{"title":"降低 2 型糖尿病患者糖化血红蛋白的最佳运动方式和剂量：配对分析、网络分析和剂量反应元分析的系统回顾","authors":"Zhide Liang, Meng Zhang, Chuanzhi Wang, Fengwei Hao, Yingdanni Yu, Shudong Tian, Yang Yuan","doi":"10.1007/s40279-024-02057-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Persistently elevated glycosylated hemoglobin (HbA1c) is associated with a higher risk of long-term vascular complications.</p><p><strong>Objective: </strong>We evaluated the effect of different exercise modalities and doses on HbA1c levels in patients with type 2 diabetes.</p><p><strong>Methods: </strong>A systematic search for randomized controlled trials involving exercise interventions in patients with type 2 diabetes was conducted across seven electronic databases, encompassing data from their inception up to October 2023. Two independent reviewers assessed the quality of the literature. Pairwise, network, and dose-response meta-analyses using the random-effects model were conducted to analyze the effect of exercise on HbA1c levels.</p><p><strong>Results: </strong>A total of 85 randomized controlled trials with 5535 participants were included. The network meta-analysis showed that high-intensity interval training (HIIT) has the highest ranked (MD = - 0.78% [- 8.50 mmol/mol]; 95% CrI: - 1.04, - 0.51), followed by combined aerobic and resistance exercise (CE) (MD = - 0.54% [- 5.90 mmol/mol]; 95% CrI: - 0.69, - 0.40), yoga (MD = - 0.45% [- 4.92 mmol/mol]; 95% CrI: - 0.77, - 0.13), and continuous aerobic exercise (CAE) (MD = - 0.42% [- 4.58 mmol/mol]; 95% CrI: - 0.54, - 0.30). In addition, a significant improvement in HbA1c levels can be observed when the total exercise dose reaches 840 metabolic equivalent of tasks-min/week.</p><p><strong>Conclusions: </strong>There was low-quality evidence that HIIT, CE, yoga, and CAE may be effective treatment modalities for improving HbA1c in patients with type 2 diabetes, and there was no significant difference in efficacy. Moreover, a non-linear dose-response relationship was found for total exercise and HbA1c levels. Future research should further investigate the specific effects of different exercise doses on HbA1c levels in patients with type 2 diabetes and provide a more personalized exercise prescription.</p>","PeriodicalId":21969,"journal":{"name":"Sports Medicine","volume":null,"pages":null},"PeriodicalIF":9.3000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Best Exercise Modality and Dose to Reduce Glycosylated Hemoglobin in Patients with Type 2 Diabetes: A Systematic Review with Pairwise, Network, and Dose-Response Meta-Analyses.\",\"authors\":\"Zhide Liang, Meng Zhang, Chuanzhi Wang, Fengwei Hao, Yingdanni Yu, Shudong Tian, Yang Yuan\",\"doi\":\"10.1007/s40279-024-02057-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Persistently elevated glycosylated hemoglobin (HbA1c) is associated with a higher risk of long-term vascular complications.</p><p><strong>Objective: </strong>We evaluated the effect of different exercise modalities and doses on HbA1c levels in patients with type 2 diabetes.</p><p><strong>Methods: </strong>A systematic search for randomized controlled trials involving exercise interventions in patients with type 2 diabetes was conducted across seven electronic databases, encompassing data from their inception up to October 2023. Two independent reviewers assessed the quality of the literature. Pairwise, network, and dose-response meta-analyses using the random-effects model were conducted to analyze the effect of exercise on HbA1c levels.</p><p><strong>Results: </strong>A total of 85 randomized controlled trials with 5535 participants were included. The network meta-analysis showed that high-intensity interval training (HIIT) has the highest ranked (MD = - 0.78% [- 8.50 mmol/mol]; 95% CrI: - 1.04, - 0.51), followed by combined aerobic and resistance exercise (CE) (MD = - 0.54% [- 5.90 mmol/mol]; 95% CrI: - 0.69, - 0.40), yoga (MD = - 0.45% [- 4.92 mmol/mol]; 95% CrI: - 0.77, - 0.13), and continuous aerobic exercise (CAE) (MD = - 0.42% [- 4.58 mmol/mol]; 95% CrI: - 0.54, - 0.30). In addition, a significant improvement in HbA1c levels can be observed when the total exercise dose reaches 840 metabolic equivalent of tasks-min/week.</p><p><strong>Conclusions: </strong>There was low-quality evidence that HIIT, CE, yoga, and CAE may be effective treatment modalities for improving HbA1c in patients with type 2 diabetes, and there was no significant difference in efficacy. Moreover, a non-linear dose-response relationship was found for total exercise and HbA1c levels. Future research should further investigate the specific effects of different exercise doses on HbA1c levels in patients with type 2 diabetes and provide a more personalized exercise prescription.</p>\",\"PeriodicalId\":21969,\"journal\":{\"name\":\"Sports Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":9.3000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Sports Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s40279-024-02057-6\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/25 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"SPORT SCIENCES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Sports Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40279-024-02057-6","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/25 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SPORT SCIENCES","Score":null,"Total":0}
The Best Exercise Modality and Dose to Reduce Glycosylated Hemoglobin in Patients with Type 2 Diabetes: A Systematic Review with Pairwise, Network, and Dose-Response Meta-Analyses.
Background: Persistently elevated glycosylated hemoglobin (HbA1c) is associated with a higher risk of long-term vascular complications.
Objective: We evaluated the effect of different exercise modalities and doses on HbA1c levels in patients with type 2 diabetes.
Methods: A systematic search for randomized controlled trials involving exercise interventions in patients with type 2 diabetes was conducted across seven electronic databases, encompassing data from their inception up to October 2023. Two independent reviewers assessed the quality of the literature. Pairwise, network, and dose-response meta-analyses using the random-effects model were conducted to analyze the effect of exercise on HbA1c levels.
Results: A total of 85 randomized controlled trials with 5535 participants were included. The network meta-analysis showed that high-intensity interval training (HIIT) has the highest ranked (MD = - 0.78% [- 8.50 mmol/mol]; 95% CrI: - 1.04, - 0.51), followed by combined aerobic and resistance exercise (CE) (MD = - 0.54% [- 5.90 mmol/mol]; 95% CrI: - 0.69, - 0.40), yoga (MD = - 0.45% [- 4.92 mmol/mol]; 95% CrI: - 0.77, - 0.13), and continuous aerobic exercise (CAE) (MD = - 0.42% [- 4.58 mmol/mol]; 95% CrI: - 0.54, - 0.30). In addition, a significant improvement in HbA1c levels can be observed when the total exercise dose reaches 840 metabolic equivalent of tasks-min/week.
Conclusions: There was low-quality evidence that HIIT, CE, yoga, and CAE may be effective treatment modalities for improving HbA1c in patients with type 2 diabetes, and there was no significant difference in efficacy. Moreover, a non-linear dose-response relationship was found for total exercise and HbA1c levels. Future research should further investigate the specific effects of different exercise doses on HbA1c levels in patients with type 2 diabetes and provide a more personalized exercise prescription.
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.
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