中国组织工程研究

中国组织工程研究 ›› 2024, Vol. 28 ›› Issue (14): 2274-2281.doi: 10.12307/2024.290

• 组织构建循证医学 evidence-based medicine in tissue construction • 上一篇    下一篇

不同强度训练方式对2型糖尿病超重或肥胖者体成分及糖代谢影响的Meta分析

刘仁凡1，2，吕丽婷2，伍  怡2，王  璐2   

  1. 1成都理工大学工程技术学院，四川省乐山市  614000；2成都体育学院运动解剖学教研室，四川省成都市  610000
  • 收稿日期:2023-02-22 接受日期:2023-04-10 出版日期:2024-05-18 发布日期:2023-07-28
  • 通讯作者: 王璐，博士，副教授，硕士生导师，成都体育学院运动解剖学教研室，四川省成都市 610000
  • 作者简介:刘仁凡，男，1995年生，重庆市人，汉族，硕士，主要从事运动与健康促进研究。
  • 基金资助:
    国家自然科学基金青年项目(31900848)，项目负责人：王璐；成都体育学院运动医学与健康研究所/郑怀贤骨伤研究所2021-2022年创新课题资助(CX21B05)，项目负责人：王璐；四川省科技厅青年项目(2022NSFSC1724)，项目负责人：王璐

Effects of high-intensity interval training and moderate-intensity continuous training on body composition and glucose metabolism in overweight or obese patients with type 2 diabetes: a Meta-analysis

Liu Renfan1, 2, Lyu Liting2, Wu Yi2, Wang Lu2   

  1. 1The Engineering & Technical College of Chengdu University of Technology, Leshan 614000, Sichuan Province, China; 2Teaching and Research Section of Sport Anatomy, Chengdu Sport University, Chengdu 610000, Sichuan Province, China
  • Received:2023-02-22 Accepted:2023-04-10 Online:2024-05-18 Published:2023-07-28
  • Contact: Wang Lu, PhD, Associate professor, Master’s supervisor, Teaching and Research Section of Sport Anatomy, Chengdu Sport University, Chengdu 610000, Sichuan Province, China
  • About author:Liu Renfan, Master, The Engineering & Technical College of Chengdu University of Technology, Leshan 614000, Sichuan Province, China; Teaching and Research Section of Sport Anatomy, Chengdu Sport University, Chengdu 610000, Sichuan Province, China
  • Supported by:
    National Natural Science Foundation of China (Youth Program), No. 31900848 (to WL); 2021-2022 Innovation Project of Medicine and Health/Zheng Huaixian Institute of Orthopedic Injuries of Chengdu Sport University, No. CX21B05 (to WL); Youth Project of Sichuan Science and Technology Department, No. 2022NSFSC1724 (to WL)

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摘要：


文题释义：

高强度间歇训练(high-intensity interval training，HIIT)：是一种在短时间高强度运动中穿插着短时间低强度运动的运动方式，特点是通过较短的时间和较少的总运动量来最大限度地提高运动强度，是能全面提高机体有氧和无氧代谢水平的新兴运动方式。
中等强度持续性训练(moderate-intensity continuous training，MICT)：是一种持续时间较长且运动强度相对较低的连续运动的训练方法，主要用于提高心肺功能和发展有氧代谢能力。


目的：系统评价高强度间歇训练(high-intensity interval training，HIIT)与中等强度持续性训练(moderate-intensity continuous training，MICT)对2型糖尿病超重或肥胖患者体成分、糖代谢相关指标干预效果，对比两种运动方式的改善效果，为2型糖尿病超重或肥胖患者运动处方的制定提供参考依据。

方法：检索The Cochrane Library、PubMed、EMbase、Web of Science、中国知网、中国生物医学文献数据库(CBM)、万方及美国临床试验注册中心数据库，搜集HIIT与MICT对2型糖尿病超重或肥胖患者体成分和糖代谢相关指标干预效果比较的随机对照试验，检索时间为各数据库建库至2022年6月。由2名研究者对所纳入的研究进行筛选、质量评价和数据提取，采用RevMan 5.4软件对结局指标进行Meta分析。
结果：①共纳入13项随机对照试验，包括371例患者，所纳入研究整体质量较高。②HIIT组与MICT组对体成分改善效果无显著性差异(体质量：WMD=2.44，95%CI：-3.01-7.89，P > 0.05；体质量指数：WMD=0.28，95%CI：-1.21-1.77，P > 0.05；腰围：WMD=2.16，95%CI：-2.04-6.35，P > 0.05；体脂百分比：WMD=0.47，95%CI：-2.11-3.05，P > 0.05)；③两组体质量与体质量指数指标“训练周期≥12周”亚组“训练频率≤3次/周”亚组差异有显著性意义(训练周期≥12周亚组：WMD=4.25，95%CI：0.90-7.59，P=0.01；WMD=2.71，95%CI：1.92-3.51，P < 0.000 01；训练频率≤3次/周亚组：WMD=5.14，95%CI：1.7-8.57，P=0.003；WMD=1.67，95%CI：0.66-2.67，P=0.001)；④敏感性分析结果显示，HIIT组与MICT组体脂百分比指标差异有显著性意义(WMD=2.17，95%CI：1.20-3.14，P < 0.000 1)，两组对糖代谢改善效果无显著性差异(空腹血糖：WMD=0.31，95%CI：-0.17-0.79，P > 0.05；糖化血红蛋白：WMD=0.01，95%CI：-0.19-0.20，P > 0.05；胰岛素抵抗指数：WMD=-0.14，95%CI：-0.71-0.42，P > 0.05)；⑤亚组分析结果显示，空腹血糖指标在“训练频率≤3次/周”亚组分析中差异有显著性意义(WMD=0.92，95%CI：0.25-1.60，P=0.007)；糖化血红蛋白在“训练频率> 3次/周”亚组分析中差异有显著性意义(WMD=-0.2，95%CI：-0.3至-0.1，P < 0.000 1)。

