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.	中華醫學會糖尿病學分會. 中國2型糖尿病防治指南(2020年版). 中華內分泌代謝雜志, 2021, 37(4): 311-398.
2.	孔樹佳, 付繼華. 胰島素抵抗與糖, 脂代謝紊亂. 中國老年學雜志, 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.	韋姣, 吳坤, 林靜, 等. 艾灸聯合抗阻運動治療對糖尿病前期人群糖脂代謝的影響. 內科, 2017, 12(4): 447-450.
13.	李文顥, 吳知凡, 陸霖, 等. 八段錦和抗阻運動對糖調節受損人群血糖和胰島素抵抗的影響. 世界科學技術-中醫藥現代化, 2019, 21(6): 1251-1256.
14.	張寧寧. 不同強度抗阻訓練對糖耐量受損老年人糖代謝的調節與強度無關. 基因組學與應用生物學, 2018, 37(5): 2243-2249.
15.	李婧. 彈力帶抗阻運動對2型糖尿病患者血糖血脂指標的影響研究. 特別健康, 2021, (1): 190-191.
16.	鄭萍萍, 陳芳, 梁麗, 等. 低GI膳食替代聯合抗阻運動對糖尿病前期人群代謝指標的影響. 護理研究, 2017, 31(35): 4569-4572.
17.	劉玉琳, 劉昊為. 加壓結合抗阻訓練對糖耐量減低人群骨密度, 胰島素敏感性, 肌力, 激素分泌影響研究. 中國骨質疏松雜志, 2018, 24(11): 1451-1458.
18.	顏愛英, 賈冬青, 孫陽. 抗阻力運動干預對初診2型糖尿病患者的影響. 齊魯護理雜志, 2016, 22(17): 39-40.
19.	劉定忠. 抗阻運動對2型糖尿病患者糖脂代謝的影響. 中國實用醫藥, 2019, 14(17): 33-34.
20.	汪亞群, 樓青青, 嵇加佳, 等. 抗阻運動對糖尿病前期患者糖脂代謝的影響. 中華物理醫學與康復雜志, 2015, 37(4): 294-297.
21.	季紅, 樓青青, 張玉梅, 等. 抗阻運動對糖尿病前期患者作用效果的研究. 現代醫藥衛生, 2017, 33(8): 1136-1138,1142.
22.	陳國亮. 抗阻運動訓練配合藥物治療對2型糖尿病患者糖脂代謝指標的影響. 中國療養醫學, 2020, 29(3): 269-271.
23.	蒙芝健, 羅祖純, 勞世高, 等. 聯合抗阻-有氧運動對老年糖尿病患者骨代謝指標的影響. 現代預防醫學, 2020, 47(3): 462-465,470.
24.	陸麗榮, 戴霞, 韋薇, 等. 聯合抗阻-有氧運動對糖尿病前期人群糖及脂代謝指標的影響. 護理研究(上旬版), 2016, 30(4): 1230-1233.
25.	戴霞, 樓青青, 陳青云, 等. 聯合抗阻-有氧運動對糖尿病前期人群胰島素抵抗的影響. 護士進修雜志, 2015, (19): 1731-1733.
26.	夏婉, 黃雄昂, 劉曉林. 生物肌電反饋肌肉強化治療對高齡糖尿病患者下肢肌群改善的影響. 浙江醫學, 2020, 42(8): 828-832.
27.	麻曉君, 戴霞, 陸麗榮, 等. 有氧運動和抗阻運動對糖調節受損患者空腹血糖及胰島素抵抗的影響研究. 中國全科醫學, 2017, 20(29): 3584-3589.
28.	羅祖純, 戴霞, 張泰輝, 等. 有氧, 抗阻運動對糖尿病前期人群血清胰高血糖素樣肽1, 血糖水平的影響. 山東醫藥, 2017, 57(2): 18-21.
29.	Venoj?rvi 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.	???, ???. 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.	羅曦娟. 有氧和抗阻運動對糖尿病前期人群糖調節的影響及其機制探討. 北京: 北京體育大學, 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. 中華醫學會糖尿病學分會. 中國2型糖尿病防治指南(2020年版). 中華內分泌代謝雜志, 2021, 37(4): 311-398.
