Effects of physical activity on the progression of diabetic nephropathy: a meta-analysis.
Effects of physical activity on the progression of diabetic nephropathy: a meta-analysis.
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DOI：
10.1042/bsr20203624
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发表时间：
2021-01-29
影响因子：
4
通讯作者：
Zhang J
中科院分区：
文献类型：
--
作者：
Cai Z;Yang Y;Zhang J
背景：糖尿病肾病是糖尿病重要的微血管并发症。体力活动(PA)是糖尿病患者健康生活方式的一部分；然而，PA在糖尿病肾病中的作用尚不清楚。我们的目的是进行一项荟萃分析，以探索PA和糖尿病肾病风险之间的联系。方法：系统检索PubMed、Embase、Cochrane图书馆和Web of Science等有关糖尿病患者PA及其对肾功能影响的文章。计算标准化均数差(SMDS)和95%可信区间(CI)的优势比(OR)。该研究方案已在PROSPERO注册(CRD42020191379)。结果：18项研究共确定了38991名参与者。结果表明，PA与肾小球滤过率增加(SMD=0.0 1，95%CI=[0.0 2~0.17])、尿白蛋白肌酐比值(SMD=−0.5 3，95%CI：−0.72至−0.34)、微量白蛋白尿率(OR=0.61，95%CI=[0.46~0.81])、急性肾损伤发生率(OR=0.0 2，95%CI=0.0 1~0.0 4)、肾功能衰竭发生率(OR=0.71，95%CI=[0.52~0.97])和1型糖尿病患者发生糖尿病肾病的危险性(OR=0.67，95%CI=[0.51~0.89])。结论：这项荟萃分析表明PA在改善糖尿病肾病和减缓其进展方面是有效的；然而，在这一主题上还需要更多高质量的随机对照试验。
Background: Diabetic nephropathy (DN) is an important microvascular complication of diabetes. Physical activity (PA) is part of a healthy lifestyle for diabetic patients; however, the role of PA in DN has not been clarified. Our aim was to conduct a meta-analysis to explore the association between PA and DN risk. Methods: PubMed, Embase, Cochrane Library and Web of Science were systematically searched for articles examining PA in diabetic patients and its effect on renal function. Standardized mean differences (SMDs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. The study protocol is registered with PROSPERO (CRD42020191379). Results: A total of 38991 participants were identified from 18 studies. The results indicated that PA was associated with increases in the glomerular filtration rate (SMD = 0.01, 95% CI = [0.02–0.17]) and decreases in the urinary albumin creatinine ratio (SMD = −0.53, 95% CI: −0.72 to −0.34), rate of microalbuminuria (OR = 0.61, 95% CI = [0.46–0.81]), rate of acute kidney injury (OR = 0.02, 95% CI = [0.01–0.04]), rate of renal failure (OR = 0.71, 95% CI = [0.52–0.97]) and risk of DN in patients with Type 1 diabetes (OR = 0.67, 95% CI = [0.51–0.89]). Conclusions: This meta-analysis indicated that PA is effective for improving DN and slowing its progression; however, more high-quality randomized controlled trials are required on this topic.