不同运动方式对肥胖青少年炎症反应影响的Meta分析

刘敬祺; 芦建东; 梁童婧; 陈书宁; 苏浩

doi:10.16835/j.cnki.1000-9817.2022.01.011

不同运动方式对肥胖青少年炎症反应影响的Meta分析

doi: 10.16835/j.cnki.1000-9817.2022.01.011

北京体育大学运动人体科学学院，北京 100084

基金项目:

国家重点研发计划项目 2018YFC200600

详细信息

作者简介:
刘敬祺(1995-)，男，吉林辽源人，在读硕士，主要研究方向为运动促进健康与运动风险评估

通讯作者:
苏浩，E-mail: suhao1982@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G804.49 R179 R723.14
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出版历程
- 收稿日期: 2021-04-24
- 修回日期: 2021-12-01
- 刊出日期: 2022-01-25

Meta-analysis of effectiveness of different exercises on inflammatory response in obese adolescents

School of Sports Science, Beijing Sport University, Beijing (100084), China

摘要

摘要: 目的系统评价不同运动方式对肥胖青少年炎症反应改善的差异性, 为选择合理运动方式应对青少年全身慢性炎症反应导致肥胖相关的各种慢性疾病提供参考。方法检索中国知网(CNKI)、PubMed、Web of Science、EBSCOhost等数据库，采用Cochrane评价工具对纳入的肥胖青少年炎症指标影响的随机对照试验(RCT)进行方法学质量评价，运用RevMan 5.3分析软件进行统计分析。结果共纳入21项RCT，共计1 020名受试者。Meta分析显示，有氧训练(AT)和有氧联合抗阻训练(AT+RT)均可显著降低肥胖青少年的体质量指数(BMI)、血清C反应蛋白(C-reactive protein，CRP) 和瘦素水平，且AT+RT在降低肥胖青少年促炎因子CRP (MD=-0.52，95%CI=-0.75~-0.30，P < 0.01)，瘦素(MD=-7.20，95%CI=-10.45~-3.94，P < 0.01)和提高抗炎因子脂联素(MD=1.28，95%CI=1.01~1.55，P < 0.01)的效果优于AT。高强度间歇运动(HIIT)可改善BMI(MD=-1.14，95%CI=-1.92~-0.36，P < 0.01)以及显著提高脂联素水平(MD=1.79，95%CI=1.09~2.50，P < 0.01)，且HIIT在提高肥胖青少年脂联素方面的作用优于AT以及AT+RT。结论长期规律的AT、AT+RT和HIIT均有助于改善肥胖青少年炎症状态，其中HIIT是肥胖青少年抵抗炎症值得关注的运动方式。
- 运动活动 /
- 肥胖症 /
- 炎症 /
- Meta分析 /
- 青少年
Abstract: Objective To systematically evaluate effectiveness of exercises on inflammatory response among obese adolescents. Methods By searching CNKI, PubMed, Web of Science, EBSCOhost and other databases, randomized controlled trials (RCTs) on the influence of different exercises on inflammatory indicators in obese adolescents were collected according to the inclusion and exclusion criteria. Cochrane evaluation tools were conducted methodological studies on the included literature quality evaluation, and RevMan 5.3 analysis software was used for statistical analysis. Results A total of 21 RCTs were included, involving 1 020 subjects. The results of Meta-analysis showed that aerobic training (AT) and aerobic plus resistance training (AT+RT) could significantly reduce BMI, serum C-reactive protein (CRP) and leptin levels in obese adolescents. In addition, the effects of AT+RT on pro-inflammatory CRP (MD=-0.52, 95%CI=-0.75--0.30, P < 0.01), leptin (MD=-7.20, 95%CI=-10.45--3.94, P < 0.01) and anti-inflammatory adiponectin (MD=1.28, 95%CI=1.01-1.55, P < 0.01) were stronger than AT. High intensity interval training (HIIT) was associated with BMI reduction (MD=-1.14, 95%CI=-1.92--0.36, P < 0.01) and increased adiponectin in obese adolescents (MD=1.79, 95%CI=1.09-2.50, P < 0.01), and HIIT was superior in improving adiponectin level in obese adolescents than AT and AT+RT. Conclusion Long-term and regular AT, AT+RT and HIIT can reduce inflammation in obese adolescents. HIIT is a notable exercise method for obese adolescents to resist inflammation.
- Motor activity /
- Obesity /
- Inflammation /
- Meta-analysis /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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图 1 文献筛选流程

