本系统评价和荟萃分析的目的是(1)确定运动对绝经后妇女骨矿物质密度(BMD)的影响,以及(2)解决绝经后妇女骨和绝经状态或监督的相应含义。根据截至2022年8月9日的PRISMA声明,对八个电子数据库进行了全面搜索,包括≥6个月的对照运动试验。腰椎(LS)的BMD变化(标准化平均差:SMD),股骨颈(FN),和全髋关节(TH)被认为是结果。研究组比较骨量减少/骨质疏松与正常骨密度,早期与晚期绝经后妇女,主要是监督和主要是非监督研究组。我们应用了逆异质性(IVhet)模型。总之,80项研究包括94个训练组和80个对照组,共有5581名参与者。IVhet模型确定的SMD为0.29(95%CI:0.16-0.42),0.27(95%CI:0.16-0.39),LS为0.41(95%CI:0.30-0.52),FN,和THBMD,分别。试验结果之间的异质性从低变化(I2=20%,THBMD)达到实质性(I2=68%,LS-BMD)。发表偏倚/小研究影响的证据低得可忽略不计(FN-,TH-BMD)至高(LSBMD)。我们观察到运动对LS-,FN-,或TH-BMD-LS之间的研究/研究组有或没有骨质减少/骨质疏松症,早期与晚期绝经后妇女,或主要监督运动计划与非监督运动计划。使用稳健的统计方法,本研究为运动对绝经后女性BMD的积极影响提供了进一步的证据.骨状态的差异(骨质减少/骨质疏松与正常骨),绝经状态(绝经后早期与晚期),和监督(是与否)没有显着影响运动对LS或股骨近端BMD的影响。
The aim of this systematic
review and meta-analysis was (1) to determine exercise effects on bone mineral density (BMD) in postmenopausal women and (2) to address the corresponding implication of bone and menopausal status or supervision in postmenopausal women. A comprehensive search of eight electronic databases according to the PRISMA statement up to August 9, 2022, included controlled exercise trials ≥ 6 months. BMD changes (standardized mean differences: SMD) at the lumbar spine (LS), femoral neck (FN), and total hip (TH) were considered as outcomes. Study group comparisons were conducted for osteopenia/osteoporosis versus normal BMD, early versus late postmenopausal women, and predominantly supervised versus predominantly non-supervised study arms. We applied an inverse heterogeneity (IVhet) model. In summary, 80 studies involving 94 training and 80 control groups with a pooled number of 5581 participants were eligible. The IVhet model determined SMDs of 0.29 (95% CI: 0.16-0.42), 0.27 (95% CI: 0.16-0.39), and 0.41 (95% CI: 0.30-0.52) for LS, FN, and THBMD, respectively. Heterogeneity between the trial results varied from low (I2 = 20%, TH BMD) to substantial (I2 = 68%, LS-BMD). Evidence for publication bias/small study effects was negligibly low (FN-, TH-BMD) to high (LSBMD). We observed no significant differences (p > .09) for exercise effects on LS-, FN-, or TH-BMD-LS between studies/study arms with or without osteopenia/osteoporosis, early versus late postmenopausal women, or predominantly supervised versus non-supervised exercise programs. Using robust statistical methods, the present work provides further evidence for a positive effect of exercise on BMD in postmenopausal women. Differences in bone status (osteopenia/osteoporosis versus normal bone), menopausal status (early versus late postmenopausal), and supervision (yes versus no) did not significantly affect the exercise effects on BMD at LS or proximal femur.