Efficacy of resistance training on individuals with different glucose metabolism status: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

GUO Qiaofeng , GAN Yanming , ZHANG Yuhang ,  ZHOU Yue

Key Laboratory of Sports and Physical Health of the Ministry of Education, Beijing Sport University, Beijing 100084, P.R.China;

Corresponding author：

ZHOU Yue, Email: zhouy@bsu.edu.cn

Keywords：

Resistance training; Type 2 diabetes; Prediabetic state; Glucose metabolism disorder; Meta-analysis; Systematic review; Randomized controlled trial

DOI：

10.7507/1672-2531.202107086

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To systematically review the intervention efficacy of resistance exercise on prediabetes and type 2 diabetes. Methods PubMed, The Cochrane Library, EMbase, Web of Science, EBSCO, VIP, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials (RCTs) of resistance exercise applied to pre-diabetic and type 2 diabetic population from 2010 to April, 2021. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using Revman 5.1 and Stata 12.0 software. Results A total of 26 RCTs involving 2 078 patients were included. The results of meta-analysis showed that resistance exercise could improve fasting blood glucose (MD=−0.57, 95%CI −0.69 to −0.45, P<0.000 01), glycosylated hemoglobin (MD=−0.28, 95%CI −0.33 to −0.22, P<0.000 01), high density lipoprotein (MD=0.06, 95%CI 0.01 to 0.11, P=0.01), low density lipoprotein (MD=−0.35, 95%CI −0.47 to −0.24 , P<0.000 01), total cholesterol (MD=−0.25, 95%CI −0.39 to −0.12, P=0.000 3), steady-state model-insulin resistance index (MD=−0.74, 95%CI −0.80 to −0.68, P<0.000 01), and body mass index (MD=−0.54, 95%CI −1.03 to −0.05, P=0.03) compared with control group. Conclusions Resistance exercise can improve the blood glucose, blood lipid, and insulin resistance levels of individuals with abnormal glucose and lipid metabolism. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusions.

Citation： GUO Qiaofeng, GAN Yanming, ZHANG Yuhang, ZHOU Yue. Efficacy of resistance training on individuals with different glucose metabolism status: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2021, 21(12): 1432-1440. doi: 10.7507/1672-2531.202107086 Copy

