A meta-analysis of the comparison of intervention effects of high-intensity interval training and moderate-intensity continuous training on patients with metabolic syndrome_West China Medical Journal

Authors：

WANG Wenxing ^1,2 , YU Wenlang ^1,2 , ZHAO Yuanhui ^1,2 ,  REN Hong ^1,2

1. College of Sports Human Sciences, Beijing Sport University, Beijing 100084, P. R. China;
2. Key Laboratory of Physical Fitness and Exercise, Ministry of Education, Beijing Sport University, Beijing 100084, P. R. China;

Corresponding?author：

REN Hong, Email: renhong@bsu.edu.cn

Keywords：

Metabolic syndrome; high-intensity interval training; moderate-intensity continuous training

DOI：

10.7507/1002-0179.202207041

Video：

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Objective To explore the difference of intervention effect between high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on patients with metabolic syndrome (MetS). Methods China National Knowledge Infrastructure, WanFang Data, PubMed, Web of Science and EBSCO were searched for randomized controlled trials (RCTs) till May 2022. Two reviewers independently reviewed the literature, extracted data, and assessed the risk of bias of included RCTs. Comprehensive Meta-Analysis software was used for meta-analysis. Result A total of 5 RCTs were included, including 216 patients. The results of meta-analysis showed that: except fasting blood glucose, high-density lipoprotein cholesterol, systolic blood pressure, waist circumference, body mass index and body fat percentage (P>0.005), low-density lipoprotein cholesterol [mean difference (MD)=?7.487 mg/dL, 95% confidence interval (CI) (?12.543, ?2.431) mg/dL, P=0.004], total cholesterol [MD=?11.487 mg/dL, 95%CI (?16.523, ?6.452) mg/dL, P<0.001], triglycerides [MD=?26.296 mg/dL, 95%CI (?50.557, ?2.035) mg/dL, P=0.034] and diastolic blood pressure [MD=?2.770 mm Hg (1 mm Hg=0.133 kPa), 95%CI (?5.131, ?0.409) mm Hg, P=0.021] of HIIT were better than MICT. Conclusion In terms of blood glucose indicators and morphological indicators, the effect of HIIT group and MICT group was similar, but the effect of HIIT on blood lipid indicators and blood pressure indicators of patients with MetS was better than MICT.

Citation： WANG Wenxing, YU Wenlang, ZHAO Yuanhui, REN Hong. A meta-analysis of the comparison of intervention effects of high-intensity interval training and moderate-intensity continuous training on patients with metabolic syndrome. West China Medical Journal, 2023, 38(2): 261-269. doi: 10.7507/1002-0179.202207041 Copy

