고혈압을 동반한 제2형 당뇨병 환자를 위한 운동중재의 효과: 체계적 문헌고찰 및 메타분석

Abstract

Purpose: This study was a systematic review and meta-analysis designed to investigate effects of exercise intervention for hypertensive patients with Type 2 Diabetes Mellitus. Methods: Three databases in overseas and four databases in domestic were searched. Two reviewers independently performed the selection of the studies, data extraction and assessment. The risk of bias was assessed using Cochrane Collaboration’s tool. To estimate the effect size, meta-analysis of the studies was performed using Review Manager(Revman, V5.3.5) and STATA 15.1(StataCorp, USA). Results: Of 3,207 publications identified, 8 studies were used to estimate effect size of exercise intervention. Effect sizes(Weight Mean Difference, WMD) were heterogeneous and random effects models were used in the analyses. Exercise intervention was effective for systolic blood pressure(WMD -5.25mmHg, 95% CI: -8.39 to -2.12), diastolic blood pressure(WMD -3.16mmHg, 95% CI: -4.91 to -1.40), BMI(WMD -1.47㎏/㎡, 95% CI: -2.39 to -0.55), and waist circumference(WMD -2.91㎝, 95% CI: -5.68 to -0.15). Subgroup analysis showed that aerobic exercise might be the most effective intervention for systolic and diastolic blood pressure, but combined exercise and device-guided breathing exercise was not an effective intervention for primary outcomes. BMI and waist circumference were not analyzed because of the small number of studies included in the analysis. There was no publication bias through contour-enhanced funnel plot, but systolic blood pressure and HbA1c were at risk of publication bias in the trim-and- fill test. Conclusion: Exercise intervention appears to be effective in reducing systolic and diastolic blood pressure, but it is more likely that aerobic exercise might be effective as a result of subgroup analysis. However, no domestic research, high heterogeneity, and publication bias suggest that additional well-designed studies should be conducted in the future.