1.	中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版). 中华内分泌代谢杂志, 2021, 37(4): 311-398.
2.	孔树佳, 付继华. 胰岛素抵抗与糖, 脂代谢紊乱. 中国老年学杂志, 2009, 29(18): 2403-2405.
3.	Huang XL, Pan JH, Chen D, et al. Efficacy of lifestyle interventions in patients with type 2 diabetes: a systematic review and meta-analysis. Eur J Intern Med, 2016, 27: 37-47.
4.	Nah EH, Chu J, Kim S, et al. Efficacy of lifestyle interventions in the reversion to normoglycemia in Korean prediabetics: one-year results from a randomised controlled trial. Prim Care Diabetes, 2019, 13(3): 212-220.
5.	Dadgostar H, Firouzinezhad S, Ansari M, et al. Supervised group-exercise therapy versus home-based exercise therapy: their effects on quality of life and cardiovascular risk factors in women with type 2 diabetes. Diabetes Metab Syndr, 2016, 10(Suppl 1): S30-36.
6.	Dai X, Zhai L, Chen Q, et al. Two-year-supervised resistance training prevented diabetes incidence in people with prediabetes: a randomised control trial. Diabetes Metab Res Rev, 2019, 35(5): e3143.
7.	Davy BM, Winett RA, Savla J, et al. Resist diabetes: a randomized clinical trial for resistance training maintenance in adults with prediabetes. PLoS One, 2017, 12(2): e0172610.
8.	Faroqi L, Bonde S, Goni DT, et al. STRONG-D: Strength training regimen for normal weight diabetics: Rationale and design. Contemp Clin Trials, 2019, 78: 101-106.
9.	Jorge ML, de Oliveira VN, Resende NM, et al. The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus. Metabolism, 2011, 60(9): 1244-1252.
10.	Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane handbook for systematic reviews of interventions. Cochrane Database Syst Rev, 2019, (10): ED000142.
11.	Schmidt L, Shokraneh F, Steinhausen K, et al. Introducing RAPTOR: RevMan parsing tool for reviewers. Syst Rev, 2019, 8(1): 151.
12.	韦姣, 吴坤, 林静, 等. 艾灸联合抗阻运动治疗对糖尿病前期人群糖脂代谢的影响. 内科, 2017, 12(4): 447-450.
13.	李文颢, 吴知凡, 陆霖, 等. 八段锦和抗阻运动对糖调节受损人群血糖和胰岛素抵抗的影响. 世界科学技术-中医药现代化, 2019, 21(6): 1251-1256.
14.	张宁宁. 不同强度抗阻训练对糖耐量受损老年人糖代谢的调节与强度无关. 基因组学与应用生物学, 2018, 37(5): 2243-2249.
15.	李婧. 弹力带抗阻运动对2型糖尿病患者血糖血脂指标的影响研究. 特别健康, 2021, (1): 190-191.
16.	郑萍萍, 陈芳, 梁丽, 等. 低GI膳食替代联合抗阻运动对糖尿病前期人群代谢指标的影响. 护理研究, 2017, 31(35): 4569-4572.
17.	刘玉琳, 刘昊为. 加压结合抗阻训练对糖耐量减低人群骨密度, 胰岛素敏感性, 肌力, 激素分泌影响研究. 中国骨质疏松杂志, 2018, 24(11): 1451-1458.
18.	颜爱英, 贾冬青, 孙阳. 抗阻力运动干预对初诊2型糖尿病患者的影响. 齐鲁护理杂志, 2016, 22(17): 39-40.
19.	刘定忠. 抗阻运动对2型糖尿病患者糖脂代谢的影响. 中国实用医药, 2019, 14(17): 33-34.
20.	汪亚群, 楼青青, 嵇加佳, 等. 抗阻运动对糖尿病前期患者糖脂代谢的影响. 中华物理医学与康复杂志, 2015, 37(4): 294-297.
21.	季红, 楼青青, 张玉梅, 等. 抗阻运动对糖尿病前期患者作用效果的研究. 现代医药卫生, 2017, 33(8): 1136-1138,1142.
22.	陈国亮. 抗阻运动训练配合药物治疗对2型糖尿病患者糖脂代谢指标的影响. 中国疗养医学, 2020, 29(3): 269-271.
23.	蒙芝健, 罗祖纯, 劳世高, 等. 联合抗阻-有氧运动对老年糖尿病患者骨代谢指标的影响. 现代预防医学, 2020, 47(3): 462-465,470.
24.	陆丽荣, 戴霞, 韦薇, 等. 联合抗阻-有氧运动对糖尿病前期人群糖及脂代谢指标的影响. 护理研究(上旬版), 2016, 30(4): 1230-1233.
25.	戴霞, 楼青青, 陈青云, 等. 联合抗阻-有氧运动对糖尿病前期人群胰岛素抵抗的影响. 护士进修杂志, 2015, (19): 1731-1733.
26.	夏婉, 黄雄昂, 刘晓林. 生物肌电反馈肌肉强化治疗对高龄糖尿病患者下肢肌群改善的影响. 浙江医学, 2020, 42(8): 828-832.
27.	麻晓君, 戴霞, 陆丽荣, 等. 有氧运动和抗阻运动对糖调节受损患者空腹血糖及胰岛素抵抗的影响研究. 中国全科医学, 2017, 20(29): 3584-3589.
28.	罗祖纯, 戴霞, 张泰辉, 等. 有氧, 抗阻运动对糖尿病前期人群血清胰高血糖素样肽1, 血糖水平的影响. 山东医药, 2017, 57(2): 18-21.
29.	Venojärvi M, Wasenius N, Manderoos S, et al. Nordic walking decreased circulating chemerin and leptin concentrations in middle-aged men with impaired glucose regulation. Ann Med, 2013, 45(2): 162-170.
30.	Shabkhiz F, Khalafi M, Rosenkranz S, et al. Resistance training attenuates circulating FGF-21 and myostatin and improves insulin resistance in elderly men with and without type 2 diabetes mellitus: A randomised controlled clinical trial. Eur J Sport Sci, 2021, 21(4): 636-645.