1.	王芬. 代謝綜合征與 2 型糖尿病病人慢性腎臟病的相關性分析. 安徽醫藥, 2021, 25(3): 508-511.
2.	楊鈺, 劉順, 仇小強, 等. 廣西 35~74 歲壯族居民慢性腎臟病患病及其與代謝綜合征的相關性研究. 廣西醫科大學學報, 2021, 38(3): 599-604.
3.	Bitew ZW, Alemu A, Tenaw Z, et al. Prevalence of metabolic syndrome among children and adolescents in high-income countries: a systematic review and meta-analysis of observational studies. BioMed Res Int. (2021-03-27)[2022-07-01]. https://downloads.hindawi.com/journals/bmri/2021/6661457.pdf.
4.	郭海健, 念馨, 梁友芳, 等. 基于多中心橫斷面調查的中國人群代謝綜合征的流行情況及危險因素. 中華疾病控制雜志, 2019, 23(7): 796-801.
5.	So R, Matsuo T. The effect of domain-specific sitting time and exercise habits on metabolic syndrome in Japanese workers: a cross-sectional study. Int J Environ Res Public Health, 2020, 17(11): 3883.
6.	Colpitts BH, Spencer Smith, Bouchard DR, et al. Are physical activity and sedentary behavior patterns contributing to diabetes and metabolic syndrome simultaneously?. Transl Sports Med. (2020-11-18)[2022-07-01]. https://onlinelibrary.wiley.com/doi/epdf/10.1002/tsm2.216.
7.	Vella CA, Taylor K, Drummer D. High-intensity interval and moderate-intensity continuous training elicit similar enjoyment and adherence levels in overweight and obese adults. Eur J Sport Sci, 2017, 17(9): 1203-1211.
8.	Mattioni Maturana F, Martus P, Zipfel S, et al. Effectiveness of HIIE versus MICT in improving cardiometabolic risk factors in health and disease: a meta-analysis. Med Sci Sports Exerc, 2021, 53(3): 559-573.
9.	Rugbeer N, Constantinou D, Torres G. Comparison of high-intensity training versus moderate-intensity continuous training on cardiorespiratory fitness and body fat percentage in persons with overweight or obesity: a systematic review and meta-analysis of randomized controlled trials. J Phys Act Health, 2021, 18(5): 610-623.
10.	Su L, Fu J, Sun S, et al. Effects of HIIT and MICT on cardiovascular risk factors in adults with overweight and/or obesity: a meta-analysis. PloS One, 2019, 14(1): e0210644.
11.	Khalafi M, Symonds ME. The impact of high-intensity interval training on inflammatory markers in metabolic disorders: a meta-analysis. Scand J Med Sci Sports, 2020, 30(11): 2020-2036.
12.	Ross LM, Porter RR, Durstine JL. High-intensity interval training (HIIT) for patients with chronic diseases. J Sport Health Sci, 2016, 5(2): 139-144.
13.	Freyssin C, Verkindt C, Prieur F, et al. Cardiac rehabilitation in chronic heart failure: effect of an 8-week, high-intensity interval training versus continuous training. Arch Phys Med Rehabil, 2012, 93(8): 1359-1364.
14.	Rognmo ?, Hetland E, Helgerud J, et al. High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease. Eur J Cardiovasc Prev Rehabil, 2004, 11(3): 216-222.
15.	Guiraud T, Nigam A, Gremeaux V, et al. High-intensity interval training in cardiac rehabilitation. Sports Med, 2012, 42(7): 587-605.
16.	Wisl?ff U, St?ylen A, Loennechen JP, et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation, 2007, 115(24): 3089-3094.
17.	Midgley AW, McNaughton LR, et al. Physiological determinants of time to exhaustion during intermittent treadmill running at vVO_2max. Int J Sports Med, 2007, 28(4): 273-280.
18.	Karstoft K, Winding K, Knudsen SH, et al. The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial. Diabetes Care, 2013, 36(2): 228-236.
19.	Drigny J, Gremeaux V, Guiraud T, et al. Long-term high-intensity interval training associated with lifestyle modifications improves QT dispersion parameters in metabolic syndrome patients. Ann Phys Rehabil Med, 2013, 56(5): 356-370.
20.	Dun Y, Thomas RJ, Smith JR, et al. High-intensity interval training improves metabolic syndrome and body composition in outpatient cardiac rehabilitation patients with myocardial infarction. Cardiovasc Diabetol, 2019, 18(1): 104.
21.	Jo EA, Cho KI, Park JJ, et al. Effects of high-intensity interval training versus moderate-intensity continuous training on epicardial fat thickness and endothelial function in hypertensive metabolic syndrome. Metab Syndr Relat Disord, 2020, 18(2): 96-102.
