Chinese Journal of Tissue Engineering Research ›› 2019, Vol. 23 ›› Issue (35): 5718-5726.doi: 10.3969/j.issn.2095-4344.1482
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Liang Min1, Wang Hainiu2, Huang Peng2, Zhu Weihua2, Li Shunchang1
Online:
2019-12-18
Published:
2019-12-18
Supported by:
the Science and Technology Program of Sichuan Province, No. 2018JY0499 (to LSC); the Project of Sichuan Provincial Key Laboratory for Sports Medicine, No. 2018-A009
CLC Number:
Liang Min, Wang Hainiu, Huang Peng, Zhu Weihua, Li Shunchang . Systematic review and meta-analysis of effect of resistance exercise on glucose and lipid metabolism disorder in type 2 diabetes mellitus patients[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(35): 5718-5726.
2.2 纳入研究的基本特征 见表1。 2.3 纳入文献的方法学质量评价 纳入文献信息对照Cochrane系统评价标准分别从随机分组产生、隐藏分组、双盲实验、效应指标盲检、实验数据不完整、实验结果的选择性报告、其他偏倚风险等7个评价指标对纳入文献偏倚风险进行综合评价。图2为纳入文献偏倚评价,图3为纳入文献的风险总结图。总体分析,纳入文献存在一定的偏倚风险。其中Canmen隐藏分组和效应指标盲检评估为不清楚;Ng CL和Plotnikoff RC的文献质量很高,偏倚风险较低;Ronald J、周欢欢、李荣娟、欧雪群、理同新和许东明的隐藏分组和效应指标盲检评估为不清楚;王一书的和谭俊珍的研究由于未明确提出试验按照随机分配原则进行分组,故随机分组产生项的评估为不清楚;所有文献均未采用双盲,因受试者对干预手段不能采用盲法操作;试验结果的选择性报告和其他偏倚风险指标由于其独特性,所有文献的该两项评估均为不清楚,但整体文献质量处于中等偏上。 "
2.4 Meta分析结果 2.4.1 抗阻运动对2型糖尿病患者空腹血糖的影响 空白对照与抗阻运动对2型糖尿病患者空腹血糖影响研究共纳入8个RCTs[9-16],各研究间存在统计学异质性(χ2=27.94,I2=75%,P=0.000 2),因此通过随机效应模型进行Meta分析。Meta分析结果显示,相对于空白对照组,抗阻训练对2型糖尿病患者空腹血糖的改善差异有显著性意义[SMD=0.84,95%CI(0.39,1.29),P=0.000 2,见图4A]。 有氧运动与抗阻运动对2型糖尿病患者空腹血糖影响研究共纳入4个RCTs[9-10,17-18],各研究间不存在统计学异质性(χ2=1.29,I2=0%,P=0.73) ,因此通过固定效应模型进行Meta分析。Meta分析结果显示,与有氧训练组相比,抗阻训练对于空腹血糖的改善差异无显著性意义[SMD=-0.06,95%CI(-0.34,0.22),P=0.67,见图4B]。 2.4.2 抗阻运动对2型糖尿病患者糖化血红蛋白的影响 空白对照与抗阻运动对2型糖尿病患者糖化血红蛋白影响研究共纳入8个RCTs[9-14,16,19],各研究间存在统计学异质性 (χ2=23.41,I2=70%,P=0.001),因此通过随机效应模型进行 Meta分析。Meta分析结果显示,相对于空白对照组,抗阻训练对2型糖尿病患者糖化血红蛋白的改善差异有显著性意义[SMD=0.44,95%CI(0.06,0.81),P=0.02,见图5A]。 有氧运动与抗阻运动对2型糖尿病患者糖化血红蛋白影响研究共纳入5个RCTs[9-10,17-19],各研究间不存在统计学异质性(χ2=1.22,I2=0%,P=0.87),因此通过固定效应模型进行Meta分析。Meta分析结果显示,与有氧训练组相比,抗阻训练对于糖化血红蛋白的改善差异无显著性意义[SMD=-0.16,95%CI(-0.39,0.07),P=0.17,见图5B]。 2.4.3 抗阻运动对2型糖尿病患者三酰甘油的影响 空白对照与抗阻运动对2型糖尿病患者三酰甘油影响研究共纳入7个RCTs[9-14,19],各研究间存在统计学异质性(χ2= 28.44,I2=79%,P < 0.000 1), 因此通过随机效应模型进行Meta分析。