不同运动方式对2型糖尿病患者内脏及皮下脂肪影响的Meta分析  

Effectiveness of different exercise on visceral and subcutaneous fat in patients with type 2 diabetes mellitus:A Meta analysis

作　　者：严娟 左盼盼 Anne Folta Fish 楼青青[3] Yan Juan;Zuo Panpan;Anne Folta Fish;Lou Qingqing(Nursing College,Nanjing University of Chinese Medicine,Jiangsu,Nanjing 210023;Nursing College,University of Missouri-St Louis,St.Louis,America 63121;Department of Health Education,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing University of Chinese Medicine,Jiangsu,Nanjing 210028)

机构地区：[1]南京中医药大学护理学院,江苏南京210023 [2]美国密苏里大学圣路易斯分校护理学院,美国圣路易斯63121 [3]南京中医药大学附属中西医结合医院健康教育科,江苏南京210028

出　　处：《护士进修杂志》2020年第14期1249-1255,共7页Journal of Nurses Training

基　　金：国家自然科学基金资助项目(编号:81370923);国家中医药管理局课题(编号:JDZX2015132)。

摘　　要：目的系统评价有氧运动(AT)、抗阻运动(RT)及有氧联合抗阻运动(AT+RT)对2型糖尿病(T2DM)患者腹部内脏脂肪(VAT)、皮下脂肪(SAT)的影响。方法计算机检索Embase、Web of Science、MEDLINE、中国生物医学文献数据库(CBM)、中国期刊全文数据库(CNKI)、万方数字化期刊全文数据库及中文科技期刊全文数据库(VIP)中关于有氧、抗阻及联合运动对2型糖尿病患者VAT和SAT影响的随机对照试验(RCT),提取纳入研究的特征信息。用RevMan5.3软件对纳入文献数据进行Meta分析。结果最终纳入14篇文献,共864例患者。Meta分析结果显示:与对照组相比,运动可以降低T2DM患者VAT和SAT(P<0.01);亚组分析结果显示,有氧、抗阻、有氧联合抗阻运动均能够显著降低T2DM患者的VAT水平(P<0.05)。另外,有氧运动能够显著降低SAT水平(P<0.01),然而抗阻、有氧联合抗阻运动组与对照组在降低SAT水平差异无统计学意义(P>0.05)。结论三种不同运动均能够降低T2DM患者的VAT,且VAT水平降低比SAT降低效果更显著;其中有氧运动降低腹部脂肪幅度效果优于其它两种运动,抗阻及有氧联合抗阻运动有降低SAT的趋势,但考虑到此次纳入文献质量为中等,且关于抗阻和有氧联合抗阻运动对T2DM患者内脏及皮下脂肪的研究较少,因此其有效性仍需要大样本、高质量的研究进一步探讨。Objective To systematically evaluate the effects of aerobic training(AT),resistance training(RT)and combined aerobic and resistance training(AT+RT)on visceral and subcutaneous adipose tissue(VAT,SAT)in patients with type 2 diabetes mellitus(T2DM).Methods Randomized controlled trials(RCTs)regarding the effects of AT,RT and AT+RT on VAT and SAT in patients with T2DM were retrieved by searching Embase,Web of science,MEDLINE,CBM,CNKI,WanFang Database and VIP Database.The studies were extracted the feature information.Meta-analysis for included studies was performed using RevMan5.3 software.Results Fourteen studies involving 864 patients with T2DM were included.The results of Meta-analysis supported the effectiveness of exercise on decreasing VAT and SAT in patients with T2DM compared to control group(all P<0.01).Subgroup analysis indicated that AT,RT and AT+RT could significantly decrease VAT(all P<0.05).AT had a significant effect on SAT(P<0.01).However,compared to control group,RT and AT+RT did not cause statistically significant difference in SAT(all P>0.05).Conclusion All three kinds of exercise can reduce VAT level of patients with T2DM,the effect of reducing VAT level is more significant than that of reducing SAT.AT is better than the other two types of exercise in reducing the amplitude of abdominal fat.RT and AT+RT have a tendency to reduce SAT.But considering the methodological quality of the included studies was medium,and few studies on VAT and SAT in patients with T2DM have been conducted by RT and AT+RT.Therefore,large sample and more high quality experiments are needed to demonstrate its effectiveness wherever possible.

关 键 词：2型糖尿病 有氧运动 抗阻运动 有氧联合抗阻运动 内脏脂肪 皮下脂肪 META分析 

分 类 号：R471[医药卫生—护理学] R473.58[医药卫生—临床医学]