同时进行有氧和力量训练对2型糖尿病患者的影响：贝叶斯配对和剂量反应荟萃分析

IF 3.7 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

BMJ Open Diabetes Research & Care Pub Date : 2024-11-28 DOI:10.1136/bmjdrc-2024-004400

Han Xue, Yuehui Zou, Shijie Zhang

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引用次数: 0

摘要

本研究旨在探讨同时进行有氧和力量训练（CT）对2型糖尿病患者的影响，并确定CT的最有效剂量。从数据库建立到2024年3月，我们对四个电子数据库（PubMed、Embase、Web of Science和Cochrane Library）进行了系统检索，以确定CT干预2型糖尿病患者的随机对照试验（RCTs）。两位独立作者使用Cochrane偏倚风险评估工具评估了该研究的偏倚风险。分析结果包括糖化血红蛋白（HbA1c）、空腹血糖（FBG）、体重指数、体脂率、血压和最大摄氧量。采用贝叶斯分层随机效应模型进行两两和剂量-反应荟萃分析，分析CT对2型糖尿病患者的影响。从数据库建立到2024年3月，我们对四个电子数据库（PubMed、Embase、Web of Science和Cochrane Library）进行了系统检索，以确定CT干预2型糖尿病患者的随机对照试验（RCTs）。两位独立作者使用Cochrane偏倚风险评估工具评估了该研究的偏倚风险。分析结果包括糖化血红蛋白（HbA1c）、空腹血糖（FBG）、体重指数、体脂率、血压和最大摄氧量。采用贝叶斯分层随机效应模型进行两两和剂量-反应荟萃分析，分析CT对2型糖尿病患者的影响。23项随机对照试验共纳入1948名参与者（935名男性）。参与者男女比例为52/48；平均年龄在50-65岁之间。结果显示，CT可显著降低HbA1c水平（MD=-0.48%, 95% CrI: -0.55 ~ -0.40），但不同水平间存在一定的异质性（SD=0.31, 95% CrI: 0.17 ~ 0.51），模型收敛良好。同样，FBG水平也显著改善（MD=-0.48 mmol/L, 95% CrI: -0.55 ~ -0.40），异质性更大（SD=17.73, 95% CrI: 11.23 ~ 28.09）。此外，我们发现CT和HbA1c水平之间存在非线性剂量-反应关系，最佳剂量为1030 METs-min/week （MD=-0.47%, 95% CrI: -0.68 ~ -0.26， SE=0.11）。CT可显著改善2型糖尿病患者的多项健康指标。CT训练剂量与HbA1c呈非线性剂量-反应关系，建议每周进行270分钟中等强度CT或160分钟高强度CT。普洛斯彼罗注册号：CRD42024547119。关键词:荟萃分析;同时进行有氧和力量训练。

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Effects of concurrent aerobic and strength training in patients with type 2 diabetes: Bayesian pairwise and dose-response meta-analysis.

This study aimed to investigate the effects of concurrent aerobic and strength training (CT) in patients with type 2 diabetes and determine the most effective dose of CT. From the inception of the databases to March 2024, we conducted a systematic search of four electronic databases (PubMed, Embase, Web of Science, and Cochrane Library) to identify randomized controlled trials (RCTs) on CT intervention in patients with type 2 diabetes. Two independent authors assessed the risk of bias of the study using the Cochrane Risk of Bias Assessment Tools. Results analyzed included glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), body mass index, body fat percentage, blood pressure, and VO₂max. Pairwise and dose-response meta-analyses using Bayesian hierarchical random-effects modeling were performed to analyze the effects of CT in patients with type 2 diabetes. From the inception of the databases to March 2024, we conducted a systematic search of four electronic databases (PubMed, Embase, Web of Science, and Cochrane Library) to identify randomized controlled trials (RCTs) on CT intervention in patients with type 2 diabetes. Two independent authors assessed the risk of bias of the study using the Cochrane Risk of Bias Assessment Tools. Results analyzed included glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), body mass index, body fat percentage, blood pressure, and VO₂max. Pairwise and dose-response meta-analyses using Bayesian hierarchical random-effects modeling were performed to analyze the effects of CT in patients with type 2 diabetes. A total of 1948 participants (935 males) were included in 23 RCTs. The male/female ratio of participants was 52/48; the mean age range was 50-65 years. The results show that CT significantly reduced HbA1c levels (MD=-0.48%, 95% CrI: -0.55 to -0.40), with some heterogeneity among different levels (SD=0.31, 95% CrI: 0.17 to 0.51), and the model converged well. Similarly, FBG levels were also significantly improved (MD=-0.48 mmol/L, 95% CrI: -0.55 to -0.40), with greater heterogeneity (SD=17.73, 95% CrI: 11.23 to 28.09). Additionally, we found a non-linear dose-response relationship between CT and HbA1c levels, with an optimal dose of 1030 METs-min/week (MD=-0.47%, 95% CrI: -0.68 to -0.26, SE=0.11). CT significantly improves several health indicators in patients with type 2 diabetes. A non-linear dose-response relationship was observed between the training dose of CT and HbA1c, and it is recommended that 270 min of moderate-intensity CT or 160 min of vigorous-intensity CT be performed weekly.PROSPERO registration number: CRD42024547119.Keywords: meta-analysis; concurrent aerobic and strength training.

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来源期刊

BMJ Open Diabetes Research & Care Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

9.30

自引率

2.40%

发文量

123

审稿时长

18 weeks

期刊介绍： BMJ Open Diabetes Research & Care is an open access journal committed to publishing high-quality, basic and clinical research articles regarding type 1 and type 2 diabetes, and associated complications. Only original content will be accepted, and submissions are subject to rigorous peer review to ensure the publication of high-quality — and evidence-based — original research articles.