运动联合营养干预对老年糖尿病患者肌肉减少症改善效果的Meta分析

Meta-Analysis of the Effect of Exercise Combined with Nutritional Intervention on the Improvement of Sarcopenia in Elderly Diabetic Patients

摘要: 目的：本研究旨在评估结合运动与营养干预对老年型糖尿病患者肌少症状态的改善效果，以期为临床干预提供科学依据。方法：文献检索覆盖了中国知网、万方、维普、中国生物医学文献数据库、PubMed、Web of Science和Embase，截至2024年2月，针对运动与营养干预对老年糖尿病患者肌少症影响的随机对照试验进行了系统评估。独立筛选、提取数据，并对纳入研究的质量进行评估。结果：共纳入11项研究，涉及862名患者。Meta分析结果显示，与对照组相比，干预组在握力[SMD = 0.56, 95%CI (0.25, 0.87), P < 0.0001]、骨骼肌质量指数[SMD = 0.41, 95%CI (0.19, 0.62), P < 0.0001]、起坐试验时间[SMD = −0.64, 95%CI (−0.94, −0.34), P < 0.0001]、日常生活能力[SMD = 0.60, 95%CI (0.30, 0.91), P < 0.0001]指标上均有显著改善。结论：运动结合营养干预对改善老年糖尿病患者的肌少症状况具有显著效果，特别是在提升肌肉质量、功能性表现和日常生活能力方面。

Abstract: Objective: This study aims to evaluate the efficacy of combined exercise and nutritional interventions on sarcopenia in elderly patients with diabetes, providing a scientific basis for clinical interventions. Methods: Systematic assessments were conducted on randomized controlled trials (RCTs) focusing on the impact of exercise and nutritional interventions on sarcopenia in elderly diabetic patients. Literature searches covered databases including CNKI (China National Knowledge Infrastructure), Wanfang, VIP (Chinese Scientific Journals Database), China Biology Medicine disc, PubMed, Web of Science, and Embase up to February 2024. Studies were independently selected and data extracted, and the quality of included studies was assessed. Result: A total of 11 studies involving 862 participants were included. Meta-analysis indicated significant improvements in grip strength [SMD = 0.56, 95%CI (0.25, 0.87), P < 0.0001], skeletal muscle mass index [SMD = 0.41, 95%CI (0.19, 0.62), P < 0.0001], chair stand test times [SMD = −0.64, 95%CI (−0.94, −0.34), P < 0.0001], and ability of daily living [SMD = 0.60, 95%CI (0.30, 0.91), P < 0.0001] in the intervention groups compared to control groups. Conclusion: The integration of exercise and nutritional strategies significantly enhances sarcopenia conditions in elderly diabetic patients, particularly in increasing muscle mass, functional performance and ability of daily living.