DataSheet_1_Exercise training modalities in prediabetes: a systematic review and network meta-analysis.pdf

BackgroundLifestyle modification based on exercise intervention is still the primary way to delay or reverse the development of diabetes in patients with prediabetes. However, there are still challenges in setting up a detailed exercise prescription for people with prediabetes. This study mainly ranks exercise prescriptions by comparing the improvement of glucose and lipid metabolism and the level of weight loss in patients.
MethodAll studies on exercise intervention in prediabetes were identified by searching five electronic databases. Risk assessment and meta-analysis were performed on eligible studies.
ResultsTwenty-four studies involving 1946 patients with prediabetes and seven exercise intervention models were included in the final analysis. The meta-analysis showed that exercise of any type was more effective for glycemic control in prediabetes than no exercise. However, the changes in blood glucose were moderate. In prediabetes, combining moderate-intensity aerobic exercise with low-to moderate-load resistance training showed the most significant improvements in glycosylated hemoglobin (HbA1c), body mass index (BMI), body weight (BW), total cholesterol (TC), and low-density lipoprotein cholesterol (LDL) (P-score=0.82; 0.70; 0.87; 1; 0.99), low-to moderate-load resistance training showed the most significant improvements in fasting blood glucose (FBG) (P-score=0.98), the vigorous-intensity aerobic exercise showed the most significant improvements in 2-hour post-meal blood glucose (2hPG) and systolic blood pressure (SBP) (P-score=0.79; 0.78), and moderate-intensity aerobic exercise showed the most significant improvements in diastolic blood pressure (DBP) (P-score=0.78).
ConclusionIn summary, moderate-intensity aerobic exercise, low-to moderate-load resistance training and the combination of both have beneficial effects on glycemic control, weight loss, and cardiovascular health in patients with prediabetes. These findings provide valuable guidance for rehabilitation clinicians and patients alike to follow.
Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, identifier CRD 42021284922.

背景：基于运动干预的生活方式调整，仍是前驱糖尿病（prediabetes）患者延缓或逆转糖尿病进展的首要手段。然而，为前驱糖尿病患者制定精细化运动处方仍存在诸多挑战。本研究通过比较不同运动干预对患者糖脂代谢改善效果及体重减轻程度，对各类运动处方进行排序评估。

方法：通过检索5个电子数据库，筛选所有针对前驱糖尿病患者的运动干预相关研究，并对符合纳入标准的研究开展风险偏倚评估与Meta分析。

结果：最终纳入24项研究，共涉及1946名前驱糖尿病患者及7种运动干预模型。Meta分析结果显示，相较于无运动干预，任何类型的运动均能更有效地改善前驱糖尿病患者的血糖控制情况，但血糖改善幅度较为温和。在前驱糖尿病患者中，中等强度有氧运动联合低-中等负荷抗阻训练对糖化血红蛋白（glycosylated hemoglobin, HbA1c）、体质量指数（body mass index, BMI）、体质量（body weight, BW）、总胆固醇（total cholesterol, TC）及低密度脂蛋白胆固醇（low-density lipoprotein cholesterol, LDL）的改善效果最为显著（P分值分别为0.82、0.70、0.87、1、0.99）；低-中等负荷抗阻训练对空腹血糖（fasting blood glucose, FBG）的改善效果最为显著（P分值=0.98）；高强度有氧运动对餐后2小时血糖（2-hour post-meal blood glucose, 2hPG）及收缩压（systolic blood pressure, SBP）的改善效果最为显著（P分值分别为0.79、0.78）；中等强度有氧运动对舒张压（diastolic blood pressure, DBP）的改善效果最为显著（P分值=0.78）。

结论：综上，中等强度有氧运动、低-中等负荷抗阻训练以及二者联合方案，均可改善前驱糖尿病患者的血糖控制、体重减轻情况及心血管健康水平。本研究结果可为康复临床医师与患者提供具有参考价值的实践指导。

系统评价注册：https://www.crd.york.ac.uk/PROSPERO/，编号CRD 42021284922。