31.	Botton CE, Umpierre D, Rech A, et al. Effects of resistance training on neuromuscular parameters in elderly with type 2 diabetes mellitus: A randomized clinical trial. Exp Gerontol, 2018, 113: 141-149.
32.	Yuan X, Dai X, Liu L, et al. Comparing the effects of 6 months aerobic exercise and resistance training on metabolic control and β-cell function in Chinese patients with prediabetes: A multicenter randomized controlled trial. J Diabetes, 2020, 12(1): 25-37.
33.	Shabani R, Nazari M, Dalili S, et al. Effect of circuit resistance training on glycemic control of females with diabetes type II. Int J Prev Med, 2015, 6: 34.
34.	Swift DL, Johannsen NM, Earnest CP, et al. Effect of exercise training modality on C-reactive protein in type 2 diabetes. Med Sci Sports Exerc, 2012, 44(6): 1028-1034.
35.	Church TS, Blair SN, Cocreham S, et al. Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial. JAMA, 2010, 304(20): 2253-2262.
36.	Kadoglou NP, Fotiadis G, Kapelouzou A, et al. The differential anti-inflammatory effects of exercise modalities and their association with early carotid atherosclerosis progression in patients with type 2 diabetes. Diabet Med, 2013, 30(2): e41-50.
37.	Hangping Z, Xiaona Q, Qi Z, et al. The impact on glycemic control through progressive resistance training with bioDensity TM in Chinese elderly patients with type 2 diabetes: The PReTTy2 (progressive resistance training in type 2 diabetes) trial. Diabetes Res Clin Pract, 2019, 150: 64-71.
38.	Yuing Farias T, Santos-Lozano A, Solís Urra P, et al. Effects of training and detraining on glycosylated haemoglobin, glycaemia and lipid profile in type-ii diabetics. Nutr Hosp, 2015, 32(4): 1729-1734.
39.	Simonsen AB, Simonsen MS, Hansen H, et al. Randomized, single blind study of the effects of intensive strenght training, high protein diet and creatine supplement in type-2 diabetics. Clin Nutr, 2011, 6(1): 62.
40.	Benham JL, Booth JE, Dunbar MJ, et al. Significant dose-response between exercise adherence and hemoglobin a1c change. Med Sci Sports Exerc, 2020, 52(9): 1960-1965.
41.	Nunes PR, Barcelos LC, Oliveira AA, et al. Effect of resistance training on muscular strength and indicators of abdominal adiposity, metabolic risk, and inflammation in postmenopausal women: controlled and randomized clinical trial of efficacy of training volume. Age (Dordr), 2016, 38(2): 40.
42.	유영창, 박병근. Effects of circuit weight training on lipoprotein metabolism. Korea Sport Res, 2004, 15(4): 1741-1750.
43.	Srikanthan P, Karlamangla AS. Relative muscle mass is inversely associated with insulin resistance and prediabetes. Findings from the third national health and nutrition examination survey. J Clin Endocrinol Metab, 2011, 96(9): 2898-2903.
44.	Burrows RA, Leiva LB, Weisstaub G, et al. High HOMA-IR, adjusted for puberty, relates to the metabolic syndrome in overweight and obese Chilean youths. Pediatr Diabetes, 2011, 12(3 Pt 2): 212-218.
45.	Marini E, Mariani PG, Ministrini S, et al. Combined aerobic and resistance training improves microcirculation in metabolic syndrome. J Sports Med Phys Fitness, 2019, 59(9): 1571-1576.
46.	Balducci S, Zanuso S, Nicolucci A, et al. Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss. Nutr Metab Cardiovasc Dis, 2010, 20(8): 608-617.
47.	Strasser B, Pesta D. Resistance training for diabetes prevention and therapy: experimental findings and molecular mechanisms. Biomed Res Int, 2013, 2013: 805217.
48.	罗曦娟. 有氧和抗阻运动对糖尿病前期人群糖调节的影响及其机制探讨. 北京: 北京体育大学, 2015.
49.	Chadt A, Al-Hasani H. Glucose transporters in adipose tissue, liver, and skeletal muscle in metabolic health and disease. Pflugers Arch, 2020, 472(9): 1273-1298.

