运动对肌少症及其合并症老年人影响的Meta分析  

Effect of exercise intervention in elderly individuals with sarcopenia and its comorbidities:a meta-analysis

作　　者：孙嘉禾 史冀鹏[1] 朱天瑞 权赫龙 徐红旗[1] Sun Jiahe;Shi Jipeng;Zhu Tianrui;Quan Helong;Xu Hongqi(School of Physical Education,Northeast Normal University,Changchun 130024,Jilin Province,China)

机构地区：[1]东北师范大学,体育学院,吉林省长春市130024

出　　处：《中国组织工程研究》2026年第4期997-1007,共11页Chinese Journal of Tissue Engineering Research

基　　金：国家社会科学基金项目(22BTY075);课题名称:运动防治老年活动障碍综合征理论向实践转化的智慧化方案研究,项目负责人:徐红旗。

摘　　要：目的:大量证据表明,定期运动能改善老年人的健康状态,包括降低全身和腹部脂肪水平,增加四肢肌肉质量和骨密度,从而预防或延缓肌少症及其合并症的发生。此次研究通过Meta分析确定最可靠的运动干预类型、时间和强度,以预防、延缓及减轻老年人的肌少症及其合并症。方法:在PubMed、Embase、Web of Science、Cochrane Library以及中国知网和万方数据库中,搜索关于运动干预对肌少症及其合并症老年人影响的随机对照试验。使用Cochrane风险偏倚评估工具对研究质量进行评估,并利用RevMan 5.3软件进行Meta分析。通过亚组分析探讨不同运动干预方案对结局指标的影响。此外,采用Stata 16.0软件进行敏感性分析,评估结果的稳定性,并通过漏斗图和Egger检验进行发表偏倚分析,以确保结果的全面性和可靠性。结果:(1)纳入16项研究,包括861例肌少症及其合并症患者;(2)Meta分析结果表明,与对照组相比,运动干预能显著改善多个指标,包括握力、膝关节肌肉力量、四肢骨骼肌质量、骨骼肌指数、起立-行走计时测试结果、步速、胰岛素样生长因子1水平(P<0.05);然而,运动干预对坐立测试结果未能显著改善(P > 0.05);(3)根据亚组分析结果,建议肌少症及其合并症的老年患者每周进行至少3次运动,每次运动时间不超过30 min,或每次运动时间45 min以上,干预周期为至少12周;运动方案应根据患者的健康状况和个人需求进行灵活调整。结论:运动干预能够显著改善肌少症及其合并症患者的肌肉质量、肌肉力量、身体功能和胰岛素样生长因子1水平,提升其生活质量。但是需要更多的研究进一步验证这些发现,并优化具体的干预方案。OBJECTIVE:A great deal of evidence indicates that regular exercise can improve the health status of elderly individuals,including reducing overall and abdominal fat levels,increasing muscle mass and bone mineral density of the limbs,thereby preventing or delaying the onset of sarcopenia and its comorbidities.This study aims to determine the most reliable type,duration,and intensity of exercise interventions through meta-analysis to prevent,delay,and alleviate sarcopenia and its comorbidities in elderly individuals.METHODS:Randomized controlled trials examining the effects of exercise interventions on elderly individuals with sarcopenia and its comorbidities were searched in the PubMed,Embase,Web of Science,Cochrane Library,CNKI,and WanFang databases.The Cochrane Risk of Bias Tool was used to assess the quality of the included studies,and RevMan 5.3 software was employed for meta-analysis.Subgroup analyses were conducted to explore the effects of different exercise intervention protocols on various outcome measures.In addition,Stata 16.0 software was used to perform sensitivity analysis to assess the stability of the results,and funnel plots and Egger’s test were employed to evaluate publication bias,ensuring the comprehensiveness and reliability of the results.RESULTS:(1)Sixteen studies involving 861 patients with sarcopenia and its comorbidities were included.(2)The meta-analysis results indicated that,compared with the control group,exercise significantly improved grip strength,knee muscle strength,appendicular skeletal muscle mass,skeletal muscle index,Timed Up and Go test results,gait speed,and insulin-like growth factor 1 levels(P<0.05).However,the effect of exercise intervention on the sit-to-stand test was not significantly improved(P>0.05).(3)Based on the results of subgroup analysis,it is recommended that elderly patients with sarcopenia and its comorbidities engage in exercise at least three times per week,with each session lasting no more than 30 minutes or exceeding 45 minutes,for at least 12 weeks.

关 键 词：老年人 肌少症及其合并症 运动 随机对照试验 肌肉质量 肌肉力量 META分析 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R592