不同抗阻训练方案对改善2型糖尿病患者血脂及胰岛素抵抗作用的网状Meta分析  

Improvement of different resistance training regimens on blood lipids and insulin resistance in patients with type 2 diabetes mellitus:a network meta-analysis

作　　者：梁振 岳文静 王珍玉 李永杰 王柱 冯常武[5] LIANG Zhen;YUE Wenjing;WANG Zhenyu;LI Yongjie;WANG Zhu;FENG Changwu(Maritime College,Qingdao Harbour Vocational and Technical College,Qingdao,Shandong 266404,P.R.China;School of Sports Medicine,Wuhan Sports University,Wuhan,Hubei 430079,P.R.China;School of Safety Science and Emergency Management,Wuhan University of Technology,Wuhan,Hubei 430079,P.R.China;Department of Rehabilitation Medicine,Beijing Jishuitan Hospital-Guizhou Hospital,Guiyang,Guizhou 550014,P.R.China;Department of Rehabilitation Medicine,Huangshi Central Hospital,Huangshi,Hubei 435000,P.R.China)

机构地区：[1]青岛港湾职业技术学院海事学院,青岛266404 [2]武汉体育学院运动医学院,武汉430079 [3]武汉理工大学安全科学与应急管理学院,武汉430079 [4]北京积水潭医院贵州医院康复医学科,贵阳550014 [5]黄石市中心医院康复医学科,湖北黄石435000

出　　处：《华西医学》2024年第2期259-267,共9页West China Medical Journal

基　　金：贵州省卫生健康委科学技术基金(gzwkj2022-306)。

摘　　要：目的 评价不同抗阻训练方案对2型糖尿病患者血脂代谢及胰岛素抵抗的改善作用。方法 检索PubMed、ProQuest、Embase、Web of Science、中国知网、万方和维普数据库中关于抗阻运动改善2型糖尿病患者血脂和胰岛素抵抗相关的随机对照试验,检索区间为建库至2023年5月。由2位评审员通过物理治疗证据数据库量表评估纳入文献的偏倚风险,并使用Stata 16.0软件对提取的数据进行网状Meta分析。结果 最终纳入24篇文献,总计983例受试者。网状Meta分析结果显示:高频-中等强度抗阻运动对胰岛素抵抗[标准化均数差=-1.71,95%置信区间(confidence interval, CI)(-2.75,-0.67)]、甘油三酯[加权均数差(weighted mean difference, WMD)=-0.27 mmol/L,95%CI(-0.51,-0.04)mmol/L]、总胆固醇[WMD=-0.16 mmol/L,95%CI(-0.20,-0.12)mmol/L]水平的改善效果有统计学意义,在改善高密度脂蛋白[WMD=0.05 mmol/L,95%CI(-0.02,0.11)mmol/L]和低密度脂蛋白[WMD=-0.20 mmol/L,95%CI(-0.42,0.03)mmol/L]水平方面效果无统计学意义。累积概率排序结果显示:高频-中等强度抗阻运动在改善胰岛素抵抗、甘油三酯、高密度脂蛋白和低密度脂蛋白水平方面均最优。结论 基于当前证据,高频-中等强度抗阻运动可能是改善2型糖尿病患者胰岛素抵抗和血脂代谢的最佳抗阻运动方案。Objective To assess the improvement of different resistance training regimens on blood lipid metabolism and insulin resistance in patients with type 2 diabetes mellitus(T2DM).Methods PubMed,ProQuest,Embase,Web of Science,China National Knowledge Infrastructure,Wanfang,and VIP databases were searched to collect randomized controlled trials of resistance training intervention to improve blood lipids and insulin resistance in patients with T2DM.The search time range was from the establishment of the databases to May 2023.Two reviewers assessed the risk of bias of the included studies using the Physiotherapy Evidence Database scale,and performed a network meta-analysis of the extracted data using Stata 16.0 software.Results In the end,24 articles were included,and a total of 983 participants were enrolled.The result of network meta-analysis showed that high-frequency and moderate-intensity resistance exercise significantly improved the levels of insulin resistance[standardized mean difference=−1.71,95%confidence interval(CI)(−2.75,−0.67)],triglycerides[weighted mean difference(WMD)=−0.27 mmol/L,95%CI(−0.51,−0.04)mmol/L],and total cholesterol[WMD=−0.16 mmol/L,95%CI(−0.20,−0.12)mmol/L],but had no significant effect on improving the level of high-density lipoprotein[WMD=0.05 mmol/L,95%CI(−0.02,0.11)mmol/L]or low-density lipoprotein[WMD=−0.20 mmol/L,95%CI(−0.42,0.03)mmol/L].The results of cumulative probability ranking showed that high-frequency and moderate-intensity resistance exercise was the best in improving insulin resistance,triglycerides,high-density lipoprotein and low-density lipoprotein levels.Conclusion Based on current evidence,high-frequency and moderate-intensity resistance exercise may be the best resistance exercise regimen to improve insulin resistance and lipid metabolism in patients with T2DM.

关 键 词：抗阻方案 运动强度 运动频率 2型糖尿病 糖脂代谢 网状Meta分析 

分 类 号：R587.1[医药卫生—内分泌]