Iranian Journal of Diabetes and Lipid Disorders
مجله دیابت و متابولیسم ایران
ijdld
Medical Sciences
http://ijdld.tums.ac.ir
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admin
2345-4008
2345-4016
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fa
jalali
1401
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gregorian
2023
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online
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fulltext
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اثر تمرینهای ورزشی بر آنزیمهای کبدی و محتوی چربی کبد در بزرگسالان مبتلا به کبد چرب غیرالکلی: مرور نظاممند فراتحلیل
The impact of exercise training on liver enzymes and liver fat content in adults with NAFLD: A systematic review and meta-analysis
تخصصي
Special
مروري
Review
<span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:107%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Calibri",sans-serif"><b><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">مقدمه: </span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">بیماری کبد چرب غیرالکلی (</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">NAFLD</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">) یک سندرم پاتولوژیک است که با افزایش سطوح سرمی آنزیم</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"Cambria",serif"><span style="color:black"></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">های کبدی همراه است. هدف مطالعهی حاضر بررسی اثر تمرینهای ورزشی بر آنزیم</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"Cambria",serif"><span style="color:black"></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">های کبدی (</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">ALT</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">، </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">AST</span></span></span><span style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black"> و </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">GGT</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">) و محتوی چربی کبد در بزرگسالان مبتلا به </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">NAFLD</span></span></span><span style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black"> بود.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:107%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Calibri",sans-serif"><b><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">روشها:</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black"> جستجوی سیستماتیک در پایگاه</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"Cambria",serif"><span style="color:black"></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">های اطلاعاتی </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">PubMed</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">، </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">Web of Science</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">، </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">SID</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">، </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">Magiran</span></span></span><span style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black"> و </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">Google scholar</span></span></span><span style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black"> برای مقالات انگلیسی و فارسی منتشر شده تا فوریه سال 2022 انجام شد. فراتحلیل برای مقایسه تاثیر تمرین ورزشی بر عملکرد کبد در بیماران مبتلا به کبد چرب غیرالکلی انجام شد. اندازه اثر (</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">SMD</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">) و فاصله اطمینان 95 درصد (</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">95% CI</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">) با استفاده از مدل اثر تصادفی و مدل اثر ثابت محاسبه شد. همچنین، برای تعیین ناهمگونی از آزمون </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">I2</span></span></span><span style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black"> و برای بررسی سوگیری انتشار از آزمون فونل پلات و تست </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">Egger</span></span></span><span style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black"> در سطح معنی</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"Cambria",serif"><span style="color:black"></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">داری 1/0 استفاده شد.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:107%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Calibri",sans-serif"><b><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">یافتهها: </span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">نتایج 36 مطالعه با 1602 بیمار مبتلا به </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">NAFLD</span></span></span><span style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black"> نشان داد که تمرین ورزشی سبب کاهش معنادار آنزیم </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">ALT ] 001/0P=</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">، </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">(95/0- </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">الی 51/0-) 73/0-=</span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">SMD] </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">، آنزیم </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">AST ]001/0p=</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">، </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">(83/0- </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">الی 39/0-95% </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">CI=) 61/0-=SMD] </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">، آنزیم </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">GGT ]007/0 p=</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">، </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">(14/1- </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">الی 18/0-95% </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">CI=) 66/0-= [SMD</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">و چربی داخل کبدی ]001/0 </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">p=</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">، </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">(38/0- </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">الی 78/0-95% </span></span></span><span dir="LTR" style="font-size:10.