低氧训练对肥胖人群身体成分和血脂影响的meta分析
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摘要
[目的]运用meta分析法评估低氧训练对肥胖人群身体成分和血脂水平的影响。[方法]检索PubMed、EBSCO、Medline,Central、中国期刊全文数据库、万方等中外期刊数据库,收集有关低氧训练对肥胖人群身体成分及血脂影响的临床随机对照实验(RCT)文献。英文检索词为hypoxia training、hypoxia exercise、normobaric hypoxia training、clinical trial、randomized controlled trial、obesity、body mass index,中文检索词为低氧训练、低氧运动、缺氧训练、临床试验、临床随机对照试验、肥胖、身体成分,检索时限为从建库至2017年12月,未进行语言限制。通过文献筛选后,采用RevMan 5.3软件进行meta分析,效应值以均数(MD)及其95%可信区间(95%CI)表示。[结果]共纳入8个RCT,205个单纯肥胖患者。低氧训练组与常氧训练组在体重指数(MD=-1.4,95%CI:-2.54～-0.25,P <0.001)、体脂率(MD=-0.84,95%CI:-1.42～-0.26,P=0.004)和血液中总胆固醇水平(MD=-1.52,95%CI:-2.98～-0.05,P=0.040)3个指标比较,差异具有统计学意义;而腰臀比、高密度脂蛋白、低密度脂蛋白、甘油三脂等指标的差异不具有统计学意义。不同干预时间和不同低氧训练模式是体重指数异质性的主要来源。低氧训练时间>4周的体重指数差异具有统计学意义(MD=-5.73,95%CI:-9.36～-2.10,P <0.001);间歇性低氧训练(MD=-0.94,95%CI:-1.31～-0.74,P=0.050)的模式对肥胖者体重指数差异亦具有统计学意义。不同干预时间是血清总胆固醇水平异质性的主要来源,低氧训练时间>4周的肥胖者总胆固醇水平差异具有统计学意义(MD=-2.42,95%CI:-4.20～-0.65,P <0.001)。[结论]低氧训练>4周对肥胖者的体重指数和血清总胆固醇有影响。间歇性低氧训练对肥胖者的体重指数有改善作用。
[Objective] To clarify the effects of hypoxic training on body composition and lipid level ofobese people by meta analysis method.[Methods] In this study, we searched PubMed, EBSCO, Medline, Central, Chinese Academic Journals Full-text Database, Wanfang databases from inception to December 2017 to collect literatures on the effects of hypoxia training on body composition and blood lipid of obese people by using search words in either English or Chinese such as hypoxia training, hypoxia exercise, normobaric hypoxia training, clinical trial, randomized controlled trial, obesity, and body mass index, without language restriction. After literature screening, meta analysis was conducted using RevMan 5.3 software, and effect values were reported as mean difference and 95% confidence interval.[Results] A total of 8 RCT and 205 obese patients were included. Body mass index(MD=-1.4, 95%CI:-2.54--0.25, P < 0.001), body fat percentage(MD=-0.84, 95%CI:-1.42--0.26, P=0.004), and total cholesterol concentration(MD=-1.52, 95%CI:-2.98--0.05, P=0.040) were statistically different between hypoxia training group and normoxia training group. However, waist-tohip ratio, high-density lipoprotein, low-density lipoprotein, and triglyceride were not. Different intervention time and different hypoxia training patterns were the main sources of heterogeneity in body mass index. Hypoxia training > 4 weeks affected body mass index(MD=-5.73, 95%CI:-9.36--2.10, P < 0.001); intermittent hypoxic training(MD=-0.94, 95%CI:-1.31--0.74, P=0.050) also affected body mass index of the obese people. Different intervention time was the main source of heterogeneity in total cholesterol concentration. Hypoxia training > 4 weeks affected total cholesterol concentration(MD=-2.42, 95%CI:-4.20--0.65, P < 0.001).[Conclusion] Hypoxia training > 4 weeks affects body mass index and serum total cholesterol of obese patients. Intermittent hypoxic training is effective for improving body mass index.