22.	Nazari M, Minasian V, Hovsepian S. Effects of two types of moderate- and high-intensity interval training on serum salusin-α and salusin-β levels and lipid profile in women with overweight/obesity. Diabetes Metab Syndr Obes, 2020, 13: 1385-1390.
23.	Ramos JS, Dalleck LC, Borrani F, et al. High-intensity interval training and cardiac autonomic control in individuals with metabolic syndrome: a randomised trial. Int J Cardiol, 2017, 245: 245-252.
24.	汪雅靜, 張超, 呂少萍, 等. 高強度間歇運動對 2 型糖尿病患者糖脂代謝指標影響的研究. 中華護理雜志, 2019, 54(11): 1605-1609.
25.	甘慧君. HIIT 與 MCT 對普通男性大學生糖代謝的影響. 北京: 北京體育大學, 2018.
26.	阮凌, 王光華, 吳榮平, 等. 運動強度與高脂飲食模型大鼠脂代謝紊亂和氧化應激的相關性. 中國組織工程研究, 2023, 27(8): 1149-1155.
27.	王倩倩, 王曉航, 邱山虎, 等. 運動對肥胖相關代謝異常的作用. 中國實用內科雜志, 2022, 42(2): 102-106.
28.	高艷敏, 王光明, 楊文禮, 等. 高強度間歇訓練和有氧運動對肥胖青年脂代謝及慢性炎癥的影響. 中國運動醫學雜志, 2017, 36(7): 628-632,650.
29.	Huang JF, Li Y, Shin J, Chia YC, et al. Characteristics and control of the 24‐hour ambulatory blood pressure in patients with metabolic syndrome. J Clin Hypertens (Greenwich), 2021, 23(3): 450-456.
30.	吳壽嶺, 阮春雨, 李冬青, 等. 高血壓前期人群中代謝綜合征發生情況. 中華高血壓雜志, 2010, 18(4): 335-338.
31.	Asgharnezhad M, Joukar F, Naghipour M, et al. Exploratory factor analysis of gender-based metabolic syndrome components: results from the PERSIAN Guilan cohort study (PGCS). Clin Nutr ESPEN, 2020, 40: 252-256.
32.	Clark T, Morey R, Jones MD, et al. High-intensity interval training for reducing blood pressure: a randomized trial vs. moderate-intensity continuous training in males with overweight or obesity. Hypertens Res, 2020, 43(5): 396-403.
33.	Perrier-Melo RJ, Germano-Soares AH, Freitas Brito A, et al. Post-exercise hypotension in response to high-intensity interval exercise: potential mechanisms. Rev Port Cardiol (Engl Ed), 2021, 40(10): 797-799.
34.	史云聰, 王立立, 郭藝芳. 運動、高血壓與認知功能. 中國心血管雜志, 2020, 25(4): 393-396.
35.	劉泉清, 劉敏. 不同運動形式對原發性高血壓的影響研究進展. 中國體育科技, 2021, 57(12): 82-91.
36.	MartinezAguirre-Betolaza A, Mujika I, Fryer SM, et al. Effects of different aerobic exercise programs on cardiac autonomic modulation and hemodynamics in hypertension: data from EXERDIET-HTA randomized trial. J Hum Hypertens, 2020, 34(10): 709-718.
37.	Lacombe SP, Goodman JM, Spragg CM, et al. Interval and continuous exercise elicit equivalent postexercise hypotension in prehypertensive men, despite differences in regulation. Appl Physiol Nutr Metab, 2011, 36(6): 881-891.
38.	Morales-Palomo F, Ramirez-Jimenez M, Ortega JF, et al. Acute hypotension after high-intensity interval exercise in metabolic syndrome patients. Int J Sports Med, 2017, 38(7): 560-567.
39.	Costa EC, Kent DE, Boreskie KF, et al. Acute effect of high-intensity interval versus moderate-intensity continuous exercise on blood pressure and arterial compliance in middle-aged and older hypertensive women with increased arterial stiffness. J Strength Cond Res, 2020, 34(5): 1307-1316.
40.	Miguet M, Fearnbach NS, Metz L, et al. Effect of HIIT versus MICT on body composition and energy intake in dietary restrained and unrestrained adolescents with obesity. Appl Physiol Nutr Metab, 2020, 45(4): 437-445.
41.	孫文新, 秦曼, 李麗麗, 等. 高強度間歇訓練對超重肥胖女大學生減脂效果的 Meta 分析. 中國學校衛生, 2021, 42(10): 1480-1486.
42.	朱琳, 劉景新, 于洋, 等. 高強度間歇訓練對超重和肥胖青少年減脂效應的研究: meta 分析. 廣州體育學院學報, 2020, 40(1): 96-101.
43.	Ramos JS, Dalleck LC, Borrani F, et al. Low-volume high-intensity interval training is sufficient to ameliorate the severity of metabolic syndrome. Metab Syndr Relat Disord, 2017, 15(7): 319-328.
44.	Taylor KL, Weston M, Batterham AM. Evaluating intervention fidelity: an example from a high-intensity interval training study. PloS One, 2015, 10(4): e0125166.
45.	馬桂月, 馬珂珂, 段應龍, 等. 中青年高血壓患者運動干預的研究進展. 中華護理雜志, 2020, 55(2): 304-308.
46.	袁國強, 秦永生, 彭朋. 高強度間歇運動對自發性高血壓模型大鼠病理性心臟肥大的影響及機制. 中國組織工程研究, 2020, 24(23): 3708-3715.
47.	林堅, 趙紅勤, 黃雄昂, 等. 高強度間歇訓練對肥胖女大學生體成分和血脂及空腹胰島素水平的影響. 中國全科醫學, 2016, 19(18): 2139-2144.
48.	楊麗麗. 分類和連續性兒童代謝綜合征定義篩檢早期血管損傷效果評價. 山東大學, 2018.