Meta分析结果显示,相对于空白对照组,抗阻训练对2型糖尿病患者三酰甘油的改善差异有显著性意义[SMD=0.55,95%CI(0.07,1.04),P=0.02,见图6A]。 有氧运动与抗阻运动对2型糖尿病患者三酰甘油影响研究共纳入5个RCTs [9-10,17-19],各研究间不存在统计学异质性(χ2=2.54,I2=0%,P=0.64) ,因此通过固定效应模型进行 Meta分析。Meta分析结果显示,与有氧训练组相比,抗阻训练对于三酰甘油的改善差异无显著性意义[SMD=-0.13,95%CI(-0.36,0.10),P=0.27,见图6B]。 "
2.4.4 抗阻运动对2型糖尿病患者高密度脂蛋白胆固醇的影响 抗阻运动对2型糖尿病患者高密度脂蛋白胆固醇影响研究共纳入9个RCTs[9-16,19],各研究间不存在统计学异质性(χ2=9.49,I2=16%,P=0.30),因此通过固定效应模型进行Meta分析。Meta分析结果显示,相对于空白对照组,抗阻训练对2型糖尿病患者高密度脂蛋白胆固醇的改善差异有显著性意义[SMD=-0.33,95%CI(-0.53,-0.13),P= 0.001,见图7A]。 有氧运动与抗阻运动与对2型糖尿病患者高密度脂蛋白胆固醇影响研究共纳入5个RCTs[9-10,17-19],各研究间不存在统计学异质性(χ2=3.75,I2=0%,P=0.44) ,因此通过固定效应模型进行Meta分析。Meta分析结果显示,与有氧训练组相比,抗阻训练对于高密度脂蛋白胆固醇的改善差异无显著性意义[SMD=-0.05,95%CI(-0.28,0.17),P=0.65,见图7B]。 2.4.5 抗阻运动对2型糖尿病患者低密度脂蛋白胆固醇的影响 抗阻运动对2型糖尿病患者低密度脂蛋白胆固醇影响研究共纳入9个RCTs[9-16,19],各研究间存在统计学异质性(χ2=57.74,I2=86%,P < 0.000 01),因此通过随机效应模型进行Meta分析。Meta分析结果显示,相对于空白对照组,抗阻训练对2型糖尿病患者低密度脂蛋白胆固醇的改善差异有显著性意义[SMD=0.49,95%CI(-0.03,1.01),P=0.06,见图8A]。 有氧运动与抗阻运动对2型糖尿病患者低密度脂蛋白胆固醇影响研究共纳入5个RCTs[9-10,17-19],各研究间不存在统计学异质性(χ2=0.71,I2=0%,P=0.95) ,因此通过固定效应模型进行Meta分析。Meta分析结果显示,与有氧训练组相比,抗阻训练对于低密度脂蛋白胆固醇的改善差异无显著性意义[SMD=-0.04,95%CI(-0.27,0.18),P=0.70,见图8B]。 2.5 有氧运动与抗阻运动不同干预周期的亚组分析 2.5.1 有氧运动与抗阻运动不同干预周期对2型糖尿病患者糖化血红蛋白的影响 2篇文献报道了干预12周的结 果[9,19],亚组分析结果显示,两组差异无显著性意义[SMD=-0.16,95%CI(-0.48,0.15),P=0.30,见图9A]。2篇文献报道了干预24周的结果[12,17],亚组分析结果显示,两组差异无显著性意义[SMD=-0.20,95%CI(-0.51,0.10),P=0.18,见图9B]。 2.5.2 有氧运动与抗阻运动不同干预周期对2型糖尿病患者三酰甘油的影响 2篇文献报道了干预12周的结果[9,19],亚组分析结果显示,两组差异无统计学意义。[SMD=-0.08,95%CI(-0.39,0.23),P=0.59,见图10A]。2篇文献报道了干预24周的结果[12,17],亚组分析结果显示,两组差异无显著性意义[SMD=-0.10,95%CI(-0.40,0.21),P=0.53,见图10B]。 2.5.3 有氧运动与抗阻运动不同干预周期对2型糖尿病患者高密度脂蛋白胆固的影响 2篇文献报道了干预12周的结果[9,19],亚组分析结果显示,两组差异显著性意义[SMD=-0.05,95%CI(-0.36,0.26),P=0.76,见图11A]。2篇文献报道了干预24周的结果[12,17],亚组分析结果显示,两组差异无显著性意义[SMD=0.06,95%CI(-0.24,0.36),P=0.69,见图11B]。 2.5.4 有氧运动与抗阻运动不同干预周期对2型糖尿病患者低密度脂蛋白胆固醇的影响 2篇文献报道了干预12周的结果[9,19],亚组分析结果显示,两组差异无显著性意义[SMD=0.05,95%CI(-0.26,0.36),P=0.73,见图12A]。2篇文献报道了干预24周的结果[12,17],亚组分析结果显示,两组差异无显著性意义[SMD=0.01,95%CI(-0.29,0.31),P=0.95,见图12B]。 "
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