2. 孔樹佳, 付繼華. 胰島素抵抗與糖, 脂代謝紊亂. 中國老年學雜志, 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. 韋姣, 吳坤, 林靜, 等. 艾灸聯合抗阻運動治療對糖尿病前期人群糖脂代謝的影響. 內科, 2017, 12(4): 447-450.
13. 李文顥, 吳知凡, 陸霖, 等. 八段錦和抗阻運動對糖調節受損人群血糖和胰島素抵抗的影響. 世界科學技術-中醫藥現代化, 2019, 21(6): 1251-1256.
14. 張寧寧. 不同強度抗阻訓練對糖耐量受損老年人糖代謝的調節與強度無關. 基因組學與應用生物學, 2018, 37(5): 2243-2249.
15. 李婧. 彈力帶抗阻運動對2型糖尿病患者血糖血脂指標的影響研究. 特別健康, 2021, (1): 190-191.
16. 鄭萍萍, 陳芳, 梁麗, 等. 低GI膳食替代聯合抗阻運動對糖尿病前期人群代謝指標的影響. 護理研究, 2017, 31(35): 4569-4572.
17. 劉玉琳, 劉昊為. 加壓結合抗阻訓練對糖耐量減低人群骨密度, 胰島素敏感性, 肌力, 激素分泌影響研究. 中國骨質疏松雜志, 2018, 24(11): 1451-1458.
18. 顏愛英, 賈冬青, 孫陽. 抗阻力運動干預對初診2型糖尿病患者的影響. 齊魯護理雜志, 2016, 22(17): 39-40.
19. 劉定忠. 抗阻運動對2型糖尿病患者糖脂代謝的影響. 中國實用醫藥, 2019, 14(17): 33-34.
20. 汪亞群, 樓青青, 嵇加佳, 等. 抗阻運動對糖尿病前期患者糖脂代謝的影響. 中華物理醫學與康復雜志, 2015, 37(4): 294-297.
21. 季紅, 樓青青, 張玉梅, 等. 抗阻運動對糖尿病前期患者作用效果的研究. 現代醫藥衛生, 2017, 33(8): 1136-1138,1142.
22. 陳國亮. 抗阻運動訓練配合藥物治療對2型糖尿病患者糖脂代謝指標的影響. 中國療養醫學, 2020, 29(3): 269-271.
23. 蒙芝健, 羅祖純, 勞世高, 等. 聯合抗阻-有氧運動對老年糖尿病患者骨代謝指標的影響. 現代預防醫學, 2020, 47(3): 462-465,470.
24. 陸麗榮, 戴霞, 韋薇, 等. 聯合抗阻-有氧運動對糖尿病前期人群糖及脂代謝指標的影響. 護理研究(上旬版), 2016, 30(4): 1230-1233.
25. 戴霞, 樓青青, 陳青云, 等. 聯合抗阻-有氧運動對糖尿病前期人群胰島素抵抗的影響. 護士進修雜志, 2015, (19): 1731-1733.
26. 夏婉, 黃雄昂, 劉曉林. 生物肌電反饋肌肉強化治療對高齡糖尿病患者下肢肌群改善的影響. 浙江醫學, 2020, 42(8): 828-832.
27. 麻曉君, 戴霞, 陸麗榮, 等. 有氧運動和抗阻運動對糖調節受損患者空腹血糖及胰島素抵抗的影響研究. 中國全科醫學, 2017, 20(29): 3584-3589.
28. 羅祖純, 戴霞, 張泰輝, 等. 有氧, 抗阻運動對糖尿病前期人群血清胰高血糖素樣肽1, 血糖水平的影響. 山東醫藥, 2017, 57(2): 18-21.
29. Venoj?rvi 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. ???, ???. 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. 羅曦娟. 有氧和抗阻運動對糖尿病前期人群糖調節的影響及其機制探討. 北京: 北京體育大學, 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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