接受抗阻训练中老年人白细胞介素6与C-反应蛋白变化的Meta分析

Effect of resistance training on interleukin-6 and C-reactive protein in middle-age and elderly people: a Meta-analysis

目的:由年龄增长造成的慢性低度炎症在中老年人群中易发生,并引发多种慢性疾病,从事抗阻运动能否有效降低中老年人炎症因子水平尚无定论。定量评价抗阻训练对中老年人白细胞介素6与C-反应蛋白水平的影响,并分析不同干预对象、干预时间和干预方式对效果的影响,旨在为从事抗阻训练在中老年人健身中应用提供理论依据。方法:检索中国知网、万方数据、PubMed、Web of Science与EBSCO数据库,检索抗阻训练对中老年人白细胞介素6与C-反应蛋白水平影响的随机对照试验或自身对照试验研究,检索截止日期为2020年5月,根据制定的文献纳入与排除标准筛选文献、提取数据资料并采用Cochrane手册5.1.0标准与ROBINS-I 2.0标准评价文献质量,采用Rev Man 5.3软件进行Meta分析,对纳入文献中不同干预性别、干预时间与干预方式进行分组亚组分析。结果:(1)最终纳入13篇文献,受试对象共计246例,总体评估为低风险偏倚文献;(2)Meta分析结果显示,抗阻训练能显著降低中老年人白细胞介素6水平(MD=-0.30,95%CI:-0.48至-0.11,P=0.002),不能显著降低C-反应蛋白水平(MD=-0.26,95%CI:-0.54至-0.02,P=0.07);(3)亚组分析结果显示,中老年群体中抗阻训练有效降低白细胞介素6水平,受干预对象与干预时间影响小(P <0.05),≤12周的抗阻训练能有效降低C-反应蛋白水平(P <0.05),抗阻训练(MD=-0.25,95%CI:-0.54-0.04,P=0.05)较弹力带抗阻训练(MD=-0.34,95%CI:-1.39-0.71,P=0.87)对降低C-反应蛋白水平效果较为明显。结论:(1)抗阻训练能有效降低中老年人白细胞介素6水平,且不排除抗阻训练显著降低中老年人C-反应蛋白水平的可能;(2)中老年人短期从事抗阻运动训练(≤12周)对降低白细胞介素6与C-反应蛋白炎症因子水平效果明显,且进行机械抗阻训练相较于弹力带抗阻训练可能获得更大效益;(3)明确抗阻训练对C-反应蛋白水平干预效果或不同研究对象间干预效果是否存在显著性差异,还需要未来更多的研究进一步验证。

OBJECTIVE: Chronic low-grade inflammation which causes many chronic diseases caused by age is easy to occur in the middle-age and elderly people. In order to estimate the effect of resistance training on interleukin-6 and C-reactive protein in middle-aged and elderly people, and study the effects of different sexes, duration of intervention and mode, this study provided scientific theory for the application of resistance training in the middle-aged and elderly. METHODS: CNKI, WanFang Data, PubMed, Web of Science, and EBSCO were searched for randomized controlled trials or self-controlled trials about the effect of resistance training on interleukin-6 and C-reactive protein levels in the middle-aged and elderly published before May 2020. Literature screening and data extraction were conducted according to the established literature inclusion and exclusion criteria. Enrolled literatures were evaluated using Cochrane Handbood 5.1.0 and ROBINS-I 2.0. Meta-analysis was conducted using RevMan 5.3. Subgroup analysis was carried out between different sexes, duration of intervention and interventional modes.RESULTS: There were 13 eligible articles with 246 subjects, all of which were assessed as low-risk bias. Meta-analysis results showed that resistance training significantly reduced interleukin-6 levels(mean difference [MD]=-0.30, 95% confidence interval [Ci]:-0.48 to-0.11, P=0.002), but showed no significant reduction in C-reactive protein levels(MD=-0.26, 95%Ci:-0.54 to-0.02, P=0.07) in the middle-aged and elderly. Subgroup analysis indicated resistance training effectively reduced interleukin-6 levels in middle-aged and elderly people, which showed less association with interventional subjects and duration of intervention(P < 0.05). Resistance training less than 12 weeks could effectively reduce the C-reactive protein level(P < 0.05), and resistance training(MD=-0.25, 95% Ci:-0.54 to 0.04, P=0.05) had better effect on reducing the C-reactive protein level compared with elastic band resistance training(MD=-0.34, 95% Ci:-1.39 to 0.71, P=0.87).CONCLUSION: Resistance training can effectively reduce the interleukin-6 level, but has no significant reduction in the C-reactive protein level in the middleaged and elderly. The short-term resistance training(< 12 weeks) has obvious effect on reducing the levels of interleukin-6 and C-reactive protein inflammatory factors. Furthermore, mechanical resistance training may be more effective than elastic band resistance training. Further explorations on the effect of resistance training on C-reactive protein level in different research objects are required in future.