不同运动形式对非酒精性脂肪性肝病疗效的Meta分析

The Therapeutic Effects of Different Exercise Forms on Nonalcoholic Fatty Liver Disease: A Meta-Analysis

摘要: 目的：比较和评价不同运动形式对非酒精性脂肪肝病(NAFLD)患者肝功能、糖代谢、BMI以及血脂代谢指标的康复治疗效果。方法：检索中国知网、PubMed、WanFangDate、Web of Science数据库，筛选运动对NAFLD的随机对照试验。对纳入文献进行质量评价、数据分析、森林图绘制、亚组分析、漏斗图绘制、Egger检验。结果：有氧运动对NAFLD患者的肝功能、BMI以及血脂代谢指标具有显著效益；高强度间歇运动对降低NAFLD患者的部分肝功能和部分血脂代谢指标具有显著效益；抗阻运动对NAFLD患者的部分肝功能、全部糖代谢以及部分血脂代谢指标具有显著效益；有氧结合抗阻运动对NAFLD患者的部分肝功能、BMI和部分血脂代谢指标具有显著效益。亚组分析显示，国家、干预周期、干预频次、研究设计等因素不同可能会影响研究间的效果差异，Egger检验显示部分结论可能存在发表偏倚。结论：有氧运动对减脂、减重以及改善肝功能效果最好，抗阻运动的显著优势是降低血糖代谢指标，有氧结合抗阻治疗效果次之，高强度间歇性训练较不理想。

Abstract: Objective: To compare and evaluate the rehabilitation effects of different exercise forms on liver function, glucose metabolism, BMI and blood lipid metabolism in patients with nonalcoholic fatty liver disease (NAFLD). Methods: The databases of CNKI, PubMed, WanFangDate, and Web of Science were searched to screen randomized controlled trials of exercise on NAFLD. Quality evaluation, data analysis, forest plot, analysis, funnel plot and Egger’s test were performed for the included re-searches. Results: Aerobic exercise had significant benefits on liver function, BMI and blood lipid metabolism indicators in NAFLD patients; high-intensity intermittent exercise had significant bene-fits on reducing partial indicators of liver function and blood lipid metabolism in NAFLD patients; resistance exercise had significant benefits on partial indicators of liver function, all glucose metab-olism indicators and partial indicators of blood lipid metabolism in NAFLD patients; aerobic com-bined with resistance exercise had significant benefits on some liver function indicators, BMI and some blood lipid metabolism indicators in NAFLD patients. Analysis showed that different factors such as country, intervention cycle, intervention frequency, and study design may affect the effects among studies, and Egger’s test showed that some conclusions may have publication bias. Conclu-sions: In the effects of treating NAFLD, aerobic exercise has the best effects on fat reduction, weight loss and improvements of liver function; the significant advantage of resistance exercise is to reduce the indexes of blood glucose metabolism; followed by aerobic combined with resistance therapy; and high intensity intermittent training is not ideal.