运动和节食对肥胖者体成分、糖尿病和心血管疾病指标影响的文献分析

Effects of exercise and diet on body composition, diabetes and cardiovascular disease indexes in obese individuals: a literature analysis

目的系统评价节食、运动和综合(节食+运动)减肥方法对肥胖个体体重、体成分、糖尿病和心血管疾病指标的影响。方法通过检索PubMed、Cochrane Library、史蒂芬斯数据库(EBSCO)host、Science Direct、WOSTM核心合集和中国学术期刊全文数据库(CNKI)等数据库,收集节食、运动和综合减肥方法对肥胖个体干预的随机对照试验。使用Cochrane偏倚风险评估工具对纳入文献进行方法学质量评估,应用ReMan 5.3.5和GPower 3.1软件进行数据处理和检验效能评价。结果共纳入文献33篇,纳入总样本量2918例;其中低偏倚风险文献19篇,中等偏倚风险10篇,较高偏倚风险4篇。研究结果显示,综合组肥胖个体体重降低程度高于节食组和运动组(P值均<0.01)。节食组BMI、腰围、体脂量(FM)、FBG、收缩压(SBP)、舒张压(DBP)的改善效果均优于运动组(P值均<0.05),而运动组抑制肥胖个体瘦体重(LBM)降低和提高最大摄氧量绝对值(VO2max)的效果均优于节食组(P值均<0.05)。综合组BMI、FM、瘦素、胰岛素抵抗(HOMA-IR)、TG等指标的改善效果均优于节食组和运动组(P值均<0.05)。结论综合干预(节食+运动)的减肥效果优于单一节食或运动减肥。运动可抑制节食减肥对机体造成的负面影响,促进节食减肥对肥胖个体糖尿病和心血管疾病因子的改善作用。

Objective To compare the effects of diet,exercise,or diet plus exercise on body weight,body composition,risk factors of diabetes and cariovascular diseases in obesity adults.Methods Randomized controlled trials(RCT)on the obesity individual intervention(diets,exercise and comprehensive weight loss)were collected from databases,such as PubMed,Cochrane Library,Elton B.Stephens.Company(EBSCO)host,Science Direct,WOSTM core collection and China National Knowledge Infrastructure(CNKI)database.The Cochrane Bias Risk Assessment Tool was used to evaluate the methodological quality of the enrolled literatures.ReMan 5.3.5 and GPower 3.1 were used for data processing and test performance evaluation.Results A total of 33 articles(2918 samples)were included in this study.There were 19 articles with low bias risk,10 with moderate bias risk,and 4 with high bias risk.Research result showed that the weight loss in the diet plus exercise group was higher than that in the diet group and exercise group(both P<0.01).Compared with those in the exercise group,body mass index(BMI),waist circumference,fat mass(FM),fasting blood glucose(FBG),systolic blood pressure(SBP)and diastolic blood pressure(DBP)were significantly improved in the diet group(all P<0.05).But the degree of lean body mass(LBM)decrease and absolute value of maximal oxygen uptake(VO2 max)increase in the exercise was superior to the diet group(both P<0.05).Comprehensive intervention significantly improved BMI,FM,leptin,insulin resistance(HOMA-IR),and triglyceride(TG)in comparison with single diet or exercise(all P<0.05).Conclusion Diet+exercise is a better overall weight loss method than diet or exercise alone.Exercise can inhibit the negative effects of diet on the body and promote the improvement of diabetes and cardiovascular disease related factors.