1. 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2020年版). 中华内分泌代谢杂志, 2021, 37(4): 311-398.
2. 孔树佳, 付继华. 胰岛素抵抗与糖, 脂代谢紊乱. 中国老年学杂志, 2009, 29(18): 2403-2405.
3. Huang XL, Pan JH, Chen D, et al. Efficacy of lifestyle interventions in patients with type 2 diabetes: a systematic review and meta-analysis. Eur J Intern Med, 2016, 27: 37-47.
4. Nah EH, Chu J, Kim S, et al. Efficacy of lifestyle interventions in the reversion to normoglycemia in Korean prediabetics: one-year results from a randomised controlled trial. Prim Care Diabetes, 2019, 13(3): 212-220.
5. Dadgostar H, Firouzinezhad S, Ansari M, et al. Supervised group-exercise therapy versus home-based exercise therapy: their effects on quality of life and cardiovascular risk factors in women with type 2 diabetes. Diabetes Metab Syndr, 2016, 10(Suppl 1): S30-36.
6. Dai X, Zhai L, Chen Q, et al. Two-year-supervised resistance training prevented diabetes incidence in people with prediabetes: a randomised control trial. Diabetes Metab Res Rev, 2019, 35(5): e3143.
7. Davy BM, Winett RA, Savla J, et al. Resist diabetes: a randomized clinical trial for resistance training maintenance in adults with prediabetes. PLoS One, 2017, 12(2): e0172610.
8. Faroqi L, Bonde S, Goni DT, et al. STRONG-D: Strength training regimen for normal weight diabetics: Rationale and design. Contemp Clin Trials, 2019, 78: 101-106.
9. Jorge ML, de Oliveira VN, Resende NM, et al. The effects of aerobic, resistance, and combined exercise on metabolic control, inflammatory markers, adipocytokines, and muscle insulin signaling in patients with type 2 diabetes mellitus. Metabolism, 2011, 60(9): 1244-1252.
10. Cumpston M, Li T, Page MJ, et al. Updated guidance for trusted systematic reviews: a new edition of the Cochrane handbook for systematic reviews of interventions. Cochrane Database Syst Rev, 2019, (10): ED000142.
11. Schmidt L, Shokraneh F, Steinhausen K, et al. Introducing RAPTOR: RevMan parsing tool for reviewers. Syst Rev, 2019, 8(1): 151.
12. 韦姣, 吴坤, 林静, 等. 艾灸联合抗阻运动治疗对糖尿病前期人群糖脂代谢的影响. 内科, 2017, 12(4): 447-450.
13. 李文颢, 吴知凡, 陆霖, 等. 八段锦和抗阻运动对糖调节受损人群血糖和胰岛素抵抗的影响. 世界科学技术-中医药现代化, 2019, 21(6): 1251-1256.
14. 张宁宁. 不同强度抗阻训练对糖耐量受损老年人糖代谢的调节与强度无关. 基因组学与应用生物学, 2018, 37(5): 2243-2249.
15. 李婧. 弹力带抗阻运动对2型糖尿病患者血糖血脂指标的影响研究. 特别健康, 2021, (1): 190-191.
16. 郑萍萍, 陈芳, 梁丽, 等. 低GI膳食替代联合抗阻运动对糖尿病前期人群代谢指标的影响. 护理研究, 2017, 31(35): 4569-4572.
17. 刘玉琳, 刘昊为. 加压结合抗阻训练对糖耐量减低人群骨密度, 胰岛素敏感性, 肌力, 激素分泌影响研究. 中国骨质疏松杂志, 2018, 24(11): 1451-1458.
18. 颜爱英, 贾冬青, 孙阳. 抗阻力运动干预对初诊2型糖尿病患者的影响. 齐鲁护理杂志, 2016, 22(17): 39-40.
