Association Between Physical Activity, Sedentary Behavior and Physical Fitness and Glycated Hemoglobin in Youth with Type 1 Diabetes: A Systematic Review and Meta-analysis,Sports Medicine

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Association Between Physical Activity, Sedentary Behavior and Physical Fitness and Glycated Hemoglobin in Youth with Type 1 Diabetes: A Systematic Review and Meta-analysis
Sports Medicine ( IF 9.3 ) Pub Date : 2022-08-03 , DOI: 10.1007/s40279-022-01741-9
Nidia Huerta-Uribe ₁ , Robinson Ramírez-Vélez ₁ , Mikel Izquierdo ₁ , Antonio García-Hermoso ₁

Affiliation

Background

Scientific literature suggests poor glycemic control in youth with type 1 diabetes (T1D) and physical inactivity, sedentary behavior and low physical fitness levels, although results are not entirely consistent.

Objective

To meta-analyze the association between glycated hemoglobin and physical activity, sedentary behavior, and physical fitness in children and adolescents with T1D.

Methods

Our meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA). Three databases were searched for studies. All studies meeting the following criteria were included: (1) Population: children and adolescents with a mean age between 3 and 18 years diagnosed with T1D; (2) Exposition: physical activity and/or sedentary behavior and/or cardiorespiratory fitness and/or muscular fitness; (3) Outcome: glycated hemoglobin; (4) Study design: cross-sectional, longitudinal, and case–control studies. Pooled effects were calculated using a random effects inverse-variance model with the Hartung–Knapp–Sidik–Jonkman adjustment.

Results

Thirty-seven studies were included, accounting for a total of 34,863 youths with T1D (51.9% girls). Twenty-nine studies evaluated physical activity, eight sedentary behavior, 14 cardiorespiratory fitness, and two muscular fitness. A negative association between physical activity (r = − 0.09, 95% CI − 0.14 to − 0.04; I² = 63.5%), cardiorespiratory fitness (r = − 0.31, 95% CI − 0.44 to − 0.19; I² = 57.0%) and glycated hemoglobin was found. Also, the association with sedentary behavior was positive (r = 0.20, 95% CI 0.04 to 0.35; I² = 92.6%). All the associations were independent of the glycated hemoglobin levels and diabetes duration.

Conclusions

Low levels of physical activity and cardiorespiratory fitness and extensive sedentary behavior may explain part of the variance in glycated hemoglobin and part of the risk for poor glycemic control in youth with T1D.

Prospero

Registration number: CRD42021254362.

中文翻译：

青少年 1 型糖尿病患者身体活动、久坐行为和身体健康与糖化血红蛋白之间的关联：系统评价和荟萃分析

背景

科学文献表明，患有 1 型糖尿病 (T1D) 和身体缺乏活动、久坐行为和身体健康水平低下的青少年血糖控制不佳，但结果并不完全一致。

客观的

荟萃分析糖化血红蛋白与患有 T1D 的儿童和青少年的身体活动、久坐行为和身体健康之间的关联。

方法

我们的荟萃分析是根据系统评价和荟萃分析指南 (PRISMA) 的首选报告项目进行的。搜索了三个数据库以进行研究。符合以下标准的所有研究均包括在内：(1) 人群：平均年龄在 3 至 18 岁之间的诊断为 T1D 的儿童和青少年；(2) 说明：体力活动和/或久坐行为和/或心肺适能和/或肌肉适能；(3) 结果：糖化血红蛋白；(4) 研究设计：横断面研究、纵向研究和病例对照研究。使用具有 Hartung–Knapp–Sidik–Jonkman 调整的随机效应逆方差模型计算合并效应。

结果

纳入了 37 项研究，共计 34,863 名患有 T1D 的青少年（51.9% 为女孩）。29 项研究评估了身体活动、8 项久坐行为、14 项心肺健康和 2 项肌肉健康。体力活动 ( r = − 0.09, 95% CI − 0.14 至 − 0.04; I ² = 63.5%)、心肺适能 ( r = − 0.31, 95% CI − 0.44 至 − 0.19; I ² = 57.0%)之间呈负相关) 和糖化血红蛋白被发现。此外，与久坐行为的关联是积极的（r = 0.20，95% CI 0.04 至 0.35；I ² = 92.6%）。所有关联均独立于糖化血红蛋白水平和糖尿病持续时间。