A meta-analysis of the comparison of intervention effects of high-intensity interval training and moderate-intensity continuous training on patients with metabolic syndrome_West China Medical Journal

Authors：

WANG Wenxing ^1,2 , YU Wenlang ^1,2 , ZHAO Yuanhui ^1,2 ,  REN Hong ^1,2

1. College of Sports Human Sciences, Beijing Sport University, Beijing 100084, P. R. China;
2. Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing 100084, P. R. China;

Corresponding author：

REN Hong, Email: renhong@bsu.edu.cn

Keywords：

Metabolic syndrome; high-intensity interval training; moderate-intensity continuous training

DOI：

10.7507/1002-0179.202207041

Video：

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Objective To explore the difference of intervention effect between high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on patients with metabolic syndrome (MetS). Methods China National Knowledge Infrastructure, WanFang Data, PubMed, Web of Science and EBSCO were searched for randomized controlled trials (RCTs) till May 2022. Two reviewers independently reviewed the literature, extracted data, and assessed the risk of bias of included RCTs. Comprehensive Meta-Analysis software was used for meta-analysis. Result A total of 5 RCTs were included, including 216 patients. The results of meta-analysis showed that: except fasting blood glucose, high-density lipoprotein cholesterol, systolic blood pressure, waist circumference, body mass index and body fat percentage (P>0.005), low-density lipoprotein cholesterol [mean difference (MD)=−7.487 mg/dL, 95% confidence interval (CI) (−12.543, −2.431) mg/dL, P=0.004], total cholesterol [MD=−11.487 mg/dL, 95%CI (−16.523, −6.452) mg/dL, P<0.001], triglycerides [MD=−26.296 mg/dL, 95%CI (−50.557, −2.035) mg/dL, P=0.034] and diastolic blood pressure [MD=−2.770 mm Hg (1 mm Hg=0.133 kPa), 95%CI (−5.131, −0.409) mm Hg, P=0.021] of HIIT were better than MICT. Conclusion In terms of blood glucose indicators and morphological indicators, the effect of HIIT group and MICT group was similar, but the effect of HIIT on blood lipid indicators and blood pressure indicators of patients with MetS was better than MICT.

Citation： WANG Wenxing, YU Wenlang, ZHAO Yuanhui, REN Hong. A meta-analysis of the comparison of intervention effects of high-intensity interval training and moderate-intensity continuous training on patients with metabolic syndrome. West China Medical Journal, 2023, 38(2): 261-269. doi: 10.7507/1002-0179.202207041 Copy