19. 刘定忠. 抗阻运动对2型糖尿病患者糖脂代谢的影响. 中国实用医药, 2019, 14(17): 33-34.
20. 汪亚群, 楼青青, 嵇加佳, 等. 抗阻运动对糖尿病前期患者糖脂代谢的影响. 中华物理医学与康复杂志, 2015, 37(4): 294-297.
21. 季红, 楼青青, 张玉梅, 等. 抗阻运动对糖尿病前期患者作用效果的研究. 现代医药卫生, 2017, 33(8): 1136-1138,1142.
22. 陈国亮. 抗阻运动训练配合药物治疗对2型糖尿病患者糖脂代谢指标的影响. 中国疗养医学, 2020, 29(3): 269-271.
23. 蒙芝健, 罗祖纯, 劳世高, 等. 联合抗阻-有氧运动对老年糖尿病患者骨代谢指标的影响. 现代预防医学, 2020, 47(3): 462-465,470.
24. 陆丽荣, 戴霞, 韦薇, 等. 联合抗阻-有氧运动对糖尿病前期人群糖及脂代谢指标的影响. 护理研究(上旬版), 2016, 30(4): 1230-1233.
25. 戴霞, 楼青青, 陈青云, 等. 联合抗阻-有氧运动对糖尿病前期人群胰岛素抵抗的影响. 护士进修杂志, 2015, (19): 1731-1733.
26. 夏婉, 黄雄昂, 刘晓林. 生物肌电反馈肌肉强化治疗对高龄糖尿病患者下肢肌群改善的影响. 浙江医学, 2020, 42(8): 828-832.
27. 麻晓君, 戴霞, 陆丽荣, 等. 有氧运动和抗阻运动对糖调节受损患者空腹血糖及胰岛素抵抗的影响研究. 中国全科医学, 2017, 20(29): 3584-3589.
28. 罗祖纯, 戴霞, 张泰辉, 等. 有氧, 抗阻运动对糖尿病前期人群血清胰高血糖素样肽1, 血糖水平的影响. 山东医药, 2017, 57(2): 18-21.
29. Venojärvi M, Wasenius N, Manderoos S, et al. Nordic walking decreased circulating chemerin and leptin concentrations in middle-aged men with impaired glucose regulation. Ann Med, 2013, 45(2): 162-170.
30. Shabkhiz F, Khalafi M, Rosenkranz S, et al. Resistance training attenuates circulating FGF-21 and myostatin and improves insulin resistance in elderly men with and without type 2 diabetes mellitus: A randomised controlled clinical trial. Eur J Sport Sci, 2021, 21(4): 636-645.
31. Botton CE, Umpierre D, Rech A, et al. Effects of resistance training on neuromuscular parameters in elderly with type 2 diabetes mellitus: A randomized clinical trial. Exp Gerontol, 2018, 113: 141-149.
32. Yuan X, Dai X, Liu L, et al. Comparing the effects of 6 months aerobic exercise and resistance training on metabolic control and β-cell function in Chinese patients with prediabetes: A multicenter randomized controlled trial. J Diabetes, 2020, 12(1): 25-37.
33. Shabani R, Nazari M, Dalili S, et al. Effect of circuit resistance training on glycemic control of females with diabetes type II. Int J Prev Med, 2015, 6: 34.
34. Swift DL, Johannsen NM, Earnest CP, et al. Effect of exercise training modality on C-reactive protein in type 2 diabetes. Med Sci Sports Exerc, 2012, 44(6): 1028-1034.
35. Church TS, Blair SN, Cocreham S, et al. Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial. JAMA, 2010, 304(20): 2253-2262.
36. Kadoglou NP, Fotiadis G, Kapelouzou A, et al. The differential anti-inflammatory effects of exercise modalities and their association with early carotid atherosclerosis progression in patients with type 2 diabetes. Diabet Med, 2013, 30(2): e41-50.
