运动干预糖尿病前期患者疗效的Meta分析

Meta-analysis of the Effect of Exercise Intervention on Pre-diabetes Patients

目的运用Meta分析的方法检验运动干预糖尿病前期(pre-diabetes,PD)患者的效果,提出针对PD患者最优的运动方案。方法检索运动干预PD患者的随机对照实验,运用Review Manager 5.3进行Meta分析。结果11个随机对照实验纳入Meta分析,共1113名患者。Meta分析结果显示,实验组在降低PD患者的空腹血糖(fasting blood glucose,FBG)[d=-0.65,95%CI(-0.78,-0.35),p<0.00001]优于对照组,干预时间(I^(2)=94%)、干预强度(I^(2)=93%)、干预频率(I^(2)=95%)、干预周期(I^(2)=92%)、干预类型(I^(2)=91%)对运动干预和PD患者的FBG之间的关系存在高度异质性;实验组在降低PD患者的餐后两小时血糖(two hours postprandial blood glucose,2hPG)时[d=-0.57,95%CI(-0.78,-0.35),p<0.00001]优于对照组;实验组在降低PD患者的糖化血红蛋白(Glycated Haemoglobin,HbA1C)时[d=-1.09,95%CI(-1.26,-0.93),p<0,00001]优于对照组,干预时间(I^(2)=87%)、干预强度(I^(2)=87%)、干预频率(I^(2)=87%)、干预周期(I^(2)=87%)、干预类型(I^(2)=89%)对运动锻炼与PD患者的HbA1C之间的关系存在高度异质性。结论1)运动干预具有显著改善PD患者的FBG、2hPG、HbA1C的效果;2)在改善PD患者的FBG时,采用中等运动强度的抗阻运动,每次干预60min以上,每周干预3次,干预12周以上效果最好;3)在改善PD患者的HbA1C时,采用大强度的抗阻运动,每次干预60min以上,每周干预3次,干预12周的效果最好。

Objective To use the method of Meta analysis to test the effect of exercise intervention in pre-diabetes(PD)patients,and to propose the best exercise program for PD patients.Methods Retrieve randomized controlled trials of exercise intervention in PD patients,and use Review Manager 5.3 to conduct Meta analysis.Results 11 randomized controlled trials were included in the meta-analysis,with a total of 1113 patients.Meta-analysis results showed that the experimental group was better than the control group in reducing fasting blood glucose(FBG)[d=-0.65,95%CI(-0.78,-0.35),p<0.00001]in PD patients,and the intervention time(I^(2)=94%),intervention intensity(I^(2)=93%),intervention frequency(I^(2)=95%),intervention period(I^(2)=92%),intervention type(91%)on the relationship between exercise intervention and PD patients’FBG The relationship is highly heterogeneous;the experimental group reduced the two hours postprandial blood glucose(2hPG)of PD patients[d=-0.57,95%CI(-0.78,-0.35),p<0.00001]Better than the control group;the experimental group was better than the control group in reducing Glycated Haemoglobin(HbA1C)in PD patients[d=-1.09,95%CI(-1.26,-0.93),p<0,00001],intervention Time(I^(2)=87%),intervention intensity(I^(2)=87%),intervention frequency(I^(2)=87%),intervention period(I^(2)=87%),intervention type(I^(2)=89%)for exercise and PD patients The relationship between HbA1C is highly heterogeneous.Conclusion 1)Exercise intervention can significantly improve the FBG,2hPG,HbA1C of PD patients.2)When improving the FBG of PD patients,use moderate exercise intensity resistance exercises,each intervention for more than 60 minutes,3 times a week.Intervention for more than 12 weeks has the best effect.3)When improving the HbA1C of PD patients,use high-intensity resistance exercise,each intervention for more than 60 minutes,3 times a week,and the best effect for 12 weeks.