中老年2型糖尿病有氧运动干预的Meta分析

Meta-analysis of Aerobic Exercise Intervention in Middle-aged and Elderly Patients with Type 2 Diabetes Mellitus

目的:检验间歇和持续有氧运动对中老年2型糖尿病患者的干预效果,从而提供较为科学合理的运动处方。方法:通过Web of science、PubMed/MEDLINE、Cochrane Library、EMBASE、SportDiscus、中国知网(CNKI)、万方等中外文数据库,检索有关间歇与持续有氧运动干预中老年2型糖尿病患者的随机对照试验研究,利用Review Manager 5.3统计软件进行计量分析,包括偏倚风险评估、异质性分析、合并效应与效应大小检验和敏感性分析。结果:1)共纳入9项研究,包括297名被试;2)间歇训练与持续训练能有效改善中老年2型糖尿病患者胰岛素抵抗、BMI、有氧适能和疲劳、幸福感等身心健康指标;3)两者在改善HbA1c%(P=0.04)、总胆固醇(P=0.00)、收缩压(P=0.00)和有氧适能(P=0.00)方面存在显著差异;4)15~30 min/次、3~5次/周,持续8~12周的中至高等强度间歇训练对糖化血红蛋白、收缩压和有氧适能的干预效应更优,而长于12周、5次/周、大于30 min/次的中等强度间歇训练对总胆固醇可以产生较好的干预效应。结论:间歇训练与持续训练能一定程度改善中老年2型糖尿病患者的身心健康,相较于持续训练,间歇训练能更有效降低HbA1c%、总胆固醇、收缩压、提高有氧适能,15~30 min/次、3~5次/周、持续8~12周的中等强度间歇训练是干预中老年2型糖尿病较为有效的运动处方。

Objective:This paper aims to test the intervention effects of Interval and continuous aerobic exercise on the middle-aged and elderly patients with type 2 diabetes mellitus and provide a more scientific and reasonable exercise prescription for them.Methods:Through Web of science,PubMed/MEDLINE,Cochrane Library,EMBASE,SportDiscus,CNKI,Wan Fang and other Chinese and foreign databases,we searched the randomized controlled trial of intermittent and continuous aerobic exercise intervention in the middle-aged and elderly patients with type 2 diabetes mellitus,and used Review Manager 5.3 statistical software for data processing,including bias risk assessment,heterogeneity analysis,combined effect and effect size test and sensitivity analysis.Results:1) There are 9 studies including 297 participants;2) Interval training and continuous training can effectively improve the physical and mental health indicators of middle-aged and elderly patients with type 2 diabetes mellitus,such as insulin resistance,BMI,aerobic fitness,fatigue and well-being;3) There were significant differences in improving HbA1 c(P=0.04),total cholesterol(P=0.00),systolic blood pressure(P=0.00) and aerobic fitness(P=0.00);4) The intervention effect of medium to high intensity interval training lasting for 8-12 weeks,15-30 min/time,3-5 times/week on HbA1 c,SBP and aerobic fitness was better,while the intervention effect of medium intensity interval training longer than 12 weeks,5 times/week and more than 30 min/time on total cholesterol was better.Conclusion:Interval training and continuous training can improve the physical and mental health of middle-aged and elderly patients with type 2 diabetes mellitus to a certain extent.Compared with continuous training,interval training can effectively reduce HbA1 c%,total cholesterol,systolic blood pressure,and improve aerobic fitness.15-30 min/time,3-5 times/week,and 8-12 weeks of moderate intensity interval training is a more effective exercise prescription for intervention of middle-aged and elderly patients with type 2 diabetes mellitus.