| Objectives1.To clarify the effectiveness and safety of Tai Chi intervention in T2 DM and provide evidence-based medical evidence for Tai Chi intervention in T2DM;2.Explore the possible microbiological mechanism of Tai Chi intervention in T2 DM,and provide the bioinformatics basis of microbiology and metabolomics for Tai Chi exercise intervention in T2DMMethods1.Retrieving published systematic reviews of the effectiveness and safety of Tai Chi on T2 DM in major Chinese and English medical databases,using AMSTAR 2 methodological quality assessment tools and ROBIS systematic review bias risk assessment tools to evaluate the methodological quality of the included literature,and qualitative description of methodological quality and main outcome indicators is synthesized to clarify the effectiveness and safety of Tai Chi for T2 DM.2.Combined Application of the third generation of high-throughput Pacio fulllength 16 s r DNA sequencing technology and untargeted metabolomics technology were used to explore the differences in intestinal flora structure and metabolomics between T2 DM patients and normal people.This part of the study included 20 T2 DM patients and 10 healthy controls.T2 DM patients were randomly divided into Tai Chi group and walking group,with 10 cases in each group.Tai Chi group subjects received simplified 24-style Tai Chi training,weekly three times for 60 minutes each time for a total of 12 weeks;The subjects in the walking group received interventions for walking and walking 3 times a week for 60 minutes each time for a total of 12 weeks.Compared the differences in intestinal microflora and metabolomics between T2 DM and healthy controls,and before and after different aerobic exercise interventions(Tai Chi,vigorous walking);explore the possible microbiological correlation of aerobic exercise such as Tai Chi to T2 DM Mechanism.Results1.The main result of overviewAfter systematic literature retrieval and screening,a total of 11 RCTS-based systematic reviews on Tai Chi for T2 DM were finally included.In terms of conclusions,8 articles obtained positive results,suggesting that Tai Chi could better improve the blood glucose level and quality of life of T2 DM patients compared with the control group;2 articles considered differences compared to the placebo,but no difference when compared with aerobic exercise.One article obtained negative results,and believed that Tai Chi exercise was not better than other aerobic exercises in improving T2 DM.Literature quality evaluation by the AMTAR 2 were not satisfactory.One article was of low quality,and the remaining 10 articles were of very low quality.Regarding the results of ROBIS's methodological quality evaluation of the included literatures,two articles were rated as low risk of bias,and the other 9 were high risk of bias.2.Results of Tai Chi on gut microbiota and metabolomics of T2 DM patientsT2DM patients compared with normal people,the dominant bacteria composition of the intestinal flora structure is basically the same,mainly Bacteroides,thick-walled bacteria and Proteobacteria;Wilcoxon rank-sum test test results found Significantly different levels of fungi;LEf Se analysis shows that the main biomaker that is significant for T2 DM includes Barnesiella,Barnesiellaceae,Actinobacteria and Lachnospira;the differential flora that is significant for healthy people includes the beneficial bacteria Roseburia,Megamonas,Anaerobacterium,Gammaproteobacteria,Selenomonadaceae,Selenomonadales and Prevotella;The results of the rank sum test suggested that the abundance of Blautia-luti decreased after Tai Chi exercise intervention;Lef Se results showed that there was only one Ruminococcaceae after walking exercise intervention.It shows that there is a significant difference in the structure of intestinal flora between T2 DM patients and healthy people.Tai Chi and walking exercise for 3 months can affect the intestinal flora of patients to some extent,but the changes that can be observed are relatively limited.T2DM patients and normal people have significant differences in serum,urine,and fecal metabolism.Serum differential metabolites include glucose,mannose,galactose,and inositol,etc.The metabolic pathways involved mainly include galactose metabolism,phosphate muscle Alcohol metabolism and amino acid metabolism;39 urine metabolites include N-methyl serotonin,5-methoxytryptamine,L-histidine,deoxycytidine,etc.The major metabolic pathways involved are phenylalanine Acid metabolism pathways and arachidonic acid pathways;differential metabolites of fecal metabolomics include Lyso SM(d18: 1),45 palmitic acid,betaine,indoleacetaldehyde,leucine,etc.,involved pathways It mainly includes tyrosine metabolism,phenylalanine metabolism,arginine and proline metabolism.The analysis of metabolite pathway enrichment in serum,urine and stool metabolites suggests that T2 DM and healthy people share the same pathway enrichment in the degradation pathway of valine,leucine and isoleucine,tyrosine metabolism pathway and protein digestion and absorption pathway,which needs to be focused on to study the overall metabolism of T2 DM host.Tai Chi and walking exercise can affect the metabolic status of T2 DM patients to a certain extent,which may be mainly through arachidonic acid metabolism and protein related pathways.Conclusions1.Tai Chi exercise can effectively improve the fasting blood glucose and glycated hemoglobin levels in patients with T2 DM,but due to the limited number of studies on blood lipid related indicators,body mass index,patients' quality of life and balance function,the risk of research bias is too high to be To draw an effective conclusion,further clinical research is needed to confirm it.2.Compared with normal people,T2 DM patients have a state of intestinal microflora disorder and metabolic disorders.3.Tai Chi and brisk wailking are low-intensity aerobic exercises which can affect the intestinal flora and host metabolic state of T2 DM patients to a certain extent,possibly by promoting the growth of certain intestinal beneficial bacteria,affecting amino acid and protein metabolism,etc.To achieve the purpose of improving the host's metabolic state. |
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