营养结合抗阻训练复合干预对老年人瘦体重和骨骼肌力量影响的Meta分析

A Meta-Analysis of the Effects of Combined Nutrition and Resistance Training Intervention on Lean Body Mass and Skeletal Muscle Strength in Older Adults

研究目的:本文运用Meta分析方法综合定量评估营养结合抗阻训练复合干预和接受抗阻力训练老年人瘦体重和骨骼肌力量的关系,旨在给预防老年人骨骼肌疾病的发生和促进老年人的身体健康提供理论参考。研究方法:从各大数据库检索营养结合抗阻训练复合干预对接受抗阻力训练老年人瘦体重与骨骼肌力量影响的随机对照试验研究,并将其根据纳入标准和排除标准进行筛选,采用Cochrane的偏倚风险工具评估纳入研究的方法学质量,使用RevMan 5.4软件将纳入文献进行Meta分析。研究结果:本文共纳入了16篇文献,样本总量为762例。Meta分析的结果显示,抗阻力训练和营养复合干预未能显著增加老年人的瘦体重含量(异质性检验:P=0.14>0.05,I^(2)=34%<50%,WMD=-0.12,95%CI-0.53~0.30;整体效应检验:P=0.58>0.05);未能显著提高老年人的伸膝力量水平(异质性检验:P=0.17>0.05,I^(2)=29%<50%,WMD=0.09,95%CI-0.07~0.25;整体效应检验:P=0.28>0.05);未能显著提高老年人的握力水平(异质性检验:P=0.45>0.05,I^(2)=0,WMD=1.00,95%CI-1.32~3.32;整体效应检验:P=0.40>0.05)。经敏感性分析显示纳入文献结果较为稳定,采用漏斗图分析得出本文纳入文献未有明显发表偏倚,即所纳入研究结果具有较高的可靠性。研究结论:本研究经Meta分析显示,营养干预对接受抗阻力训练老年人的瘦体重、伸膝力量和握力没有显著影响。该领域的研究要把重点放在样本特征以及营养干预的种类、频率、剂量上。

OBJECTIVE:The study aims to provide a theoretical reference for the prevention of skeletal muscle diseases of the older adults and improve their physical health,by a meta-analysis for quantitative and comprehensive assessment of the effects of combined nutrition and resistance training intervention on the lean body mass and skeletal muscle strength of the older adults as compared to those who have resistance training.METHODS:Pertinent articles from major databases were searched and a randomized controlled trial(RCT)study was conducted of the effects of combined nutrition and resistance training intervention on the lean body mass and skeletal muscle strength in older adults with resistance training.The articles were screened as per the inclusion and exclusion criteria.Assessment of the methodological quality of the included studies was done by using Cochrane’s risk of bias tool,and a meta-analysis was done of the included studies by using the software RevMan 5.4.RESULTS:A total of 16 articles with a total sample of 762 cases were selected for this study.The meta-analysis findings showed that the combined resistance training and nutrition intervention failed to significantly increase the lean body mass in older adults(test of heterogeneity:P=0.14>0.05,I^(2)=34%<50%,WMD=-0.12,95%CI-0.53~0.30;test of overall effect:P=0.58>0.05);it failed to significantly improve knee extension strength levels in older adults(test of heterogeneity:P=0.17>0.05,I^(2)=29%<50%,WMD=0.09,95%CI-0.07~0.25;overall effect test:P=0.28>0.05);it failed to significantly increase grip strength levels in older adults(test of heterogeneity:P=0.45>0.05,I^(2)=0,WMD=1.00,95%CI-1.32~3.32;overall effect test:P=0.40>0.05).A sensitivity analysis showed that the results of the included studies were stable,and a funnel plot analysis arrives at the conclusion that there was no significant publication bias in the included studies,which means that the results of the included studies were highly reliable.CONCLUSION:This study showed no significant effect of nutritional interventions on lean body mass,knee extension strength and grip strength in older adults with resistance training as revealed by the meta-analysis.Research in this area should focus on sample characteristics as well as the type,frequency and dose of nutritional interventions.