1.	王芬. 代谢综合征与 2 型糖尿病病人慢性肾脏病的相关性分析. 安徽医药, 2021, 25(3): 508-511.
2.	杨钰, 刘顺, 仇小强, 等. 广西 35~74 岁壮族居民慢性肾脏病患病及其与代谢综合征的相关性研究. 广西医科大学学报, 2021, 38(3): 599-604.
3.	Bitew ZW, Alemu A, Tenaw Z, et al. Prevalence of metabolic syndrome among children and adolescents in high-income countries: a systematic review and meta-analysis of observational studies. BioMed Res Int. (2021-03-27)[2022-07-01]. https://downloads.hindawi.com/journals/bmri/2021/6661457.pdf.
4.	郭海健, 念馨, 梁友芳, 等. 基于多中心横断面调查的中国人群代谢综合征的流行情况及危险因素. 中华疾病控制杂志, 2019, 23(7): 796-801.
5.	So R, Matsuo T. The effect of domain-specific sitting time and exercise habits on metabolic syndrome in Japanese workers: a cross-sectional study. Int J Environ Res Public Health, 2020, 17(11): 3883.
6.	Colpitts BH, Spencer Smith, Bouchard DR, et al. Are physical activity and sedentary behavior patterns contributing to diabetes and metabolic syndrome simultaneously?. Transl Sports Med. (2020-11-18)[2022-07-01]. https://onlinelibrary.wiley.com/doi/epdf/10.1002/tsm2.216.
7.	Vella CA, Taylor K, Drummer D. High-intensity interval and moderate-intensity continuous training elicit similar enjoyment and adherence levels in overweight and obese adults. Eur J Sport Sci, 2017, 17(9): 1203-1211.
8.	Mattioni Maturana F, Martus P, Zipfel S, et al. Effectiveness of HIIE versus MICT in improving cardiometabolic risk factors in health and disease: a meta-analysis. Med Sci Sports Exerc, 2021, 53(3): 559-573.
9.	Rugbeer N, Constantinou D, Torres G. Comparison of high-intensity training versus moderate-intensity continuous training on cardiorespiratory fitness and body fat percentage in persons with overweight or obesity: a systematic review and meta-analysis of randomized controlled trials. J Phys Act Health, 2021, 18(5): 610-623.
10.	Su L, Fu J, Sun S, et al. Effects of HIIT and MICT on cardiovascular risk factors in adults with overweight and/or obesity: a meta-analysis. PloS One, 2019, 14(1): e0210644.
11.	Khalafi M, Symonds ME. The impact of high-intensity interval training on inflammatory markers in metabolic disorders: a meta-analysis. Scand J Med Sci Sports, 2020, 30(11): 2020-2036.
12.	Ross LM, Porter RR, Durstine JL. High-intensity interval training (HIIT) for patients with chronic diseases. J Sport Health Sci, 2016, 5(2): 139-144.
13.	Freyssin C, Verkindt C, Prieur F, et al. Cardiac rehabilitation in chronic heart failure: effect of an 8-week, high-intensity interval training versus continuous training. Arch Phys Med Rehabil, 2012, 93(8): 1359-1364.
14.	Rognmo Ø, Hetland E, Helgerud J, et al. High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease. Eur J Cardiovasc Prev Rehabil, 2004, 11(3): 216-222.
15.	Guiraud T, Nigam A, Gremeaux V, et al. High-intensity interval training in cardiac rehabilitation. Sports Med, 2012, 42(7): 587-605.
16.	Wisløff U, Støylen A, Loennechen JP, et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation, 2007, 115(24): 3089-3094.
17.	Midgley AW, McNaughton LR, et al. Physiological determinants of time to exhaustion during intermittent treadmill running at vVO_2max. Int J Sports Med, 2007, 28(4): 273-280.
18.	Karstoft K, Winding K, Knudsen SH, et al. The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial. Diabetes Care, 2013, 36(2): 228-236.
19.	Drigny J, Gremeaux V, Guiraud T, et al. Long-term high-intensity interval training associated with lifestyle modifications improves QT dispersion parameters in metabolic syndrome patients. Ann Phys Rehabil Med, 2013, 56(5): 356-370.
20.	Dun Y, Thomas RJ, Smith JR, et al. High-intensity interval training improves metabolic syndrome and body composition in outpatient cardiac rehabilitation patients with myocardial infarction. Cardiovasc Diabetol, 2019, 18(1): 104.
21.	Jo EA, Cho KI, Park JJ, et al. Effects of high-intensity interval training versus moderate-intensity continuous training on epicardial fat thickness and endothelial function in hypertensive metabolic syndrome. Metab Syndr Relat Disord, 2020, 18(2): 96-102.