1. 王芬. 代謝綜合征與 2 型糖尿病病人慢性腎臟病的相關性分析. 安徽醫藥, 2021, 25(3): 508-511.
2. 楊鈺, 劉順, 仇小強, 等. 廣西 35~74 歲壯族居民慢性腎臟病患病及其與代謝綜合征的相關性研究. 廣西醫科大學學報, 2021, 38(3): 599-604.
3. Bitew ZW, Alemu A, Tenaw Z, et al. Prevalence of metabolic syndrome among children and adolescents in high-income countries: a systematic review and meta-analysis of observational studies. BioMed Res Int. (2021-03-27)[2022-07-01]. https://downloads.hindawi.com/journals/bmri/2021/6661457.pdf.
4. 郭海健, 念馨, 梁友芳, 等. 基于多中心橫斷面調查的中國人群代謝綜合征的流行情況及危險因素. 中華疾病控制雜志, 2019, 23(7): 796-801.
5. So R, Matsuo T. The effect of domain-specific sitting time and exercise habits on metabolic syndrome in Japanese workers: a cross-sectional study. Int J Environ Res Public Health, 2020, 17(11): 3883.
6. Colpitts BH, Spencer Smith, Bouchard DR, et al. Are physical activity and sedentary behavior patterns contributing to diabetes and metabolic syndrome simultaneously?. Transl Sports Med. (2020-11-18)[2022-07-01]. https://onlinelibrary.wiley.com/doi/epdf/10.1002/tsm2.216.
7. Vella CA, Taylor K, Drummer D. High-intensity interval and moderate-intensity continuous training elicit similar enjoyment and adherence levels in overweight and obese adults. Eur J Sport Sci, 2017, 17(9): 1203-1211.
8. Mattioni Maturana F, Martus P, Zipfel S, et al. Effectiveness of HIIE versus MICT in improving cardiometabolic risk factors in health and disease: a meta-analysis. Med Sci Sports Exerc, 2021, 53(3): 559-573.
9. Rugbeer N, Constantinou D, Torres G. Comparison of high-intensity training versus moderate-intensity continuous training on cardiorespiratory fitness and body fat percentage in persons with overweight or obesity: a systematic review and meta-analysis of randomized controlled trials. J Phys Act Health, 2021, 18(5): 610-623.
10. Su L, Fu J, Sun S, et al. Effects of HIIT and MICT on cardiovascular risk factors in adults with overweight and/or obesity: a meta-analysis. PloS One, 2019, 14(1): e0210644.
11. Khalafi M, Symonds ME. The impact of high-intensity interval training on inflammatory markers in metabolic disorders: a meta-analysis. Scand J Med Sci Sports, 2020, 30(11): 2020-2036.
12. Ross LM, Porter RR, Durstine JL. High-intensity interval training (HIIT) for patients with chronic diseases. J Sport Health Sci, 2016, 5(2): 139-144.
13. Freyssin C, Verkindt C, Prieur F, et al. Cardiac rehabilitation in chronic heart failure: effect of an 8-week, high-intensity interval training versus continuous training. Arch Phys Med Rehabil, 2012, 93(8): 1359-1364.
14. Rognmo ?, Hetland E, Helgerud J, et al. High intensity aerobic interval exercise is superior to moderate intensity exercise for increasing aerobic capacity in patients with coronary artery disease. Eur J Cardiovasc Prev Rehabil, 2004, 11(3): 216-222.
