運動訓練改善過重／肥胖兒童或青少年血壓的效果：統合分析

Effects of Exercise Training on Blood Pressure in Overweight/Obese Children and Adolescents: A Meta-analysis

蔡孟書(Meng-Shu Tsai) ； 吳英黛(Ying-Tai Wu) ； 高宓憶(Mi-Yi Kao)

《物理治療》 33卷3期 (2008/06) Pp. 161-167

摘要

背景與目的：兒童或青少年肥胖盛行率日增且其血壓較高，目前運動訓練改善肥胖兒童或青少年血壓效果的研究仍欠缺一致結論。本研究利用統合分析方法探討運動訓練改善過重／肥胖兒童及青少年血壓和其他相關因子的效果，如身體組成、血脂肪及胰島素效果。方法：從MEDLINE，CINAHL，PubMed及CEPS資料庫收尋符合關鍵詞的隨機控制研究，再利用Review Manage軟體統合分析，並分別比較單獨運動訓練及綜合式運動訓練（結合飲食、行為治療或生活型態教育）對血壓和相關因子的效果。結果：總共收錄9篇隨機控制成效比較的研究，其中3篇是單獨運動訓練，其餘6篇二組均有飲食、行為治療或生活型態教育。單獨運動訓練可以降低身體質量指數(-2.66 kg/平方公尺，95% CI: -4.44~-0.88)及胰島素(-3.56 pmol/L，95% CI: -6.56~-0.56)。而綜合式運動訓練可以明顯降低收縮壓(-4.09 mmHg，95% CI: -7.36~-0.83)，並降低身體質量指數、三酸甘油酯、總膽固醇、胰島素及增加高密度脂蛋白。結論：單獨運動訓練可以降低過重／肥胖兒童及青少年身體質量指數及胰島素，而綜合式運動訓練包含有飲食、行為治療或生活型態教育則可改善過重／肥胖兒童及青少年的收縮壓、身體質量指數、血脂及胰島素。

關鍵字

運動訓練 ； 肥胖 ； 兒童 ； 血壓 ； 統合分析

並列摘要

Background and Purposes: The prevalence of obesity in children and adolescents increases yearly and worldwide. High blood pressure (BP) has been associated with obesity in both children and adolescents. The effects of exercise training on blood pressure in overweight/obese children and adolescents are not conclusive. The purpose of this study was to analyze the effects of exercise training on BP in overweight/obese children and adolescents by a meta-analysis. This study also evaluated the effects of exercise training on some related factors, such as body composition, lipid profile and insulin. Methods: We searched the electronic databases, including MEDLINE (1966 to June 2007), CINAHL (1982 to June 2007), PubMed (1950 to June 2007) and CEPS (to June 2007), for randomized controlled trials. Weighted mean differences (WMD) and 95% confidence intervals (CI) were calculated for each variable in each trial. Data from each trial were pooled as appropriate using either fixed-or random-effects model by heterogeneity test. We compared the exercise alone and comprehensive exercise training (combined with diet or/and behavior therapy) with control group by subcategories. Results: Among the eligible nine studies (8 randomized controlled trials and one crossover comparing study), 3 of them investigated the effects of exercise alone and 6 others combined with diet, behavior therapy, or lifestyle education. The exercise training alone significantly decreased body mass index (-2.66 kg/m^2, 95% CI: -4.44 to -0.88) and insulin (-3.56 pmol/L, 95% CI: -6.56 to -0.56). The overall comprehensive exercise training significantly decreased systolic BP (-4.09 mmHg, 95% CI: -7.36 to -0.83), body mass index, triglycerides, total cholesterol, and insulin and increased HDL cholesterol. Conclusions: Exercise alone significantly decreases body mass index and insulin in overweight/obese children and adolescents. Comprehensive exercise training results in additional benefits in systolic blood pressure control and lipid profile improvement.

並列關鍵字

Exercise training ； Obese ； Children ； Blood pressure ； Meta-analysis