目的 系统分析运动结合饮食干预对肥胖合并2型糖尿病患者体质量和血糖控制的作用.方法 检索中国知网、PubMed、The Cochrane Library、Web of Science 4个数据库,检索时间从建库至2023年12月31日,筛选符合标准的随机对照试验(randomized control trial,RCT)文章.采用Rev Man 5.4和Stata 15.0软件进行Meta分析.使用Cochrane系统评价手册评估文献质量.通过亚组分析和敏感性分析寻找异质性来源.结果 纳入12篇研究,共1241例肥胖合并2型糖尿病患者.其中干预组729例,对照组512例.Meta分析结果显示,运动结合饮食干预比常规治疗组更好地改善了体质量指数(body mass index,BMI)(MD=-1.65,95％CI:-2.31～-1.00,P＜0.01)、体质量(MD=-4.58,95％CI:-6.76～-2.39,P＜0.01)、腰围(MD=-3.67,95％CI:-4.95～-2.39,P＜0.01)、糖化血红蛋白(glycosylated he-moglobin,HbA1c)(MD=-0.58,95％CI:-0.87～-0.29,P＜0.01)和空腹血糖(MD=-0.89,95％CI:-1.27～-0.50,P＜0.01).结论 运动结合饮食干预对肥胖合并2型糖尿病患者的肥胖改善、血糖控制效果显著,可以明显降低患者的BMI、体质量、腰围、HbA1c及空腹血糖,且对HbA1c＞7％的患者的BMI和血糖改善效果更好.推荐运动结合饮食干预至少3～6个月,可以更好地改善肥胖合并2型糖尿病患者的体质量和血糖指标.
Study on the health effects of exercise combined with dietary intervention in obese individuals with type 2 diabetes mellitus
Objective To systematically analyze the effects of exercise combined with dietary interventions on body weight and blood glucose control in obese individuals with type 2 diabetes mellitus.Methods A search was conducted in four Chinese and English databases,including CNKI,PubMed,Cochrane Library,and Web of Sci-ence,from establishing the databases to December 31,2023,to select randomized controlled trials that met the cri-teria.Meta-analysis was performed using RevMan 5.4 and Stata 15.0 software.The quality of the literature was evaluated using the Cochrane Systematic Review Manual.Sensitivity and subgroup analysis were carried out to find sources of heterogeneity.Results A total of 1 241 subjects from 12 articles were finally included in this review,of which 729 were in the intervention group,and 512 were in the control group.The results of the Meta-analysis re-vealed that exercise combined with dietary interventions was more effective than conventional treatment in improv-ing body mass index(BMI)(MD=-1.65,95％CI:-2.31--1.00,P＜0.01),body Weight(MD=-4.58,95％CI:-6.76--2.39,P＜0.01),waist circumference(MD=-3.67,95％CI:-4.95--2.39,P＜0.01),glycosylated hemoglobin(HbA1c)(MD=-0.58,95％CI:-0.87--0.29,P＜0.01),and fasting blood glucose(MD=-0.89,95％CI:-1.27--0.50,P＜0.01).Conclusions Exercise combined with dietary interventions significantly improves obesity and blood glucose control in obese patients with type 2 diabetes mellitus,significantly reducing BMI,body weight,waist circumference,HbA1c,and fasting blood glucose.Furthermore,the interven-tion has a better effect on improving BMI and blood glucose in patients with HbA1c＞7％.It is recommended that exercise be implemented combined with dietary intervention for 3-6 months can improve the body weight and blood glucose indicators of obese patients with type 2 diabetes mellitus better.
Exercise combined with dietary interventionsObesityType 2 diabetes mellitusMeta-analysis
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