改善儿童青少年脂肪因子的最佳运动类型及循证实践建议的网状Meta分析

Network Meta-analysis of optimal exercise modalities and evidence-based practice recommendations for improving adipokines in children and adolescents

摘要

目的 系统评估不同运动类型及剂量对儿童青少年脂肪因子的影响,为缓解儿童青少年肥胖提供精准循证实践建议。方法 检索6个数据库(建库至2024年11月),纳入不同运动类型改善儿童及青少年脂肪因子的随机对照试验(RCT),使用 R 软件进行贝叶斯分析,用Cochrane与CINeMA进行风险偏倚与证据等级评估。结果 纳入46篇随机对照试验,涵盖2 105名(女性比例48.32%)的儿童青少年。结果显示,相较于无运动组,有氧联合抗阻运动是降低瘦素水平(MD=-7.34,95%CrI:-11.17~-3.73,SUCRA=94.37)与提高脂联素水平(MD=1.79,95%CrI:0.92~2.65,SUCRA=95.42)的最佳运动类型,而高强度间歇运动是降低白细胞介素-6水平(MD=-3.98,95%CrI:-10.57~-0.19,SUCRA=95.27)与肿瘤坏死因子-α水平(MD=-6.61,95%CrI:-9.96~-3.15,SUCRA=99.98)的最佳运动。结论 高强度间歇运动与有氧联合抗阻运动是改善脂肪因子的最佳运动。

Abstract

Objective To systematically evaluate the effects of different exercise modalities and doses on adipokines in children and adolescents, so as to provide precise evidence-based practice recommendations for alleviating obesity in this population. Methods Six databases were searched from inception to November 2024 for randomized controlled trials (RCTs) investigating the effects of various exercise modalities on adipokines in children and adolescents. Bayesian network meta-analysis was conducted using R software. Risk of bias and certainty of evidence were assessed using the Cochrane risk-of-bias tool and CINeMA framework. Results A total of 46 RCTs involving 2 105 children and adolescents (48.32% female) were included. Compared with the non-exercise group, combined aerobic and resistance exercise was the most effective modality for reducing leptin levels (MD=-7.34, 95%CrI: -11.17 to -3.73, SUCRA=94.37) and increasing adiponectin levels (MD=1.79, 95%CrI: 0.92 to 2.65, SUCRA=95.42). High-intensity interval training was the most effective exercise modality for reducing interleukin-6 levels (MD=-3.98, 95%CrI:-10.57 to -0.19, SUCRA=95.27) and tumor necrosis factor-α levels (MD=-6.61, 95%CrI:-9.96 to -3.15, SUCRA=99.98). Conclusion High-intensity interval training and combined aerobic and resistance exercise appear to be the most effective exercise modalities for improving adipokines in children and adolescents.

关键词

运动 / 脂肪因子 / 儿童青少年 / 贝叶斯分析 / 剂量反应

Key words

exercise / adipokines / children and adolescents / bayes analysis / dose-response

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基金资助

国家级大学生创新训练计划项目资助(202510626037)