长期运动对健康老年人群血脂影响的系统评价及Meta分析

A systematic review and meta-analysis of the effects of long-term exercise on blood lipids in healthy elderly people

目的:评价长期运动对健康老年人群血脂的影响,探讨长期运动是否可以影响老年人群低密度脂蛋白。方法:检索Pub Med、Cochrane library、EBSCO、中国知网数据库,收集长期运动对健康老年人血脂影响的随机对照试验。应用Cochrane偏倚风险评估工具对纳入文献进行方法学质量评价,采用Stata 14.0软件进行异质性分析和潜在发表偏倚分析。结果:共纳入9篇文献,包括409名受试者,其中实验组226名,对照组183名。(1)Meta分析结果显示,与对照组相比,长期运动可以降低老年人三酰甘油(SMD=-0.67,95%CI:-1.14至-0.20,P=0.006)、总胆固醇(SMD=-0.42,95%CI:-0.82至-0.02,P=0.04),并提高高密度脂蛋白(SMD=0.71,95%CI:0.08-1.33,P=0.026),但运动干预后老年人低密度脂蛋白没有发生显著性变化(SMD=-0.17,95%CI:-0.36-0.02,P=0.085)。(2)亚组分析结果显示,每周运动时间≥150 min的运动可以有效改善血脂状况,并且总的效应量大于每周<150 min的运动。结论:长期运动可以有效改善健康老年人群三酰甘油、总胆固醇、高密度脂蛋白水平,但尚未确定对低密度脂蛋白的改善作用,这可能与多种因素相关。建议进行运动改善血脂时不应只关注于对总低密度脂蛋白的影响,还应关注于运动对不同健康状况成年或老年人的健康效益。同时为了更好地提高运动健康效应,建议老年人需要每周运动至少150 min。但是,由于纳入研究的异质性比较明显,该结论尚需要开展更多的高质量研究进行验证。

OBJECTIVE:To evaluate the effect of long-term exe rcise on the blood lipids of healthy elderly people and to explore whether long-term exercise can affect the low-density lipoprotein of older adults.METHODS:A lite rature search was performed in PubMed,Cochrane library,EBSCO,and CNKI databases to collect randomized controlled trials on the effects of long-term exercise on blood lipids of healthy elderly people.Cochrane’s risk assessment tool was used to evaluate the methodological quality of the included literature.Stata14.0 software was used to analyze the heterogeneity and potential publication bias of the included lite rature.RESULTS:A total of 9 articles were included,including 409 participants(226 in the expe rimental group and 183 in the control group).(1) Meta-analysis res ults showed that compared with the control group,long-term exercise could reduce triglyceride [standardized mean difference(SMD)=-0.67,95% confidence interval(CI):-1.14 to-0.20,P=0.006] and total cholesterol(SMD=-0.42,95% CI:-0.82 to-0.02,P=0.04),and increase high-density lipoprotein(SMD=0.71,95% CI:0.08-1.33,P=0.026) in older adults,but there was no significant change in low-density lipoprotein level after exercise intervention(SMD=-0.17,95% CI:-0.36 to 0.02,P=0.085).Subgroup analysis res ults revealed that ≥ 150 minutes of exercise per week could effectively improve blood lipids and the total effect size was greater than that of <150 minutes of exercise per week.CONCLUSION:Long-term exe rcise can effectively improve the levels of triglyceride,total cholesterol,and high-density lipoprotein in healthy elderly people,but the effect on improving low density lipoprotein has not been determined,which may be related to a variety of fa ctors.We suggest that when exercising to improve blood lipids,we should not only pay attention to the effect on total low-density lipoprotein,but also focus on the health benefits of exercise for adults or older adults with different health conditions.At the same time,in order to better improve the health effects of exercise,we recommend that older adults need at least 150 minutes of exe rcise a week.Howeve r,due to the obvious heterogeneity of the included studies,the conclusions of this study need to be ve rified by more high-quality studies.