Effectiveness of multiple exercise modalities on intervention in obese children and adolescents with metabolic syndrome: a network meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

WANG yinyu ¹ ,  JING Yan ¹ , NING yi ² , TANG Honglin ¹ , SHEN Han ¹ , DUAN Yu ¹ , CHEN Shuang ¹ , LUO Min ¹ , FENG Junnan ¹

1. College of Physical Education Training, Wuhan Sports University, Wuhan 430079, P. R. China;
2. Medical School, Hunan University of Chinese Medicine, Changsha 410208, P. R. China;

Corresponding?author：

JING Yan, Email: 18062455947@163.com

Keywords：

Exercise; Obesity; Childhood and adolescence; Metabolic syndrome; Network meta-analysis; Randomized controlled trial

DOI：

10.7507/1672-2531.202501060

Video：

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Objective To systematically review the effects of various exercise modalities on obese children and adolescents with metabolic syndrome (MetS). Methods Chinese and English databases such as CNKI, WanFang Data, VIP, PubMed and Web of Science were selected to search for RCTs on the effects of exercise on obese children and adolescents with MetS, and the search period was from January 2000 to November 2024. Two researchers independently screened the literature, extracted data and evaluated the risk of bias of the included studies, and network meta?analysis was performed using Stata 17.0 and RevMan 5.4 software. Results A total of 15 RCTs involving 968 obese children and adolescents with MetS were included. The results of reticulated meta?analysis showed that compared with the non?exercise intervention group, aerobic exercise was effective in improving the patients' body mass index (BMI) (SMD=?1.21, 95%CI ?2.31 to ?0.11, P=0.031), total cholesterol (TC) (SMD=?0.44, 95%CI ?0.82 to ?0.05, P=0.028), triglyceride (TG) (SMD=?1.10, 95%CI ?1.98 to ?0.22, P=0.014), fasting blood glucose (FBG) (SMD=?0.70, 95%CI ?1.34 to ?0.07, P=0.030), systolic blood pressure (SBP) (SMD=?1.10, 95%CI ?1.83 to ?0.38, P=0.003), diastolic blood pressure (DBP) (SMD=?0.93, 95%CI ?1.49 to ?0.37, P=0.001). Resistance exercise can effectively improve the HDL cholesterol (SMD=0.55, 95%CI 0.09 to 1.02, P=0.020) and SBP (SMD=?1.16, 95%CI ?2.18 to ?0.14, P=0.025). Aerobic combined with resistance exercise can effectively improve waist circumference (WC) (SMD=?1.09, 95%CI ?1.74 to ?0.44, P=0.001), BMI (SMD=?1.22, 95%CI ?2.32 to ?0.12, P=0.030), HDL (SMD=0.56, 95%CI 0.13 to 1.00, P=0.011), and FBG (SMD=?0.57, 95%CI ?1.13 to ?0.02, P=0.044). The results of cumulative probability ranking showed that aerobic exercise was the most effective in improving TG, TC, FBG and DBP, resistance exercise was the most effective in improving SBP, and aerobic combined with resistance exercise was the most effective in improving WC, BMI and HDL. Conclusion Different exercise modes have different improvement effects on various body indexes in obese children and adolescents with MetS. Due to the limitation of the number and quality of included studies, more high quality studies are needed to verify the above conclusions.

Citation： WANG yinyu, JING Yan, NING yi, TANG Honglin, SHEN Han, DUAN Yu, CHEN Shuang, LUO Min, FENG Junnan. Effectiveness of multiple exercise modalities on intervention in obese children and adolescents with metabolic syndrome: a network meta-analysis. Chinese Journal of Evidence-Based Medicine, 2026, 26(1): 24-34. doi: 10.7507/1672-2531.202501060 Copy