22.	Nazari M, Minasian V, Hovsepian S. Effects of two types of moderate- and high-intensity interval training on serum salusin-α and salusin-β levels and lipid profile in women with overweight/obesity. Diabetes Metab Syndr Obes, 2020, 13: 1385-1390.
23.	Ramos JS, Dalleck LC, Borrani F, et al. High-intensity interval training and cardiac autonomic control in individuals with metabolic syndrome: a randomised trial. Int J Cardiol, 2017, 245: 245-252.
24.	汪雅静, 张超, 吕少萍, 等. 高强度间歇运动对 2 型糖尿病患者糖脂代谢指标影响的研究. 中华护理杂志, 2019, 54(11): 1605-1609.
25.	甘慧君. HIIT 与 MCT 对普通男性大学生糖代谢的影响. 北京: 北京体育大学, 2018.
26.	阮凌, 王光华, 吴荣平, 等. 运动强度与高脂饮食模型大鼠脂代谢紊乱和氧化应激的相关性. 中国组织工程研究, 2023, 27(8): 1149-1155.
27.	王倩倩, 王晓航, 邱山虎, 等. 运动对肥胖相关代谢异常的作用. 中国实用内科杂志, 2022, 42(2): 102-106.
28.	高艳敏, 王光明, 杨文礼, 等. 高强度间歇训练和有氧运动对肥胖青年脂代谢及慢性炎症的影响. 中国运动医学杂志, 2017, 36(7): 628-632,650.
29.	Huang JF, Li Y, Shin J, Chia YC, et al. Characteristics and control of the 24‐hour ambulatory blood pressure in patients with metabolic syndrome. J Clin Hypertens (Greenwich), 2021, 23(3): 450-456.
30.	吴寿岭, 阮春雨, 李冬青, 等. 高血压前期人群中代谢综合征发生情况. 中华高血压杂志, 2010, 18(4): 335-338.
31.	Asgharnezhad M, Joukar F, Naghipour M, et al. Exploratory factor analysis of gender-based metabolic syndrome components: results from the PERSIAN Guilan cohort study (PGCS). Clin Nutr ESPEN, 2020, 40: 252-256.
32.	Clark T, Morey R, Jones MD, et al. High-intensity interval training for reducing blood pressure: a randomized trial vs. moderate-intensity continuous training in males with overweight or obesity. Hypertens Res, 2020, 43(5): 396-403.
33.	Perrier-Melo RJ, Germano-Soares AH, Freitas Brito A, et al. Post-exercise hypotension in response to high-intensity interval exercise: potential mechanisms. Rev Port Cardiol (Engl Ed), 2021, 40(10): 797-799.
34.	史云聪, 王立立, 郭艺芳. 运动、高血压与认知功能. 中国心血管杂志, 2020, 25(4): 393-396.
35.	刘泉清, 刘敏. 不同运动形式对原发性高血压的影响研究进展. 中国体育科技, 2021, 57(12): 82-91.
36.	MartinezAguirre-Betolaza A, Mujika I, Fryer SM, et al. Effects of different aerobic exercise programs on cardiac autonomic modulation and hemodynamics in hypertension: data from EXERDIET-HTA randomized trial. J Hum Hypertens, 2020, 34(10): 709-718.
37.	Lacombe SP, Goodman JM, Spragg CM, et al. Interval and continuous exercise elicit equivalent postexercise hypotension in prehypertensive men, despite differences in regulation. Appl Physiol Nutr Metab, 2011, 36(6): 881-891.
38.	Morales-Palomo F, Ramirez-Jimenez M, Ortega JF, et al. Acute hypotension after high-intensity interval exercise in metabolic syndrome patients. Int J Sports Med, 2017, 38(7): 560-567.
39.	Costa EC, Kent DE, Boreskie KF, et al. Acute effect of high-intensity interval versus moderate-intensity continuous exercise on blood pressure and arterial compliance in middle-aged and older hypertensive women with increased arterial stiffness. J Strength Cond Res, 2020, 34(5): 1307-1316.
40.	Miguet M, Fearnbach NS, Metz L, et al. Effect of HIIT versus MICT on body composition and energy intake in dietary restrained and unrestrained adolescents with obesity. Appl Physiol Nutr Metab, 2020, 45(4): 437-445.
41.	孙文新, 秦曼, 李丽丽, 等. 高强度间歇训练对超重肥胖女大学生减脂效果的 Meta 分析. 中国学校卫生, 2021, 42(10): 1480-1486.
42.	朱琳, 刘景新, 于洋, 等. 高强度间歇训练对超重和肥胖青少年减脂效应的研究: meta 分析. 广州体育学院学报, 2020, 40(1): 96-101.
43.	Ramos JS, Dalleck LC, Borrani F, et al. Low-volume high-intensity interval training is sufficient to ameliorate the severity of metabolic syndrome. Metab Syndr Relat Disord, 2017, 15(7): 319-328.
44.	Taylor KL, Weston M, Batterham AM. Evaluating intervention fidelity: an example from a high-intensity interval training study. PloS One, 2015, 10(4): e0125166.
45.	马桂月, 马珂珂, 段应龙, 等. 中青年高血压患者运动干预的研究进展. 中华护理杂志, 2020, 55(2): 304-308.
46.	袁国强, 秦永生, 彭朋. 高强度间歇运动对自发性高血压模型大鼠病理性心脏肥大的影响及机制. 中国组织工程研究, 2020, 24(23): 3708-3715.
47.	林坚, 赵红勤, 黄雄昂, 等. 高强度间歇训练对肥胖女大学生体成分和血脂及空腹胰岛素水平的影响. 中国全科医学, 2016, 19(18): 2139-2144.
48.	杨丽丽. 分类和连续性儿童代谢综合征定义筛检早期血管损伤效果评价. 山东大学, 2018.

