运动干预对非酒精性脂肪性肝病患者影响的meta分析

Effect of exercise intervention on patients with non-alcoholic fatty liver disease:a meta-analysis

目的系统评价运动干预对非酒精性脂肪性肝病(NAFLD)患者相关指标的影响。方法检索PubMed、Embase、EBSCO、Cochrane Library、JBI、中国知网、万方数据库、维普、中国生物医学文献数据库近十年来关于运动干预对NAFLD患者相关指标影响的随机对照试验,由2名课题组成员独立筛查文献、提取数据与评价文献质量后,运用RevMan 5.3统计软件对纳入的数据进行meta分析。结果共纳入11个随机对照试验(RCT)研究,结果显示,运动干预组患者的谷丙转氨酶(ALT)[MD=-5.77,95%CI(-10.53,-1.00),P=0.02]、谷草转氨酶(AST)[MD=-4.22,95%CI(-7.68,-0.76),P=0.02]、低密度脂蛋白胆固醇(LDL-C)[MD=-7.20,95%CI(-13.10,-1.30),P=0.02]、内脏脂肪组织(VAT)[MD=-0.51,95%CI(-0.91,-0.11),P=0.01]、皮下脂肪组织(SAT)[MD=-0.54,95%CI(-0.76,-0.33),P<0.01]水平低于常规治疗组,差异有统计学意义(P<0.05)。两组患者的高密度脂蛋白胆固醇(HDL-C)[MD=0.02,95%CI(-0.06,0.10),P=0.60]、血清总胆固醇(TC)[MD=-0.14,95%CI(-0.75,0.46),P=0.64]、三酰甘油(TG)[MD=0.04,95%CI(-0.12,0.20),P=0.62]比较,差异无统计学意义(P>0.05)。结论运动干预可作为NAFLD患者非药物治疗的首选方式,安全可靠。

Objective To evaluate the application of training in non-alcoholic fatty liver disease(NAFLD).Methods PubMed,Embase,EBSCO,Cochrane Library,JBI,China National Knowledge Infrastructure,WanFang Database,VIP and Chinese Biomedical Literature Database in recent ten years were searched on the effect of exercise intervention on related indicators in patients with NAFLD.After independent literature screening,data extraction and literature quality evaluation,RevMan 5.3 statistical software was used for meta-analysis of the included data.Results A total of 11 randomized controlled trials(RCT)were included,and the results showed that alanine aminotransferase(ALT)(MD=-5.77,95%CI[-10.53,-1.00],P=0.02),aspartate aminotransferase(AST)(MD=-4.22,95%CI[-7.68,-0.76],P=0.02),low-density lipoprotein cholesterol(LDL-C)(MD=-7.20,95%CI[-13.10,-1.30],P=0.02),visceral adipose tissue(VAT)(MD=-0.51,95%CI[-0.91,-0.11],P=0.01)and subcutaneous adipose tissue(SAT)(MD=-0.54,95%CI[-0.76,-0.33],P<0.01)of the exercise intervention group were lower than those in conventional treatment group,and the differences were statistically significant(P<0.05).There were no statistically significant differences in high density lipoprotein cholesterol(HDL-C)(MD=0.02,95%CI[-0.06,0.10],P=0.60),serum total cholesterol(TC)(MD=-0.14,95%CI[-0.75,0.46],P=0.64),triglyceride(TG)(MD=0.04,95%CI[-0.12,0.20],P=0.62)between the two groups(P>0.05).Conclusion Exercise intervention can be used as the first choice for non-drug treatment of NAFLD patients,which is safe and reliable.