Background

Dyslipidemia is a primary risk factor for cardiovascular disease (CVD). Exercise training (EXTr) improves some lipid markers but not others; the literature is dated and analyses may be underpowered.

Objectives

To clarify which lipid markers are altered with ExTr and establish if information size had yet reached futility.

Methods

We conducted a systematic review/meta-analysis, with meta-regression, to establish expected effect size in lipid profile with aerobic (AT), resistance (RT) and combined (CT = AT + RT) ExTr. We conducted trial sequence analysis (TSA) to control for type I and II error and establish if information size had reached futility.

Results

We included 148 relevant randomized controlled trials (RCTs) of ExTr, with 227 intervention groups, total 8673 participants; exercise 5273, sedentary control 3400. Total cholesterol (TC) MD – 5.90 mg/dL (95% confidence interval (CI) – 8.14, – 3.65), high-density lipoprotein cholesterol (HDL) 2.11 (95% CI 1.43, 2.79), low-density lipoprotein cholesterol (LDL) – 7.22 (95% CI – 9.08, – 5.35), triglycerides – 8.01 (95% CI – 10.45, – 5.58) and very low-density lipoprotein cholesterol (VLDL) – 3.85 (95% CI – 5.49, – 2.22) all showed significant but modest 3.5–11.7%, improvements following ExTr. TSA indicated all analyses exceeded minimum information size to reach futility. CT was optimal for dyslipidemia management. Meta-regression showed every extra weekly aerobic session reduced TC – 7.68 mg/dL and for every extra week of training by – 0.5 mg/dL. Each minute of session time produced an additional 2.11 mg/dL HDL increase.

Conclusion

TSA analysis revealed sufficient data exist to confirm ExTr will improve all five lipid outcomes. CT is optimal for lipid management. The modest effect observed may moderate dyslipidemia medication for primary prevention. Prediction intervals suggest TC, HDL, LDL and TGD are only improved in one-quarter of studies.

中文翻译：

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运动训练对血脂的影响：系统评价和荟萃分析

 背景

血脂异常是心血管疾病（CVD）的主要危险因素。运动训练 (EXTr) 可以改善一些血脂指标，但不能改善其他指标；文献已经过时，分析可能不够有力。

 目标

澄清哪些脂质标记物被 ExTr 改变，并确定信息大小是否已达到无效。

 方法

我们通过荟萃回归进行了系统回顾/荟萃分析，以确定有氧 (AT)、阻力 (RT) 和组合 (CT = AT + RT) ExTr 血脂谱的预期效应大小。我们进行了试验序列分析 (TSA)，以控制 I 型和 II 型错误，并确定信息量是否已达到无效。

 结果

我们纳入了ExTr的148个相关随机对照试验（RCT），有227个干预组，总共8673名参与者；锻炼 5273，久坐控制 3400。总胆固醇 (TC) MD – 5.90 mg/dL（95% 置信区间 (CI) – 8.14， – 3.65），高密度脂蛋白胆固醇（HDL）2.11（95% CI 1.43，2.79） 、低密度脂蛋白胆固醇 (LDL) – 7.22 (95% CI – 9.08, – 5.35)、甘油三酯 – 8.01 (95% CI – 10.45, – 5.58) 和极低密度脂蛋白胆固醇 (VLDL) – 3.85 (95% CI – 5.49, – 2.22）均显示显着但适度的 3.5-11.7%，在 ExTr 之后有所改善。 TSA 表示所有分析都超出了最小信息量，因此毫无意义。 CT 对于血脂异常管理是最佳的。荟萃回归显示，每增加一周有氧运动，TC 就会降低 7.68 mg/dL，每增加一周训练，TC 就会降低 0.5 mg/dL。每分钟的训练时间都会使 HDL 额外增加 2.11 mg/dL。

 结论

TSA 分析显示，有足够的数据证实 ExTr 将改善所有五种血脂结果。 CT 是血脂管理的最佳选择。观察到的适度效果可能会缓和血脂异常药物的一级预防作用。预测区间表明 TC、HDL、LDL 和 TGD 仅在四分之一的研究中得到改善。