1. 王芬. 代谢综合征与 2 型糖尿病病人慢性肾脏病的相关性分析. 安徽医药, 2021, 25(3): 508-511.
2. 杨钰, 刘顺, 仇小强, 等. 广西 35~74 岁壮族居民慢性肾脏病患病及其与代谢综合征的相关性研究. 广西医科大学学报, 2021, 38(3): 599-604.
3. Bitew ZW, Alemu A, Tenaw Z, et al. Prevalence of metabolic syndrome among children and adolescents in high-income countries: a systematic review and meta-analysis of observational studies. BioMed Res Int. (2021-03-27)[2022-07-01]. https://downloads.hindawi.com/journals/bmri/2021/6661457.pdf.
4. 郭海健, 念馨, 梁友芳, 等. 基于多中心横断面调查的中国人群代谢综合征的流行情况及危险因素. 中华疾病控制杂志, 2019, 23(7): 796-801.
5. So R, Matsuo T. The effect of domain-specific sitting time and exercise habits on metabolic syndrome in Japanese workers: a cross-sectional study. Int J Environ Res Public Health, 2020, 17(11): 3883.
6. Colpitts BH, Spencer Smith, Bouchard DR, et al. Are physical activity and sedentary behavior patterns contributing to diabetes and metabolic syndrome simultaneously?. Transl Sports Med. (2020-11-18)[2022-07-01]. https://onlinelibrary.wiley.com/doi/epdf/10.1002/tsm2.216.
7. Vella CA, Taylor K, Drummer D. High-intensity interval and moderate-intensity continuous training elicit similar enjoyment and adherence levels in overweight and obese adults. Eur J Sport Sci, 2017, 17(9): 1203-1211.
8. Mattioni Maturana F, Martus P, Zipfel S, et al. Effectiveness of HIIE versus MICT in improving cardiometabolic risk factors in health and disease: a meta-analysis. Med Sci Sports Exerc, 2021, 53(3): 559-573.
9. Rugbeer N, Constantinou D, Torres G. Comparison of high-intensity training versus moderate-intensity continuous training on cardiorespiratory fitness and body fat percentage in persons with overweight or obesity: a systematic review and meta-analysis of randomized controlled trials. J Phys Act Health, 2021, 18(5): 610-623.
10. Su L, Fu J, Sun S, et al. Effects of HIIT and MICT on cardiovascular risk factors in adults with overweight and/or obesity: a meta-analysis. PloS One, 2019, 14(1): e0210644.
11. Khalafi M, Symonds ME. The impact of high-intensity interval training on inflammatory markers in metabolic disorders: a meta-analysis. Scand J Med Sci Sports, 2020, 30(11): 2020-2036.
12. Ross LM, Porter RR, Durstine JL. High-intensity interval training (HIIT) for patients with chronic diseases. J Sport Health Sci, 2016, 5(2): 139-144.
13. Freyssin C, Verkindt C, Prieur F, et al. Cardiac rehabilitation in chronic heart failure: effect of an 8-week, high-intensity interval training versus continuous training. Arch Phys Med Rehabil, 2012, 93(8): 1359-1364.
14. Rognmo Ø, Hetland E, Helgerud J, et al. High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease. Eur J Cardiovasc Prev Rehabil, 2004, 11(3): 216-222.