Figure 1. Document screening flowchart

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图 2 不同运动方式对BMI影响的Meta分析

Figure 2. Meta analysis of the impact of different exercises on BMI

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图 3 不同运动方式对CRP影响的Meta分析

Figure 3. Meta analysis of the impact of different exercises on CRP

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图 4 不同运动方式对瘦素影响的Meta分析

Figure 4. Meta-analysis of the impact of different exercises on Leptin

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图 5 不同运动方式对IL-6影响的Meta分析

Figure 5. Meta-analysis of the impact of different exercises on IL-6

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图 6 不同运动方式对TNF-α影响的Meta分析

Figure 6. Meta-analysis of the impact of different exercises on TNF-α

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图 7 不同运动方式对脂联素影响的Meta分析

Figure 7. Meta-analysis of the impact of different exercises on Adiponectin

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图 8 不同运动方式对BMI影响的发表偏倚

Figure 8. Funnel plots of the impact of different exercises on BMI

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图 9 不同运动方式对脂联素影响的发表偏倚

Figure 9. Funnel plots of the impact of different exercises on Adiponectin

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表 1 纳入研究的基本特征

Table 1. Included characters in the study's basic characteristics table

第一作者及年份	国家	研究对象		干预措施			结局指标
第一作者及年份	国家	年龄/岁	样本量(男/女)	运动方式	频次/ (次·周^-1)	干预时间/周	结局指标
Park^[14]	韩国	AT: 14.2±0.5	19(0/19)	AT	6	12	BMI，CRP，
(2007)		C: 14.1±0.5	21(0/21)				瘦素，脂联素
Kim^[15]	韩国	AT: 17±0.11	14(14/0)	AT	5	6	BMI，hs-CRP，
(2007)		C: 17±0.11	12(12/0)				TNF-α，IL-6，脂联素
Wong^[16]	新加坡	AT+RT: 13.75±1.06	12(12/0)	AT+RT	2	12	BMI，CRP
(2008)		C: 14.25±1.54	12(12/0)
Balagopal^[17]	美国	AT: 15.6±0.3	8(4/4)	AT	3	12	CRP，IL-6
(2010)		C: 15.9±0.5	7(4/3)
Alberga^[18]	加拿大	AT: 15.5±1.4	75(22/53)	AT	4	22	BMI，
(2015)		RT: 15.9±1.5	78(23/55)	RT			hs-CRP
		AT+RT: 15.5±1.3	75(22/53)	AT+RT
		C: 15.6±1.3	76(24/52)
Park^[19]	韩国	AT+RT: 12.1±0.1	15(7/8)	AT+RT	3	12	BMI，hs-CRP，
(2012)		C: 12.2±0.1	14(7/7)				脂联素
Wong^[8]	美国	AT+RT: 15.2±1.2	15(0/15)	AT+RT	3	12	BMI，CRP，
(2018)		C: 15.3±1.1	15(0/15)				瘦素，脂联素
Nunes^[20]	巴西	AT+RT: 16.18±1.51	17(8/9)	AT+RT	AT: 2	24	BMI，CRP，
(2015)		C: 15.4±1.2	8(4/4)		RT: 2		脂联素
Vasconcellos^[21]	巴西	AT: 14.1±1.3	10(8/2)	AT	3	12	BMI，CRP，TNF-α，
(2015)		C: 14.8±1.4	10(6/4)				IL-6，瘦素，脂联素
Lopes^[22]	巴西	AT+RT: 14.6±1.15	17(0/17)	AT+RT	3	12	BMI，CRP，TNF-α，IL-6，
(2016)		C: 14.4±1.16	16(0/16)				瘦素，IL-10，脂联素
Meyer^[23]	德国	AT: 13.7±2.1	33(17/16)	AT	3	24	BMI，CRP
(2006)		C: 14.7±2.2	34(17/17)
Bharath^[24]	美国	AT+RT: 14.6±1.0	20(0/20)	AT+RT	5	12	BMI，瘦素
(2018)		C: 14.8±1	20(0/20)				脂联素
Lee^[25]	韩国	AT: 13±1.0	16(45/9)	AT	3	10	BMI，hs-CRP
(2010)		AT+RT: 13±1	20	AT+RT
		C: 13±1	18
Filho^[26]	巴西	AT+RT: 13.4±1.3	13(6/7)	AT+RT	3	8	BMI，hs-CRP
(2015)		C: 13.7±0.9	12(6/6)
Racil^[27]	突尼斯	HIIT: 14.2±1.2	17(0/17)	HIIT	3	12	BMI，瘦素
(2016)		C: 14.2±1.2	14(0/14)
Racil^[28]	突尼斯	HIIT: 16.6±0.9	23(0/23)	HIIT	3	12	BMI，瘦素，
(2015)		C: 16.9±1.0	19(0/19)				脂联素
Racil^[9]	突尼斯	HIIT: 15.6±0.7	11(0/11)	HIIT	3	12	BMI，
(2013)		C: 15.9±1.2	12(0/12)				Adiponectin
Alizadeh^[29]	伊朗	HIIT: 18.0±0.5	10(10/0)	HIIT	3	6	BMI，
(2019)		C: 18.0±0.5	10(10/0)				IL-4，IL-13
Plavsic^[30]	塞尔维亚	HIIT: 15.5±1.5	22(0/22)	HIIT	2	12	BMI，
(2020)		C: 16.2±1.3	22(0/22)				hs-CRP
陈琼^[31]	中国	AT: 14.1±3.1	15(15/0)	AT	3	8	BMI，IL-6，
(2015)		RT: 13.9±2.2	15(15/0)	RT			TNF-α，
		AT+RT: 14.2±3.8	15(15/0)	AT+RT			CRP
		C: 14.4±3.2	15(15/0)
郅季炘^[32]	中国	AT+RT: 14.5±1.8	31(31/0)	AT+RT	3	12	BMI，TNF-α，hs-CRP，
(2019)		C: 15.5±1.6	33(33/0)				瘦素，脂联素
注： AT指有氧训练，RT指抗阻训练，AT+RT指有氧联合抗阻训练，C指对照组。

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