Effects of different mind-body exercises on glucose and lipid metabolism in patients with type 2 diabetes: A network meta-analysis.

BACKGROUND: This study aims to compare the relative effectiveness of different forms of mind-body exercise in improving glycolipid metabolism in patients with T2DM using a network meta-analysis. METHODS: The relevant literature was systematically searched in Cochrane Library, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang database and VIP Chinese Science. A network meta-analysis was conducted using a random-effects model within a frequentist framework. RESULTS: A total of 52 studies with 6 modalities of mind-body exercise involving 4024 patients were included. Compared with controls, all exercise modalities except Yijinjing significantly improved patients' fasting blood glucose (MDs ranged from -0.72(95% CI: -1.20,-0.25) in dance to -2.06(95% CI: -2.59,-1.54) in yoga), glycated hemoglobin (MDs ranged from -0.62 (95% CI: -0.96) in taijiquan to -0.27,-0.27) in Pilates to -1.18(95% CI: 1.80,-0.57)), total cholesterol (MDs ranged from -0.73(95% CI: -1.29,-0.17) in Pilates to -0.41(95% CI: -0.62,-0.19) in Tai Chi), triglycerides (MDs ranged from -0.56 in Pilates (95% CI: -1.07,-0.04) for Pilates to -0.38 (95% CI: -0.67,-0.10)) for dance; only Tai Chi Chuan (MD:0.12 95% CI:0.04,0.20) and Baduanjin (MD:0.14 95% CI:0.06,0.22) significantly increased high-density lipoprotein cholesterol levels in patients; only yoga(MD: 0.78 95%CI: 1.20,-0.37) and Tai Chi Chuan(MD: 0.32 95%CI: 0.60,-0.04) significantly decreased high-density lipoprotein cholesterol levels in patients. CONCLUSION: All mind-body exercises help to improve blood glucose and lipid levels in T2DM patients, but the ranking of relative effectiveness needs to be rationalized. Our study suggests that T2DM patients should choose appropriate mind-body exercises according to their conditions and stick to them for a long time under their healthcare professionals' guidance to achieve effective diabetes control.

[Effects of 12-week Tai Chi exercise on the microvascular reactivity of the middle-aged and elderly patients with mild hypertension and its mechanism].

Objective: To study the effects of 12-week Taijiquan exercise on the microvascular reactivity of middle-aged and elderly patients with mild hypertension and to explore the mechanisms of microvascular reactivity. Methods: Thirty patients with mild hypertension were divided into exercise group (53.8±6.3 years old) and control group (52.6±7.5 years old). The number and gender ratio of the two groups were the same. The exercise group performed Tai Chi exercise for 12 weeks, and the control group maintained the original lifestyle and did not do other regular sports. The two groups of subjects were tested for microvascular reactivity, blood pressure, serum nitric oxide content, and nitric oxide synthase activity before exercise intervention, 6th week and 12th week, respectively. Results: There was no significant difference in the basic values of each index between the two groups of subjects before the test (P＞ 0.05). In the 6th week, the microvascular reactivity (blood flow increase rate), systolic blood pressure, diastolic blood pressure, nitric oxide content, nitric oxide synthase activity of the exercise group did not significantly change from the basic value (P＞0.05). At the 12th week, the microvascular reactivity, nitric oxide content, c nitric oxide synthase activity were significantly higher than those of the base values and the control group (P＜0.05), but the systolic blood pressure and diastolic blood pressure were significantly lower than those of the base values and control group (P＜0.05). In the control group, there were no significant changes in the 6th and 12th week values of each index from the basic value (P＞0.05). Conclusion: Twelve weeks of Taijiquan exercise can improve the microvascular reactivity of middle-aged hypertensive patients, reduce blood pressure, and increase the nitric oxide content and c nitric oxide synthase of patients. The increase of endogenous nitric oxide production is one of the biological mechanisms of Tai Chi exercise to improve the microvascular responsiveness of hypertension patients.

A Meta-Analysis of the Effects of Tai Chi on Glucose and Lipid Metabolism in Middle-Aged and Elderly Diabetic Patients: Evidence from Randomized Controlled Trials.

This research review aimed to evaluate the effect of practicing Tai Chi on glucose and lipid metabolism in middle-aged and elderly diabetic patients. Furthermore, it aimed to provide a theoretical basis for the practice of Tai Chi as a way to improve glucose and lipid metabolism in middle-aged and elderly diabetic patients. Therefore, we searched for randomized controlled trials on the practice of Tai Chi in middle-aged and elderly diabetic patients in Chinese- and English-language electronic databases, such as Web of Science, PubMed, the Cochrane Library, EMBASE, Google Scholar, CNKI, Wanfang Database, and Weipu. We collected articles published no later than August 1, 2020. The methodological quality of the included studies was evaluated according to the standards of the Cochrane Collaboration System Evaluation Manual (version 5.1.0). Finally, 14 articles were included, showing an average Physiotherapy Evidence Database scale score of 6.57. The articles were meta-analyzed using Stata 14.0 software, showing that practicing Tai Chi improved middle-aged and elderly diabetic patients' fasting blood glucose (WMD = -0.60, 95% CI [-1.08, -0.12], p=0.015), glycosylated hemoglobin (WMD = -0.87, 95% CI [-1.60, -0.14], p=0.019), total cholesterol (WMD = -0.48, 95% CI [-0.83, -0.14], p=0.006), triglycerides (WMD = -0.21, 95% CI [-0.37, -0.04], p=0.014), and low-density lipoprotein cholesterol level significantly (WMD = -0.32, 95% CI [-0.63,-0.00], p=0.050). Conversely, patients' high-density lipoprotein cholesterol levels (WMD = 0.09, 95% CI [-0.01, 0.17], p=0.136) showed no obvious improvement. In conclusion, practicing Tai Chi in sessions lasting longer than 50 minutes (at least three times per week, for at least 12 weeks) can effectively improve glucose and lipid metabolism in middle-aged and elderly diabetic patients. However, several other factors affect glucose and lipid metabolism; therefore, further high-quality research is needed. Protocol registration number: INPLASY2020120107.