 2011, 60(9): 1244-1252.
19 de OliveiraV N, BessaA, JorgeM L, et al. The effect of different training programs on antioxidant status, oxidative stress, and metabolic control in type 2 diabetes [J]. Appl Physiol Nutr Metab, 2012, 37(2): 334-344.
20 KadoglouN P, FotiadisG, KapelouzouA, et al. The differential anti-inflammatory effects of exercise modalities and their association with early carotid atherosclerosis progression in patients with type 2 diabetes [J]. Diabet Med, 2013, 30(2): 41-50.
21 SukalaW R, PageR, RowlandsD S, et al. South Pacific Islanders resist type 2 diabetes: comparison of aerobic and resistance training [J]. Eur J Appl Physiol, 2012, 112(1): 317-325.
22 SousaM V, FukuiR, KrustrupP, et al. Positive effects of football on fitness, lipid profile, and insulin resistance in Brazilian patients with type 2 diabetes [J]. Scand J Med Sci Sports, 2014, 24(S1): 57-65.
23 YavariA, NajafipoorF, AliasgharzadehA, et al. Effect of aerobic exercise, resistance training or combined training on glycaemic control and cardiovascular risk factors in patients with type 2 diabetes [J]. Biol Sport, 2012, 29(2): 135-143.
24 RahbarS, NaimiS S, RezasoltaniA, et al. Changes in vascular structure in diabetic patients after 8 weeks aerobic physical exercise: a randomized controlled trial [J]. Int J Diabetes Dev Ctries, 2018, 38(2): 202-208.
25 YuingF T, Santos-LozanoA, Solís UrraP, et al. Effects of training and detraining on glycosylated haemoglobin glycaemia and lipid profile in type-II diabetics [J]. Nutr Hosp, 2015, 32(4): 1729-1734.
26 TanS, LiW, WangJ. Effects of six months of combined aerobic and resistance training for elderly patients with a long history of type 2 diabetes [J]. J Sports Sci Med, 2012, 11(3): 495.
27 SwiftD L, JohannsenN M, EarnestC P, et al. Effect of exercise training modality on C-reactive protein in type 2 diabetes [J]. Med Sci Sports Exerc, 2012, 44(6): 1028-1034.
28 SigalR J, KennyG P, Boule?N G, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial [J]. Ann Intern Med, 2007, 147(6): 357-369.
29 HigginsJ, GreenS. Cochrane handbook for systematic reviews of interventions version 5.1.0 The Cochrane Collaboration, 2011 [DB/OL]. [2011-3-20]. http://www.handbook.cochrane.org/.
30 DiasS, WeltonN J, CaldwellD M, et al. Checking consistency in mixed treatment comparison meta-analysis [J]. Stat Med, 2010, 29(7-8): 932-944.
31 张超,鄢金柱,孙凤,等. 网状Meta分析一致性的鉴别与处理方法[J]. 中国循证医学杂志, 2014, 14(7): 884-888.
32 PattynN, CornelissenV A, EshghiS R, et al. The effect of exercise on the cardiovascular risk factors constituting the metabolic syndrome: a meta-analysis of controlled trials [J]. Sports Med, 2013, 43(2): 121-133.
33 DrenowatzC, SuiX, FritzS, et al. The association between resistance exercise and cardiovascular disease risk in women [J]. J Sci Med Sport, 2015, 18(6): 632-636.
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