运动对学龄儿童心血管疾病风险因素干预效果Meta分析

Effect of exercise interventions on cardiovascular disease risk factors among school-age children:a Meta-analysis

目的了解运动对学龄儿童心血管疾病风险因素的干预效果,为开展儿童心血管疾病风险因素运动干预提供依据和指导。方法对万方、中国知网、维普、PubMed、Web of Science等数据库的相关文献进行检索,纳入标准为针对学龄儿童心血管风险因素的随机对照干预试验相关的文献。中文检索式有(身体活动或运动)和(学龄儿童或幼儿)和(心血管疾病或血压或血脂谱或胰岛素抵抗或炎症因子或动脉僵硬或动脉厚度或心血管综合风险因子)和(干预实验或随机对照实验),英文检索式有(physical activity OR exercise OR exercise intervention)AND(school-age OR children OR 7~12)AND(cardiovascular disease OR CVD OR lipid profile OR insulin resistance OR inflammation OR arterial thickness OR arterial stiffness OR CVD combined score)AND(randomized controlled trial)等。结果共纳入37篇文献,涉及6个结局指标。Meta分析结果显示,运动干预对学龄儿童的高密度脂蛋白(SMD=0.31,95%CI=0.03~0.59)、低密度脂蛋白(SMD=-0.37,95%CI=-0.59~-0.15)、三酰甘油(SMD=-0.45,95%CI=-0.72~-0.18)、胰岛素抵抗指数(SMD=-0.35,95%CI=-0.58~-0.12)、收缩压(SMD=-0.25,95%CI=-0.36~-0.14)、舒张压(SMD=-0.29,95%CI=-0.40~-0.18)均有较好的改善效果。结论运动干预对学龄儿童心血管风险因素有积极效果,可以在改善儿童的血脂状况、降低血压的同时改善胰岛素抵抗。

Objective To understand the effect of exercise interventions on cardiovascular disease risk factors among school-age children,and to provide guidance for developing relevant interventions.Methods Relevant documents were sourced from Wanfang database,CNKI,VIP,PubMed,Web of Science and other databases,and the inclusion criteria were published literature related to randomized controlled intervention trials on cardiovascular risk factors among school-age children.The search was conducted using Chinese keywords including"physical activity or exercise or exercise intervention"and"school-age or children or 7-12"and"cardiovascular disease or blood pressure or blood lipid profile or insulin resistance or inflammatory factor or arterial stiffness or arterial thickness or cardiovascular comprehensive risk factor"and"intervention experiment or randomized controlled experiment",and English keywords including"physical activity or exercise intervention"and"school-age or children"and"cardiovascular disease or CVD or lipid profile or insulin resistance or information or arterial thickness or arterial stiffness or CVD combined score"and"randomized controlled trial."Results A total of 37 articles were included,with six outcome indicators.The results of the Meta-analysis showed that exercise interventions had a beneficial effect on high-density lipoproteins(SMD=0.31,95%CI=0.03-0.59),low-density lipoproteins(SMD=-0.37,95%CI=-0.59--0.15),triglycerides(SMD=-0.45,95%CI=-0.72--0.18),HOMA-IR(SMD=-0.35,95%CI=-0.58--0.12),systolic blood pressure(SMD=-0.25,95%CI=-0.36--0.14),and diastolic blood pressure(SMD=-0.29,95%CI=-0.40--0.18).Conclusion Exercise interventions show a positive effect on cardiovascular risk factors among school-age children,and can contribute to improvements in blood lipid status,blood pressure and insulin resistance.