[Objective] To clarify the effects of hypoxic training on body composition and lipid level ofobese people by meta analysis method.[Methods] In this study, we searched PubMed, EBSCO, Medline, Central, Chinese Academic Journals Full-text Database, Wanfang databases from inception to December 2017 to collect literatures on the effects of hypoxia training on body composition and blood lipid of obese people by using search words in either English or Chinese such as hypoxia training, hypoxia exercise, normobaric hypoxia training, clinical trial, randomized controlled trial, obesity, and body mass index, without language restriction. After literature screening, meta analysis was conducted using RevMan 5.3 software, and effect values were reported as mean difference and 95% confidence interval.[Results] A total of 8 RCT and 205 obese patients were included. Body mass index(MD=-1.4, 95%CI:-2.54--0.25, P < 0.001), body fat percentage(MD=-0.84, 95%CI:-1.42--0.26, P=0.004), and total cholesterol concentration(MD=-1.52, 95%CI:-2.98--0.05, P=0.040) were statistically different between hypoxia training group and normoxia training group. However, waist-tohip ratio, high-density lipoprotein, low-density lipoprotein, and triglyceride were not. Different intervention time and different hypoxia training patterns were the main sources of heterogeneity in body mass index. Hypoxia training > 4 weeks affected body mass index(MD=-5.73, 95%CI:-9.36--2.10, P < 0.001); intermittent hypoxic training(MD=-0.94, 95%CI:-1.31--0.74, P=0.050) also affected body mass index of the obese people. Different intervention time was the main source of heterogeneity in total cholesterol concentration. Hypoxia training > 4 weeks affected total cholesterol concentration(MD=-2.42, 95%CI:-4.20--0.65, P < 0.001).[Conclusion] Hypoxia training > 4 weeks affects body mass index and serum total cholesterol of obese patients. Intermittent hypoxic training is effective for improving body mass index.
引文
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[22]李靖,张漓,冯连世,等.高原或低氧训练对肥胖青少年减体重效果及血糖代谢相关指标的影响[J].中国运动医学杂志,2014,33(5):460-464.
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[25]CAMACHO-CARDENOSA M,CAMACHO-CARDENOSA A,MARTíNEZ GUARDADO I,et al.A new dose of maximalintensity interval training in hypoxia to improve body composition and hemoglobin and hematocrit levels:a pilot study[J].J Sports Med Phys Fitness,2017,57(1/2):60-69.
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[29]HOBBINS L,HUNTER S,GAOUA N,et al.Normobaric hypoxic conditioning to maximize weight loss and ameliorate cardio-metabolic health in obese populations:a systematic review[J].Am J Physiol Regul Integr Comp Physiol,2017,313(3):R251-R264.
[30]BALYKIN M V,GENING T P,VINOGRADOV S N.Morphological and functional changes in overweight Persons under combined normobaric hypoxia and physical training[J].Hum Physiol,2004,30(2):184-191.
[31]邓潇潇,吴红豫.低氧减肥的研究及应用[J].福建体育科技,2016,35(2):17-19,23.
[2]NG M,FLEMING T,ROBINSON M,et al.Global,regional,and national prevalence of overweight and obesity in children and adults during 1980-2013:A systematic analysis for the Global Burden of Disease Study 2013[J].Lancent,2014,384(9945):746-781.
[3]YANG Q,HUANG G Y,TIAN Q Q,et al.“living high-training low”improved weight loss and glucagon-like peptide-1 level in a 4-week weight loss program in adolescents with obesity:a pilot study[J].Medicine,2018,97(8):e9943.
[4]MELBY C,PARIS H L,FORIGHT R M,et al.Attenuating the biologic drive for weight regain following weight loss:must what goes down always go back up[J].Nutrients,2017,9(5):468.
[5]路瑛丽,谢敏豪,冯连世.高原/低氧与减控体重研究[J].中国运动医学杂志,2012,31(2):169-174.
[6]INNESS M W H,BILLAUT F,AUGHEY R J.live-high train-low improves repeated time-trial and YO-YO IR2 performance in sub-elite team-sport athletes[J].J Sci Med Sport,2017,20(2):190-195.
[7]刘云,陈晓莉,花芸.饮食和运动干预对减少孕期超重、剖宫产、巨大儿效果的meta分析[J].中国实用护理杂志,2014,30(22):43-47.
[8]吴娜娜,王茹,王雪强.急性运动成年人血浆胃肠激素肽水平变化的meta分析[J].中国组织工程研究,2015,19(15):2455-2460.
[9]虞轶群,季浏,李群,等.高原训练思想的变迁与展望[J].沈阳体育学院学报,2011,30(5):83-86.
[10]胡扬.高原训练的多元化发展--从HIHI到HILO再到HIHI+HIHILO[J].体育科学,2010,30(11):74-78.
