Responses to Exercise with Low Carbohydrate Availability on Muscle Glycogen and Cell Signaling: A Systematic Review and Meta-analysis.

IF 9.3 1区医学 Q1 SPORT SCIENCES

Sports Medicine Pub Date : 2024-10-01 DOI:10.1007/s40279-024-02119-9

Javier Diaz-Lara, Gorka Prieto-Bellver, Amelia Guadalupe-Grau, David J Bishop

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引用次数: 0

Abstract

Background: The growing interest in how exercise and carbohydrate (CHO) restriction may modify molecular responses that promote endurance adaptations has led to many interesting controversies.

Objective: We conducted a systematic review and a meta-analysis regarding the effect of low-carbohydrate availability (LOW) pre-, during, or post-exercise, on the mRNA content of commonly measured genes involved in mitochondrial biogenesis (PGC-1α, TFAM mRNA) and metabolism (PDK4, UCP3 and GLUT4 mRNA), and on muscle glycogen levels, compared with a high-CHO (CON) condition.

Methods: MEDLINE, Scopus, and Web of Science databases were searched following the PRISMA 2020 guidelines (with an end date of November 2023). In total, 19 randomized-controlled studies were considered for inclusion. We evaluated the methodological quality of all studies using the Cochrane Risk of Bias tool for randomized clinical studies. A meta-analysis was performed using a random effects model to calculate the standardized mean difference (SMD), estimated by Hedges' g, and 95% confidence intervals (CIs).

Results: The LOW condition was associated with an increased mRNA content of several genes during the early recovery period post-exercise, such as PDK4 (SMD 1.61; 95% CI 0.80-2.42), GLUT4 (SMD 1.38; 95% CI 0.46-2.30), and UCP3 (SMD 2.05; 95% CI 0.40-3.69). However, overall, there was no significant effect on the mRNA content of PGC-1α or TFAM. Finally, CHO restriction and exercise significantly reduced muscle glycogen levels (SMD 3.69; 95% CI 2.82-5.09). A meta-analysis of subgroups from studies with a difference in muscle glycogen concentration of > 200 mmol kg dw^-1 between the LOW and CON conditions showed an increase in exercise-induced PGC-1α mRNA (SMD 2.08; 95% CI 0.64-3.52; p = 0.005; I² = 75%) and a greater effect in PDK4 and GLUT4 mRNA.

Conclusion: The meta-analysis results show that CHO restriction was associated with an increase in the exercise-induced mRNA content of PDK4, UCP3, and GLUT4, but not the exercise-induced mRNA content of PGC-1ɑ and TFAM. However, when there were substantial differences in glycogen depletion between CON and LOW CHO conditions (> 200 mmol kg dw^-1), there was a greater effect of CHO restriction on the exercise-induced mRNA content of metabolic genes, and an increase in exercise-induced PGC-1α mRNA.

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低碳水化合物摄入量运动对肌肉糖原和细胞信号的影响：系统回顾与元分析》。

背景：人们越来越关注运动和碳水化合物（CHO）限制如何改变促进耐力适应的分子反应，这引发了许多有趣的争议：我们就运动前、运动中或运动后低碳水化合物（LOW）对线粒体生物生成（PGC-1α、TFAM mRNA）和新陈代谢（PDK4、UCP3 和 GLUT4 mRNA）相关常用基因的 mRNA 含量以及对肌糖原水平的影响进行了系统回顾和荟萃分析，并与高 CHO（CON）条件进行了比较：按照 PRISMA 2020 指南（截止日期为 2023 年 11 月）检索了 MEDLINE、Scopus 和 Web of Science 数据库。共考虑纳入 19 项随机对照研究。我们使用针对随机临床研究的 Cochrane 偏倚风险工具对所有研究的方法学质量进行了评估。我们使用随机效应模型进行了荟萃分析，以计算标准化均值差异（SMD）（用赫奇斯g估算）和95%置信区间（CIs）：结果：在运动后的早期恢复期，LOW 状态与几个基因的 mRNA 含量增加有关，如 PDK4（SMD 1.61；95% CI 0.80-2.42）、GLUT4（SMD 1.38；95% CI 0.46-2.30）和 UCP3（SMD 2.05；95% CI 0.40-3.69）。然而，总体而言，对 PGC-1α 或 TFAM 的 mRNA 含量没有明显影响。最后，限制碳水化合物摄入和运动会显著降低肌糖原水平（SMD 3.69；95% CI 2.82-5.09）。对肌糖原浓度在 LOW 和 CON 条件下差异大于 200 mmol kg dw-1 的研究进行的分组荟萃分析表明，运动诱导的 PGC-1α mRNA 增加（SMD 2.08；95% CI 0.64-3.52；p = 0.005；I2 = 75%），PDK4 和 GLUT4 mRNA 的影响更大：荟萃分析结果显示，CHO限制与运动诱导的PDK4、UCP3和GLUT4 mRNA含量增加有关，但与运动诱导的PGC-1ɑ和TFAM mRNA含量增加无关。然而，当CON和LOW CHO条件（> 200 mmol kg dw-1）之间的糖原耗竭存在显著差异时，CHO限制对运动诱导的代谢基因mRNA含量的影响更大，而且运动诱导的PGC-1α mRNA含量也有所增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sports Medicine 医学-运动科学

CiteScore

18.40

自引率

5.10%

发文量

165

审稿时长

6-12 weeks

期刊介绍： Sports Medicine focuses on providing definitive and comprehensive review articles that interpret and evaluate current literature, aiming to offer insights into research findings in the sports medicine and exercise field. The journal covers major topics such as sports medicine and sports science, medical syndromes associated with sport and exercise, clinical medicine's role in injury prevention and treatment, exercise for rehabilitation and health, and the application of physiological and biomechanical principles to specific sports. Types of Articles: Review Articles: Definitive and comprehensive reviews that interpret and evaluate current literature to provide rationale for and application of research findings. Leading/Current Opinion Articles: Overviews of contentious or emerging issues in the field. Original Research Articles: High-quality research articles. Enhanced Features: Additional features like slide sets, videos, and animations aimed at increasing the visibility, readership, and educational value of the journal's content. Plain Language Summaries: Summaries accompanying articles to assist readers in understanding important medical advances. Peer Review Process: All manuscripts undergo peer review by international experts to ensure quality and rigor. The journal also welcomes Letters to the Editor, which will be considered for publication.