37. Hangping Z, Xiaona Q, Qi Z, et al. The impact on glycemic control through progressive resistance training with bioDensity TM in Chinese elderly patients with type 2 diabetes: The PReTTy2 (progressive resistance training in type 2 diabetes) trial. Diabetes Res Clin Pract, 2019, 150: 64-71.
38. Yuing Farias T, Santos-Lozano A, Solís Urra P, et al. Effects of training and detraining on glycosylated haemoglobin, glycaemia and lipid profile in type-ii diabetics. Nutr Hosp, 2015, 32(4): 1729-1734.
39. Simonsen AB, Simonsen MS, Hansen H, et al. Randomized, single blind study of the effects of intensive strenght training, high protein diet and creatine supplement in type-2 diabetics. Clin Nutr, 2011, 6(1): 62.
40. Benham JL, Booth JE, Dunbar MJ, et al. Significant dose-response between exercise adherence and hemoglobin a1c change. Med Sci Sports Exerc, 2020, 52(9): 1960-1965.
41. Nunes PR, Barcelos LC, Oliveira AA, et al. Effect of resistance training on muscular strength and indicators of abdominal adiposity, metabolic risk, and inflammation in postmenopausal women: controlled and randomized clinical trial of efficacy of training volume. Age (Dordr), 2016, 38(2): 40.
42. 유영창, 박병근. Effects of circuit weight training on lipoprotein metabolism. Korea Sport Res, 2004, 15(4): 1741-1750.
43. Srikanthan P, Karlamangla AS. Relative muscle mass is inversely associated with insulin resistance and prediabetes. Findings from the third national health and nutrition examination survey. J Clin Endocrinol Metab, 2011, 96(9): 2898-2903.
44. Burrows RA, Leiva LB, Weisstaub G, et al. High HOMA-IR, adjusted for puberty, relates to the metabolic syndrome in overweight and obese Chilean youths. Pediatr Diabetes, 2011, 12(3 Pt 2): 212-218.
45. Marini E, Mariani PG, Ministrini S, et al. Combined aerobic and resistance training improves microcirculation in metabolic syndrome. J Sports Med Phys Fitness, 2019, 59(9): 1571-1576.
46. Balducci S, Zanuso S, Nicolucci A, et al. Anti-inflammatory effect of exercise training in subjects with type 2 diabetes and the metabolic syndrome is dependent on exercise modalities and independent of weight loss. Nutr Metab Cardiovasc Dis, 2010, 20(8): 608-617.
47. Strasser B, Pesta D. Resistance training for diabetes prevention and therapy: experimental findings and molecular mechanisms. Biomed Res Int, 2013, 2013: 805217.
48. 罗曦娟. 有氧和抗阻运动对糖尿病前期人群糖调节的影响及其机制探讨. 北京: 北京体育大学, 2015.
49. Chadt A, Al-Hasani H. Glucose transporters in adipose tissue, liver, and skeletal muscle in metabolic health and disease. Pflugers Arch, 2020, 472(9): 1273-1298.

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