[11]BA?ARES R,ALBILLOS A,RINCóN D.Endoscopic treatment versus endoscopic plus pharmacologic treatment for acute variceal bleeding:a meta-analysis[J].Hepatology,2002,35(3):609-615.
[12]HIGGINS J P T,GREEN S.Cochrane Handbook for Systematic Reviews of Interventions Version 5.0[EB/OL].[2008-09-01].http://www.oalib.com/references/19719850.
[13]王继红,刘晓丹,胡军,等.太极拳对老年慢性阻塞性肺疾病患者肺功能和运动耐力影响的meta分析[J].中国组织工程研究,2015,19(5):815-820.
[14]刘鸣.系统评价、meta-分析设计与实施方法[M].北京:人民卫生出版社,2011:99-101.
[15]GATTERER H,HAACKE S,BURTSCHER M,et al.Normobaric intermittent hypoxia over 8 months does not reduce body weight and metabolic risk factors-a randomized,single blind,placebo-controlled study in normobaric hypoxia and normobaric sham hypoxia[J].Obes Facts,2015,8(3):200-209.
[16]WIESNER S,HAUFE S,ENGELI S F,et al.Influences of normobaric hypoxia training on physical fitness and metabolic risk markers in overweight to obese subjects[J].Obsity,2010,18(1):116-120.
[17]GUTWENGER I,HOFER G,GUTWENGER A K.Pilot study on the effects of a 2-week hiking vacation at moderate versus low altitude on plasma parameters of carbohydrate and lipid metabolism in patients with metabolic syndrome[J].BMCRes Notes,2015,8:103.
[18]KONG Z,ZANG Y,HU Y.Normobaric hypoxia training causes more weight loss than normoxia training after a 4-week residential camp for obese young adults[J].Sleep Breath,2014,18(3):591-597.
[19]URDAMPILLETA A,GONZáLEZ-MUNIESA P,PORTILLO MP,et al.Usefulness of combining intermittent hypoxia and physical Exercise in the treatment of obesity[J].J Physiol Biochem,2012,68(2):289-304.
[20]王宁琦,胡扬,官余凌.4周低氧运动结合饮食控制对肥胖青年体重、血脂及胰岛素抵抗的影响[J].中国运动医学杂志,2012,31(4):289-294.
[21]赵述强,时洪举.低氧训练对肥胖大学生体成分和有氧耐力的影响[J].中国学校卫生,2016,37(11):1637-1640.
[22]李靖,张漓,冯连世,等.高原或低氧训练对肥胖青少年减体重效果及血糖代谢相关指标的影响[J].中国运动医学杂志,2014,33(5):460-464.
[23]GUH D P,ZHANG W,BANSBACK N,et al.The incidence of co-morbidities related to obesity and overweight:a systematic review and meta-analysis[J].BMC Public Health,2009,9:88.
[24]黄徐根,徐建方,冯连世.低氧暴露及低氧训练对体重的影响[J].体育科学,2006,26(3):86-93,96.
[25]CAMACHO-CARDENOSA M,CAMACHO-CARDENOSA A,MARTíNEZ GUARDADO I,et al.A new dose of maximalintensity interval training in hypoxia to improve body composition and hemoglobin and hematocrit levels:a pilot study[J].J Sports Med Phys Fitness,2017,57(1/2):60-69.
[26]荆文,冯连世,邹飞,等.低氧暴露及低氧训练调控脂代谢研究进展[J].中国运动医学杂志,2012,31(12):1122-1126,1108.
[27]WANG J S,CHEN L Y,FU L L,et al.Effects of moderate and severe intermittent hypoxia on vascular endothelial function and haemodynamic control in sedentary men[J].Eur J App Physiol,2007,100(2):127-135.
[28]杨云娟,许雯,杨永芳.云南省傣族地区35岁及以上居民中心性肥胖的流行现状及其影响因素分析[J].现代预防医学,2014,41(2):197-199,203.
[29]HOBBINS L,HUNTER S,GAOUA N,et al.Normobaric hypoxic conditioning to maximize weight loss and ameliorate cardio-metabolic health in obese populations:a systematic review[J].Am J Physiol Regul Integr Comp Physiol,2017,313(3):R251-R264.
[30]BALYKIN M V,GENING T P,VINOGRADOV S N.Morphological and functional changes in overweight Persons under combined normobaric hypoxia and physical training[J].Hum Physiol,2004,30(2):184-191.
[31]邓潇潇,吴红豫.低氧减肥的研究及应用[J].福建体育科技,2016,35(2):17-19,23.