Effects Of Exercise For People With Metabolic Syndrom: A Systematic Review

Objective:To evaluate the effectiveness and safety of exercise for patients with metabolic syndrome.Methods:With strictly designed search strategies,nine electronic databases including Medline,Embase,Cochrane library,Web of Science,CINAHL,CNKI,CBM,VIP and Wanfang were searched to collect randomized controlled trials or clinical controlled trials on exercise for people with metabolic syndrome dated from inception to December,2016.Eligible trials were assessed with the quality criteria for RCT from Cochrane Handbook for Systematic Reviews of Interventions5.1.0.All statistical analyses were performed with RevMan5.3 and Stata software12.0.Results:Nineteen articles were selected for inclusion in the review.Thirteen articles studied the effects of aerobic training(among them,there was one article on resistance training and two articles on combined aerobic and resistance training),and four articles on yoga and two articles on wuqinxi(Chinese traditional exercise).The quality of all included trials was moderate level.Results were as follows:(1)Efficacy of aerobic training on components of metabolic syndrome:(1)Significant mean reductions in SBP-7.16(95%CI-8.84,-5.48)mmHg,DBP-2.91(95%CI-4.84,-0.98)mmHg and a significant mean increase in HDL-C 0.09(95%CI 0.06,0.11)mmol/L were observed after aerobic training.(2)There was no significant change in components of metabolic syndrome after resistance training.(3)Significant mean reductions in WC-4.32(95%CI-5.81,-2.83)cm,SBP-5.38(95%CI-7.54,-3.22)mmHg,DBP-5.25(95%CI-6.14,-4.36)mmHg and a significant mean increase in HDL-C 0.09(95%CI 0.06,0.12)mmol/L were observed after combined aerobic and resistance training.(4)Significant mean reductions in WC-2.38(95%CI-3.76,-1.00)cm,SBP-3.11(95%CI-6.11,-0.11)mmHg were observed after yoga training.(5)Significant mean reductions in WC-2.86(95%CI-4.55,-1.17)cm,SBP-7.36(95%CI-11.65,-3.07)mmHg,DBP-6.18(95%CI-8.73,-3.64)mmHg,TG-0.62(95%CI-0.96,-0.28)mmol/L and a significant mean increase in HDL-C 0.60(95%CI 0.41,0.78)mmol/L were observed after wuqinxi training.(2)Efficacy of exercise on quality of life: a significant mean increase in PCS 0.36(95%CI 0.01,0.72)was observed after exercise training;and there was no significant change in MCS 0.20(95%CI-0.03,0.43)after exercise training.(3)Adverse events: one article reported the occurrence of minor musculo-skeletal injury/discomfort during exercise training.(4)Adherence to the group intervention: There was no significant difference between exercise groups and control groups with RR 0.92(95%CI 0.81,1.05).Conclusion:For patients with metabolic syndrome,aerobic training has favorable effects on blood pressure and high density lipoprotein cholesterol;the current evidence cannot reach a precise conclusion about the effectiveness of the four types of exercise(resistance training,combined aerobic and resistance training,yoga and wuqinxi)on components of metabolic syndrome and the efficacy of exercise on quality of life;minor musculo-skeletal injury /discomfort may occur during exercise training;there is good adherence to the intervention with no difference between the exercise and control groups.