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">CI=) 58/0-=SMD] </span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">میشود.</span></span></span><b><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black"></span></span></span></b></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="line-height:107%"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Calibri",sans-serif"><b><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">نتیجهگیری</span></span></span></b><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">: یافته</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"Cambria",serif"><span style="color:black"></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">های فراتحلیل حاضر نقش مهم تمرین ورزشی (تمرین هوازی، مقاومتی و ترکیبی) در بهبود عملکرد کبد را نشان میدهد. بهطوریکه، هر سه نوع تمرین هوازی، مقاومتی و ترکیبی بهعنوان یک راهکار غیردارویی برای کاهش آنزیم</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"Cambria",serif"><span style="color:black"></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">های کبدی و چربی داخل کبدی برای بزرگسالان مبتلا به کبد چرب غیر الکلی پیشنهاد می</span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"Cambria",serif"><span style="color:black"></span></span></span><span lang="FA" style="font-size:12.0pt"><span style="font-family:"B Lotus""><span style="color:black">شود.</span></span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="text-autospace:none"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:"Calibri",sans-serif"><b><span style="font-family:"Times New Roman",serif">Background: </span></b><span style="font-family:"Times New Roman",serif">Non-alcoholic fatty liver disease (NAFLD) is a pathological syndrome associated with increased serum levels of liver enzymes. The purpose of this study was to investigate the impact of exercise training on liver enzymes (ALT, AST, and GGT) and liver fat content in adults with NAFLD.</span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="text-autospace:none"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:"Calibri",sans-serif"><b><span style="font-family:"Times New Roman",serif">Methods: </span></b><span style="font-family:"Times New Roman",serif">The PubMed, Web of Science, SID, Magiran, and Google scholar databases were searched until February 2022 for English and Persian articles. Meta-analyses were performed to compare the impact of exercise training on liver function in patients with fatty liver. SMD and 95% confidence interval (95% CI) were calculated using effect models. Also, the I2 test was used to determine heterogeneity, and the Funnel plot and Egger tests at a significant level of 0.1 were used to determine publication bias.</span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="text-autospace:none"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:"Calibri",sans-serif"><b><span style="font-family:"Times New Roman",serif"><span style="color:black">Results:</span></span></b><span style="font-family:"Times New Roman",serif"><span style="color:black"> The results of meta-analysis of 36 studies with 1602 patient with NAFLD, showed that exercise training caused a significant decrease in ALT enzyme </span></span><span style="font-family:"Times New Roman",serif"><span style="color:black">[</span></span><span style="font-family:"Times New Roman",serif"><span style="color:black">SMD=-0.73, (95% CI: -0.51 to -0.95), <i>p</i>=0.001], AST enzyme </span></span><span style="font-family:"Times New Roman",serif"><span style="color:black">[</span></span><span style="font-family:"Times New Roman",serif"><span style="color:black">SMD=-0.61, (95% CI: -0.39 to -0.83), <i>p</i>=0.001], GTT enzyme </span></span><span style="font-family:"Times New Roman",serif"><span style="color:black">[</span></span><span style="font-family:"Times New Roman",serif"><span style="color:black">SMD=-0.66, (95% CI: -0.18 to -1.14), <i>p</i> =0.007], and intrahepatic fat </span></span><span style="font-family:"Times New Roman",serif"><span style="color:black">[</span></span><span style="font-family:"Times New Roman",serif"><span style="color:black">SMD=-0.58, (95% CI: -0.78 to -0.38), <i>p</i>=0.001].</span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="text-autospace:none"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:"Calibri",sans-serif"><b><span style="font-family:"Times New Roman",serif"><span style="color:black">Conclusion:</span></span></b><span style="font-family:"Times New Roman",serif"><span style="color:black"> The findings of the present meta-analysis show the important role of exercise training (aerobic, resistance, and combined training) in improving liver function. So, all three types of aerobic, resistance, and combined exercise are suggested as a non-drug approach to reduce liver enzymes and intrahepatic fat for adults with NAFLD.</span></span></span></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="text-justify:inter-ideograph"><span style="unicode-bidi:embed"><span style="line-height:107%"><span style="font-family:"Calibri",sans-serif"><b><span style="font-family:"Times New Roman",serif"><span style="color:black"></span></span></b></span></span></span></span></span>
تمرین ورزشی, آلانین آمینوترانسفراز, گاما-گلوتامیل ترانسفراز, آسپارتات آمینوترانسفراز, بیماری کبد چرب غیرالکلی
Exercise, Alanine aminotransferase, Gamma-glutamyl transferase, Aspartate aminotransaminase, Non-alcoholic fatty liver disease
342
360
http://ijdld.tums.ac.ir/browse.php?a_code=A-10-1864-1&slc_lang=fa&sid=1
Fatemeh
Kazeminasab
فاطمه
کاظمی نسب
f_kazemi85@yahoo.com