结论：①整体而言，HIIT与MICT对改善2型糖尿病超重或肥胖患者体质量、体质量指数、腰围及体脂百分比等体成分和空腹血糖、糖化血红蛋白及胰岛素抵抗指数等糖代谢指标无显著差异；②当训练周期≥12周、训练频率≤3次/周时，MICT对体质量以及体质量指数的改善效果具有一定优势。

https://orcid.org/0000-0002-2055-3134(刘仁凡)；https://orcid.org/0009-0009-5254-3000(王璐)

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

关键词: 高强度间歇训练, 中等强度持续训练, 2型糖尿病, 超重, 肥胖, 体成分, 糖化血红蛋白, 空腹血糖, 胰岛素抵抗指数, Meta分析

Abstract: OBJECTIVE: To systematically evaluate the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on body composition and glucose metabolism-related indexes in overweight or obese patients with type 2 diabetes and to compare the improvement effect of the two exercise modalities, thereby providing a reference basis for the development of exercise prescription for overweight or obese patients with type 2 diabetes.
METHODS: The Cochrane Library, PubMed, EMbase, Web of Science, CNKI, CBM, WanFang, and ClinicalTrials.gov were searched for randomized controlled trials comparing the effects of HIIT and MICT interventions on body composition and glucose metabolism-related indicators in overweight or obese patients with type 2 diabetes. The search was conducted from database inception to June 2022. Meta-analysis of outcome indicators was performed using RevMan 5.4.
RESULTS: (1) A total of 13 randomized controlled trials with 371 subjects were included, and the overall quality of the included studies was relatively high. (2) There was no significant difference in the improvement of body composition between HIIT and MICT [body mass: weighted mean difference (WMD)=2.44, 95% confidence interval (CI): -3.01-7.89, P > 0.05; body mass index: WMD=0.28, 95%CI: -1.21-1.77, P > 0.05; waist circumference: WMD=2.16, 95% CI: -2.04-6.35, P > 0.05; body fat percentage: WMD=0.47, 95%CI: -2.11-3.05, P > 0.05). (3) The results of subgroup analysis showed that there was a significant difference in body mass and body mass index between the “training cycle ≥ 12 weeks” subgroup and the “training frequency ≤ 3 times/week” subgroup (training cycle ≥ 12 weeks subgroup: WMD=4.25, 95% CI: 0.90-7.59, P=0.01; WMD=2.71, 95%CI: 1.92-3.51, P < 0.000 01; training frequency ≤ 3 times/week subgroup: WMD=5.14, 95%CI: 1.7-8.57, P=0.003; WMD=1.67, 95% CI: 0.66-2.67, P=0.001). (4) The results of sensitivity analysis showed that there was a significant difference in body fat percentage between the HIIT and MICT groups (WMD=2.17, 95% CI: 1.20-3.14, P < 0.000 1), while there was no significant difference in the improvement of glucose metabolism between the HIIT and MICT groups (fasting blood glucose: WMD=0.31, 95% CI: -0.17-0.79, P > 0.05; glycosylated hemoglobin: WMD=0.01, 95% CI: -0.19-0.20, P > 0.05; insulin resistance index: WMD=-0.14, 95%CI: -0.71-0.42, P > 0.05). (5) The results of subgroup analysis showed that fasting blood glucose was significantly different in the subgroup of “training frequency ≤ 3 times/week” (WMD=0.92, 95% CI: 0.25-1.60, P=0.007) and glycosylated hemoglobin was significantly different in the “training frequency > 3 times/week” subgroup (WMD=-0.2, 95% CI: -0.3 to -0.1, P < 0.000 1).
CONCLUSION: Overall, there is no significant difference between HIIT and MICT in improving body composition such as body mass, body mass index, waist circumference, body fat percentage as well as improving glucose metabolic indexes such as fasting blood glucose, glycated hemoglobin and insulin resistance index in overweight or obese patients with type 2 diabetes. When the training period is ≥ 12 weeks and the training frequency is ≤ 3 times/week, MICT has a better effect on the improvement of body mass as well as body mass index.

Key words: high-intensity interval training, moderate-intensity continuous training, type 2 diabetes, overweight, obesity, body composition, glycosylated hemoglobin, fasting blood glucose, insulin resistance index, Meta-analysis

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