15. Guiraud T, Nigam A, Gremeaux V, et al. High-intensity interval training in cardiac rehabilitation. Sports Med, 2012, 42(7): 587-605.
16. Wisløff U, Støylen A, Loennechen JP, et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation, 2007, 115(24): 3089-3094.
17. Midgley AW, McNaughton LR, et al. Physiological determinants of time to exhaustion during intermittent treadmill running at vVO_2max. Int J Sports Med, 2007, 28(4): 273-280.
18. Karstoft K, Winding K, Knudsen SH, et al. The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial. Diabetes Care, 2013, 36(2): 228-236.
19. Drigny J, Gremeaux V, Guiraud T, et al. Long-term high-intensity interval training associated with lifestyle modifications improves QT dispersion parameters in metabolic syndrome patients. Ann Phys Rehabil Med, 2013, 56(5): 356-370.
20. Dun Y, Thomas RJ, Smith JR, et al. High-intensity interval training improves metabolic syndrome and body composition in outpatient cardiac rehabilitation patients with myocardial infarction. Cardiovasc Diabetol, 2019, 18(1): 104.
21. Jo EA, Cho KI, Park JJ, et al. Effects of high-intensity interval training versus moderate-intensity continuous training on epicardial fat thickness and endothelial function in hypertensive metabolic syndrome. Metab Syndr Relat Disord, 2020, 18(2): 96-102.
22. Nazari M, Minasian V, Hovsepian S. Effects of two types of moderate- and high-intensity interval training on serum salusin-α and salusin-β levels and lipid profile in women with overweight/obesity. Diabetes Metab Syndr Obes, 2020, 13: 1385-1390.
23. Ramos JS, Dalleck LC, Borrani F, et al. High-intensity interval training and cardiac autonomic control in individuals with metabolic syndrome: a randomised trial. Int J Cardiol, 2017, 245: 245-252.
24. 汪雅静, 张超, 吕少萍, 等. 高强度间歇运动对 2 型糖尿病患者糖脂代谢指标影响的研究. 中华护理杂志, 2019, 54(11): 1605-1609.
25. 甘慧君. HIIT 与 MCT 对普通男性大学生糖代谢的影响. 北京: 北京体育大学, 2018.
26. 阮凌, 王光华, 吴荣平, 等. 运动强度与高脂饮食模型大鼠脂代谢紊乱和氧化应激的相关性. 中国组织工程研究, 2023, 27(8): 1149-1155.
27. 王倩倩, 王晓航, 邱山虎, 等. 运动对肥胖相关代谢异常的作用. 中国实用内科杂志, 2022, 42(2): 102-106.
28. 高艳敏, 王光明, 杨文礼, 等. 高强度间歇训练和有氧运动对肥胖青年脂代谢及慢性炎症的影响. 中国运动医学杂志, 2017, 36(7): 628-632,650.
29. Huang JF, Li Y, Shin J, Chia YC, et al. Characteristics and control of the 24‐hour ambulatory blood pressure in patients with metabolic syndrome. J Clin Hypertens (Greenwich), 2021, 23(3): 450-456.
30. 吴寿岭, 阮春雨, 李冬青, 等. 高血压前期人群中代谢综合征发生情况. 中华高血压杂志, 2010, 18(4): 335-338.
31. Asgharnezhad M, Joukar F, Naghipour M, et al. Exploratory factor analysis of gender-based metabolic syndrome components: results from the PERSIAN Guilan cohort study (PGCS). Clin Nutr ESPEN, 2020, 40: 252-256.
32. Clark T, Morey R, Jones MD, et al. High-intensity interval training for reducing blood pressure: a randomized trial vs. moderate-intensity continuous training in males with overweight or obesity. Hypertens Res, 2020, 43(5): 396-403.