15. Guiraud T, Nigam A, Gremeaux V, et al. High-intensity interval training in cardiac rehabilitation. Sports Med, 2012, 42(7): 587-605.
16. Wisl?ff U, St?ylen A, Loennechen JP, et al. Superior cardiovascular effect of aerobic interval training versus moderate continuous training in heart failure patients: a randomized study. Circulation, 2007, 115(24): 3089-3094.
17. Midgley AW, McNaughton LR, et al. Physiological determinants of time to exhaustion during intermittent treadmill running at vVO_2max. Int J Sports Med, 2007, 28(4): 273-280.
18. Karstoft K, Winding K, Knudsen SH, et al. The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial. Diabetes Care, 2013, 36(2): 228-236.
19. Drigny J, Gremeaux V, Guiraud T, et al. Long-term high-intensity interval training associated with lifestyle modifications improves QT dispersion parameters in metabolic syndrome patients. Ann Phys Rehabil Med, 2013, 56(5): 356-370.
20. Dun Y, Thomas RJ, Smith JR, et al. High-intensity interval training improves metabolic syndrome and body composition in outpatient cardiac rehabilitation patients with myocardial infarction. Cardiovasc Diabetol, 2019, 18(1): 104.
21. Jo EA, Cho KI, Park JJ, et al. Effects of high-intensity interval training versus moderate-intensity continuous training on epicardial fat thickness and endothelial function in hypertensive metabolic syndrome. Metab Syndr Relat Disord, 2020, 18(2): 96-102.
22. Nazari M, Minasian V, Hovsepian S. Effects of two types of moderate- and high-intensity interval training on serum salusin-α and salusin-β levels and lipid profile in women with overweight/obesity. Diabetes Metab Syndr Obes, 2020, 13: 1385-1390.
23. Ramos JS, Dalleck LC, Borrani F, et al. High-intensity interval training and cardiac autonomic control in individuals with metabolic syndrome: a randomised trial. Int J Cardiol, 2017, 245: 245-252.
24. 汪雅靜, 張超, 呂少萍, 等. 高強度間歇運動對 2 型糖尿病患者糖脂代謝指標影響的研究. 中華護理雜志, 2019, 54(11): 1605-1609.
25. 甘慧君. HIIT 與 MCT 對普通男性大學生糖代謝的影響. 北京: 北京體育大學, 2018.
26. 阮凌, 王光華, 吳榮平, 等. 運動強度與高脂飲食模型大鼠脂代謝紊亂和氧化應激的相關性. 中國組織工程研究, 2023, 27(8): 1149-1155.
27. 王倩倩, 王曉航, 邱山虎, 等. 運動對肥胖相關代謝異常的作用. 中國實用內科雜志, 2022, 42(2): 102-106.
28. 高艷敏, 王光明, 楊文禮, 等. 高強度間歇訓練和有氧運動對肥胖青年脂代謝及慢性炎癥的影響. 中國運動醫學雜志, 2017, 36(7): 628-632,650.
29. Huang JF, Li Y, Shin J, Chia YC, et al. Characteristics and control of the 24‐hour ambulatory blood pressure in patients with metabolic syndrome. J Clin Hypertens (Greenwich), 2021, 23(3): 450-456.
30. 吳壽嶺, 阮春雨, 李冬青, 等. 高血壓前期人群中代謝綜合征發生情況. 中華高血壓雜志, 2010, 18(4): 335-338.
31. Asgharnezhad M, Joukar F, Naghipour M, et al. Exploratory factor analysis of gender-based metabolic syndrome components: results from the PERSIAN Guilan cohort study (PGCS). Clin Nutr ESPEN, 2020, 40: 252-256.
