不同方式运动对2型糖尿病患者血管形态和功能的Meta分析

The Effects of Different Modes of Exercise on Vascular Morphology and Function in Patients with Type 2 Diabetes Mellitus:A Meta-analysis

目的:系统评价不同方式运动对2型糖尿病患者血管形态和功能的影响。方法:计算机检索PubMed等数据库,搜集运动治疗2型糖尿病患者血管的随机对照试验(RCT),检索时限为2010年1月至2022年2月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3和Stata16.0软件进行Meta分析。结果:共纳入22个RCT,包括1143例患者。Meta分析结果显示:运动在改善2型糖尿病患者血流介导的血管舒张、硝酸甘油介导的血管舒张、颈动脉内膜中层厚度、颈动脉至股动脉脉搏波传导速度均优于对照组。亚组分析结果显示:8~12周的高强度间歇训练可能对T2DM患者的FMD和cIMT改善效果更佳;12周的抗阻训练可能对T2DM患者的NMD改善效果更佳;有氧运动可能对T2DM患者的cfPWV改善效果更佳。结论:运动可改善2型糖尿病患者血管形态和功能,高强度间歇训练对血管厚度及功能改善效果较为明显,而有氧运动对血管僵硬度改善效果较为显著。受纳入研究数量及质量的限制,以上结论尚待更多高质量的研究予以验证。

Objective To systematically review the intervention effects of different modes of exercise on vascular morphology and function in patients with type 2 diabetes mellitus.Methods PubMed and other databases were electronically searched to collect randomized controlled trials(RCTs)of exercise applied to vascular morphology and function in patients with type 2 diabetes from January,2010 to February,2022.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Meta-analysis was then performed using RevMan 5.3 and Stata 16.0 software.Results A total of 22 RCTs involving 1143 patients were included.The results of meta-analysis showed that exercise could improve flow mediated vasodilation,nitroglycerine mediated vasodilation,carotid intima media thickness,carotid femoral pulse wave velocity.Subgroup analysis showed 8-12 weeks of high-intensity interval training may have a better effect on flow mediated vasodilation and carotid intima media thickness in T2DM patients,12 weeks of resistance training may have a better effect on nitroglycerine mediated vasodilation,rerobic exercise may improve carotid femoral pulse wave velocity better in T2DM patients.Conclusions exercise can improve vascular morphology and function in patients with type 2 diabetes,high-intensity interval training has a better improvement effect on vascular thickness and function,while aerobic exercise has a better improvement effect on vascular stiffness.Due to the limitations of the quality and quantity of the included studies,the above conclusions need to be verified by more high-quality studies.