33. Perrier-Melo RJ, Germano-Soares AH, Freitas Brito A, et al. Post-exercise hypotension in response to high-intensity interval exercise: potential mechanisms. Rev Port Cardiol (Engl Ed), 2021, 40(10): 797-799.
34. 史云聪, 王立立, 郭艺芳. 运动、高血压与认知功能. 中国心血管杂志, 2020, 25(4): 393-396.
35. 刘泉清, 刘敏. 不同运动形式对原发性高血压的影响研究进展. 中国体育科技, 2021, 57(12): 82-91.
36. MartinezAguirre-Betolaza A, Mujika I, Fryer SM, et al. Effects of different aerobic exercise programs on cardiac autonomic modulation and hemodynamics in hypertension: data from EXERDIET-HTA randomized trial. J Hum Hypertens, 2020, 34(10): 709-718.
37. Lacombe SP, Goodman JM, Spragg CM, et al. Interval and continuous exercise elicit equivalent postexercise hypotension in prehypertensive men, despite differences in regulation. Appl Physiol Nutr Metab, 2011, 36(6): 881-891.
38. Morales-Palomo F, Ramirez-Jimenez M, Ortega JF, et al. Acute hypotension after high-intensity interval exercise in metabolic syndrome patients. Int J Sports Med, 2017, 38(7): 560-567.
39. Costa EC, Kent DE, Boreskie KF, et al. Acute effect of high-intensity interval versus moderate-intensity continuous exercise on blood pressure and arterial compliance in middle-aged and older hypertensive women with increased arterial stiffness. J Strength Cond Res, 2020, 34(5): 1307-1316.
40. Miguet M, Fearnbach NS, Metz L, et al. Effect of HIIT versus MICT on body composition and energy intake in dietary restrained and unrestrained adolescents with obesity. Appl Physiol Nutr Metab, 2020, 45(4): 437-445.
41. 孙文新, 秦曼, 李丽丽, 等. 高强度间歇训练对超重肥胖女大学生减脂效果的 Meta 分析. 中国学校卫生, 2021, 42(10): 1480-1486.
42. 朱琳, 刘景新, 于洋, 等. 高强度间歇训练对超重和肥胖青少年减脂效应的研究: meta 分析. 广州体育学院学报, 2020, 40(1): 96-101.
43. Ramos JS, Dalleck LC, Borrani F, et al. Low-volume high-intensity interval training is sufficient to ameliorate the severity of metabolic syndrome. Metab Syndr Relat Disord, 2017, 15(7): 319-328.
44. Taylor KL, Weston M, Batterham AM. Evaluating intervention fidelity: an example from a high-intensity interval training study. PloS One, 2015, 10(4): e0125166.
45. 马桂月, 马珂珂, 段应龙, 等. 中青年高血压患者运动干预的研究进展. 中华护理杂志, 2020, 55(2): 304-308.
46. 袁国强, 秦永生, 彭朋. 高强度间歇运动对自发性高血压模型大鼠病理性心脏肥大的影响及机制. 中国组织工程研究, 2020, 24(23): 3708-3715.
47. 林坚, 赵红勤, 黄雄昂, 等. 高强度间歇训练对肥胖女大学生体成分和血脂及空腹胰岛素水平的影响. 中国全科医学, 2016, 19(18): 2139-2144.
48. 杨丽丽. 分类和连续性儿童代谢综合征定义筛检早期血管损伤效果评价. 山东大学, 2018.

West China Medical Journal

A meta-analysis of the comparison of intervention effects of high-intensity interval training and moderate-intensity continuous training on patients with metabolic syndrome

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