32. Clark T, Morey R, Jones MD, et al. High-intensity interval training for reducing blood pressure: a randomized trial vs. moderate-intensity continuous training in males with overweight or obesity. Hypertens Res, 2020, 43(5): 396-403.
33. Perrier-Melo RJ, Germano-Soares AH, Freitas Brito A, et al. Post-exercise hypotension in response to high-intensity interval exercise: potential mechanisms. Rev Port Cardiol (Engl Ed), 2021, 40(10): 797-799.
34. 史云聰, 王立立, 郭藝芳. 運動、高血壓與認知功能. 中國心血管雜志, 2020, 25(4): 393-396.
35. 劉泉清, 劉敏. 不同運動形式對原發性高血壓的影響研究進展. 中國體育科技, 2021, 57(12): 82-91.
36. MartinezAguirre-Betolaza A, Mujika I, Fryer SM, et al. Effects of different aerobic exercise programs on cardiac autonomic modulation and hemodynamics in hypertension: data from EXERDIET-HTA randomized trial. J Hum Hypertens, 2020, 34(10): 709-718.
37. Lacombe SP, Goodman JM, Spragg CM, et al. Interval and continuous exercise elicit equivalent postexercise hypotension in prehypertensive men, despite differences in regulation. Appl Physiol Nutr Metab, 2011, 36(6): 881-891.
38. Morales-Palomo F, Ramirez-Jimenez M, Ortega JF, et al. Acute hypotension after high-intensity interval exercise in metabolic syndrome patients. Int J Sports Med, 2017, 38(7): 560-567.
39. Costa EC, Kent DE, Boreskie KF, et al. Acute effect of high-intensity interval versus moderate-intensity continuous exercise on blood pressure and arterial compliance in middle-aged and older hypertensive women with increased arterial stiffness. J Strength Cond Res, 2020, 34(5): 1307-1316.
40. Miguet M, Fearnbach NS, Metz L, et al. Effect of HIIT versus MICT on body composition and energy intake in dietary restrained and unrestrained adolescents with obesity. Appl Physiol Nutr Metab, 2020, 45(4): 437-445.
41. 孫文新, 秦曼, 李麗麗, 等. 高強度間歇訓練對超重肥胖女大學生減脂效果的 Meta 分析. 中國學校衛生, 2021, 42(10): 1480-1486.
42. 朱琳, 劉景新, 于洋, 等. 高強度間歇訓練對超重和肥胖青少年減脂效應的研究: meta 分析. 廣州體育學院學報, 2020, 40(1): 96-101.
43. Ramos JS, Dalleck LC, Borrani F, et al. Low-volume high-intensity interval training is sufficient to ameliorate the severity of metabolic syndrome. Metab Syndr Relat Disord, 2017, 15(7): 319-328.
44. Taylor KL, Weston M, Batterham AM. Evaluating intervention fidelity: an example from a high-intensity interval training study. PloS One, 2015, 10(4): e0125166.
45. 馬桂月, 馬珂珂, 段應龍, 等. 中青年高血壓患者運動干預的研究進展. 中華護理雜志, 2020, 55(2): 304-308.
46. 袁國強, 秦永生, 彭朋. 高強度間歇運動對自發性高血壓模型大鼠病理性心臟肥大的影響及機制. 中國組織工程研究, 2020, 24(23): 3708-3715.
47. 林堅, 趙紅勤, 黃雄昂, 等. 高強度間歇訓練對肥胖女大學生體成分和血脂及空腹胰島素水平的影響. 中國全科醫學, 2016, 19(18): 2139-2144.
48. 楊麗麗. 分類和連續性兒童代謝綜合征定義篩檢早期血管損傷效果評價. 山東大學, 2018.

West China Medical Journal

A meta-analysis of the comparison of intervention effects of high-intensity interval training and moderate-intensity continuous training on patients with metabolic syndrome

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