有氧锻炼不同干预时间对绝经前后不同年龄段女性心血管功能影响的Meta分析

Influence of Aerobic Exercise at Different Intervention Durations on Cardiovascular Function in Women of Different Ages before and after Menopause:A Meta-Analysis

目的:运用Meta分析评估有氧锻炼不同干预时间对绝经前后不同年龄段未经常训练成年女性心血管功能的影响。方法:通过PubMed、Embase、Cochrane Library、Web of Science和中国知网(CNKI)等电子数据库检索截止至2017年12月的所有相关文献,根据纳入标准筛选文献,采用固定效应或随机效应模型计算加权均数差和95%置信区间(CI),并进行亚组分析和回归分析以探讨异质性来源。结果:1)共15项研究被纳入分析,共计受试者753名,根据女性年龄的生理周期特点(绝经前和绝经后两个年龄段)和锻炼持.续时间(<3个月、4～6个月、>6个月)进行亚组分析;2)短时间锻炼后的最大摄氧量(VO_2max;95%CI:2.32～5.45;I^2=81.9%)显著增加,而安静心率(HR;95%CI:-6.82～-1.24;I^2=87.6%)、收缩压(SBP;95%CI:-8.96～-0.73;I^2=.82.4%)及舒张压(DBP; 95%CI:-4.68～-2.67;I^2=13.4%)显著下降;3)中等时间锻炼后的VO_2max (95%CI:2.97～7.58;I^2=48.2%)显著增加,而中等时间锻炼后HR (95%CI:-6.34～-4.8;I^2=61.9%)、SBP(95%CI:-9.5～-5.16;I^2=89.1%)和DBP(95%CI:-4.71～-1.78;I^2=82.2%)显著降低,长时间锻炼后DBP(95%CI:-4.02～-0.19;I^2=0%)显著下降;.4)有氧运动改善了绝经前30岁以下及35～45岁成年女.性和绝经后55～65岁成年女性VO_2max;然而,有氧运动未提高绝经后65岁以上老年人VO_2max;另外,有氧运动降低了绝经前35～45岁成年女性和绝经后55～65岁成年未训练女性HR、SBP和DBP。结论:通过Meta分析得出,不同干预时间有氧锻炼对绝经前(主要为<30岁和35～45岁)和绝经后(主要为55～65岁)未经常训练的女性心血管的影响是不同的,且未经常训练女性心血管功能的改善随年龄增长而下降。短期和中期有氧锻炼使得有氧能力显著升高,而HR和血压显著降低;长期的有氧运动降低了DBP。

Purpose: Cardiovascular health in women has always been a topic in China and even in the world. Aerobic exercise intervention is considered to be an effective way to prevent cardiovascular disease and improve cardiovascular function. This paper is to evaluate influence of aerobic exercise of different durations on the cardiovascular function in untrained women before and after menopause by Meta-analysis. Methods: Published studies from inception to December 2017 were identified by searching electronic databases(PubMed, Embase, Cochrane Library, CNKI and Web of Science). Additionally, according to the inclusion criteria, weighted mean differences(WMD) and 95% confidence intervals(CI) were calculated using fixed-effects models or random-effects models. Subgroup analysis and meta-regression were conducted to explore the possible heterogeneity. Results: 15 studies were included, with a total of 753 women. The subgroup analysis was performed according to the physiological cycle characteristics of female age(before and after meno.pause) and exercise duration(less than 3 months, 4 to 6 months and more than 6 months). VO2 max(95% CI: 2.32~5.45;I2=81.9%) was significantly increased at aerobic exercise at short duration, while resting heartrate(RHR)(95% CI:-6.82^-1.24;I2=87.6%), systolic blood pressure(SBP)(95% CI:-8.96^-0.73;I2=82.4%) and diastolic blood pressure(D.BP)(95% CI:-4.68^-2.67;I2=13.4%)were significantly decreased in untrained women. VO2 max(95% CI: 2.97~7.58;I2=48.2%) was significantly increased after aerobic exercise at mid-duration, while RHR(95% CI:-6.34^-4.8;I2=61.9%), SBP(95% CI:-9.5^-5.16;I2=89.1%)and DBP(95% CI:-4.71^-1.78;I2=82.2%)were significantly decreased. Meanwhile, DBP(95% CI:-4.02^-0.19;I2=0%)was significantly decreased after long-duration of aerobic exercise. Aerobic exercise improved VO2 max in adult women under 30 years old and 35-45 years old before menopause and adult wom.en aged 55~65 after menopause. However, aerobic exercise intervention did not improve VO2 max in women older than65 years old after menopause. In addition, aerobic exercise reduces SBP, DBP and RHR in untrained women aged 35~45 before menopause and untrained women aged 55~65 after menopause. Conclusions: through the systematic review and Meta-analysis, there are significant differences in the effects of aerobic exercise at different durations on the cardiovascular health of untrained women before menopause(under 30 years old and 35~45 years old) and after menopause(55~65 years old). And improvement of cardiovascular functions decreases with age in untrained women. Short-duration and mid-duration aerobic exercise significantly increased aerobic capacity, while RHR and SBP pressure decreased significantly. DBP was significantly decreased after long-duration aerobic exercise. However, the literature is limited. This article is indeed based on certain heterogeneity. We will further collect high-quality clinical randomized controlled trials, especially the study on effects of long-term aerobic exercise intervention on cardiovascular, and further explore the prevention of cardiovascular risk and the treatment of cardiovascular diseases.