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1. 熊昱鵬, 劉文清, 祁海燕, 等. 肥胖和代謝綜合征相關機制和研究進展. 臨床醫學進展, 2023, 13(9): 14560-14568.
2. Fahed G, Aoun L, Bou Zerdan M, et al. Metabolic syndrome: updates on pathophysiology and management in 2021. Int J Mol Sci, 2022, 23(2): 786.
3. Noubiap JJ, Nansseu JR, Lontchi-Yimagou E, et al. Global, regional, and country estimates of metabolic syndrome burden in children and adolescents in 2020: a systematic review and modelling analysis. Lancet Child Adolesc Health, 2022, 6(3): 158-170.
4. 葉佩玉, 閆銀坤, 丁文清, 等. 中國兒童青少年代謝綜合征患病率Meta分析. 中華流行病學雜志, 2015, 36(8): 884-888.
5. 中華醫學會兒科學分會內分泌遺傳代謝學組, 中華醫學會兒科學分會心血管學組, 中華醫學會兒科學分會兒童保健學組. 中國兒童青少年代謝綜合征定義和防治建議. 中華兒科雜志, 2012, 50(6): 420-422.
6. 張美仙, 米杰. 中國兒童青少年代謝性心血管危險因素流行現狀. 中國循證兒科雜志, 2010, 5(3): 228-236.
7. Mottillo S, Filion KB, Genest J, et al. The metabolic syndrome and cardiovascular risk a systematic review and meta-analysis. J Am Coll Cardiol, 2010, 56(14): 1113-1132.
8. Wentzel A, Mabhida SE, Ndlovu M, et al. Prevalence of metabolic syndrome in children and adolescents with obesity: a systematic review and meta-analysis. Obesity (Silver Spring), 2025, 33(1): 12-32.
9. 鐘美容, 盧小菊, 梁志金. 自我管理健康教育對提高代謝綜合征患者治療依從性的研究. 中國實用護理雜志, 2009, 25(20): 11-13.
10. 中華醫學會老年醫學分會老年內分泌代謝疾病學組中國老年代謝綜合征藥物治療專家共識(2022)編寫組. 中國老年人代謝綜合征藥物治療專家共識(2022). 中華老年醫學雜志, 2022, 41(9): 1011-1027.
11. 徐瑞, 曹友祥. 獨立有氧運動對肥胖兒童青少年代謝綜合征患者作用效果的Meta分析. 中國體育科學學會. 上海: 第十二屆全國體育科學大會論文摘要匯編—專題報告(體質與健康分會), 2022.
12. 張艷濤, 茍小軍, 朱一冰. 兒童和青少年代謝綜合征診斷和治療的研究進展. 國際兒科學雜志, 2018, 45(5): 397-400.
13. 高鑫, 張培珍. 代謝綜合征發病機制及運動調控研究進展. 中華健康管理學雜志, 2024, 18(6): 475-480.
14. Zhou Y, Wu W, Zou Y, et al. Benefits of different combinations of aerobic and resistance exercise for improving plasma glucose and lipid metabolism and sleep quality among elderly patients with metabolic syndrome: a randomized controlled trial. Endocr J, 2022, 69(7): 819-830.
15. 周永戰, 陳佩杰, 肖衛華. 規律性有氧運動對常見慢性疾病的抗炎效應及其機制. 中國康復醫學雜志, 2019, 34(8): 974-979.
16. Stensvold D, Tj?nna AE, Skaug EA, et al. Strength training versus aerobic interval training to modify risk factors of metabolic syndrome. J Appl Physiol (1985), 2010, 108(4): 804-810.
17. Ostman C, Smart NA, Morcos D, et al. The effect of exercise training on clinical outcomes in patients with the metabolic syndrome: a systematic review and meta-analysis. Cardiovasc Diabetol, 2017, 16(1): 110.
18. Liang M, Pan Y, Zhong T, et al. Effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors: a systematic review and network meta-analysis. Rev Cardiovasc Med, 2021, 22(4): 1523-1533.
19. Zimmet P, Alberti G, Kaufman F, et al. The metabolic syndrome in children and adolescents. Lancet, 2007, 369(9579): 2059-2061.
20. Higgins JP, Altman DG, G?tzsche PC, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ, 2011, 343: d5928.
21. Salanti G, Del Giovane C, Chaimani A, et al. Evaluating the quality of evidence from a network meta-analysis. PLoS One, 2014, 9(7): e99682.
22. Higgins JTJ, Chandler J, Cumpston M, et al. Cochrane handbook for systematic reviews of interventions. Cochrane Collaboration, 2022.
23. Chaimani A, Higgins JP, Mavridis D, et al. Graphical tools for network meta-analysis in STATA. PLoS One, 2013, 8(10): e76654.
24. Shim S, Yoon BH, Shin IS, et al. Network meta-analysis: application and practice using Stata. Epidemiol Health, 2017, 39: e2017047.
25. Salanti G, Ades AE, Ioannidis JP. Graphical methods and numerical summaries for presenting results from multiple-treatment meta-analysis: an overview and tutorial. J Clin Epidemiol, 2011, 64(2): 163-171.
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Chinese Journal of Evidence-Based Medicine

Effectiveness of multiple exercise modalities on intervention in obese children and adolescents with metabolic syndrome: a network meta-analysis

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