Occupational Medicine Quarterly Journal
فصلنامه علمی تخصصی طب کار
tkj
Medical Sciences
http://tkj.ssu.ac.ir
1
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2251-7189
2251-8274
8
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8888
13
fa
jalali
1405
5
1
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2026
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1
18
2
online
1
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ارزیابی سطوح هموسیستئین و شاخصهای ترکیب بدن متعاقب تمرینات هوازی در بزرگسالان با و بدون بیماری مزمن:
مرور نظاممند و فراتحلیل
Evaluation of Homocysteine Levels and Body Composition Indices Following Aerobic Exercise in Adults with and Without Chronic Disease: A Systematic Review and Meta-Analysis
عمومى
General
مروری
Review Article
<span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><a name="_Hlk184286650"></a></span><span style="font-family:"Times New Roman","serif""><a name="_Hlk184286650"><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">مقدمه:</span></span></b></a><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""> هموسیستئین (</span></span><span dir="LTR" style="font-size:11.0pt">homocysteine :HCY</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">) یکی از عوامل خطر مهم بیماریهای مزمن است که با وضعیت نامطلوب ترکیب بدن ارتباط دارد. تمرینات هوازی میتوانند بهعنوان یک مداخله غیردارویی بر این شاخصها اثرگذار باشند، اما شواهد موجود محدود و متناقض است. هدف این مطالعه، مرور نظاممند و فراتحلیل اثر تمرینات هوازی بر سطوح هموسیستئین و شاخصهای ترکیب بدن در بزرگسالان با و بدون بیماری مزمن بود.</span></span></span></span></span></span><br>
<span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">روشبررسی: </span></span></b><a name="_Hlk149244532"><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">پایگاههای اطلاعاتی </span></span></a><span dir="LTR" style="font-size:11.0pt">PubMed</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">، </span></span><span dir="LTR" style="font-size:11.0pt">Web of Science</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">، </span></span><span dir="LTR" style="font-size:11.0pt">Scopus</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">، </span></span><span dir="LTR" style="font-size:11.0pt">IranDoc</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">، </span></span><span dir="LTR" style="font-size:11.0pt">Magiran</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">، </span></span><span dir="LTR" style="font-size:11.0pt">NoorMags</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""> و </span></span><span dir="LTR" style="font-size:11.0pt">SID</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""> تا تاریخ 29 اسفندماه 1403 (19 مارچ ۲۰۲۵) بهصورت نظاممند جستوجو شدند. برای محاسبه اندازه اثر، تفاوت میانگین وزنی (</span></span><span dir="LTR" style="font-size:11.0pt">SMD</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">)</span></span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">همراه با فاصله اطمینان ۹۵ درصد با استفاده از مدل اثرات تصادفی در نرمافزار </span></span><span dir="LTR" style="font-size:11.0pt">CMA2</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""> مورد تحلیل قرار گرفت. همچنین میزان ناهمگونی با شاخص </span></span><span dir="LTR" style="font-size:11.0pt">I<sup>2</sup></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""> ارزیابی شد و بررسی سوگیری انتشار با آزمونهای فانل پلات و ایگر انجام گرفت.</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span><br>
<span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">نتایج:</span></span></b> <a name="_Hlk171933822"><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">در مجموع </span></span></a><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">22</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""> مطالعه با </span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">609</span></span> <span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">شرکتکننده بزرگسال با و بدون بیماری مزمن مورد فراتحلیل قرار گرفت. نتایج نشان داد که مداخلات تمرینات هوازی با کاهش معنادار </span></span><span dir="LTR" style="font-size:11.0pt">HCY</span> <span dir="LTR" style="font-size:11.0pt">]</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">001</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">/0 </span></span><span dir="LTR" style="font-size:11.0pt">P</span><span dir="LTR" style="font-size:11.0pt">=</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""> ، (246/1- الی 322/0-) </span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">784</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">/0- </span></span><span dir="LTR" style="font-size:11.0pt">=</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""></span></span><span dir="LTR" style="font-size:11.0pt">[</span><span dir="LTR" style="font-size:11.0pt">SMD</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">، </span></span><span dir="LTR" style="font-size:11.0pt">BMI</span> <span dir="LTR" style="font-size:11.0pt">]</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">004</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">/0 </span></span><span dir="LTR" style="font-size:11.0pt">P=</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""> ، (639/0- الی 120/0-) </span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">379</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">/0- </span></span><span dir="LTR" style="font-size:11.0pt">=</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""></span></span><span dir="LTR" style="font-size:11.0pt">[</span><span dir="LTR" style="font-size:11.0pt">SMD</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">، </span></span><span dir="LTR" style="font-size:11.0pt">WHR</span> <span dir="LTR" style="font-size:11.0pt">]</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">002</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">/0 </span></span><span dir="LTR" style="font-size:11.0pt">P</span><span dir="LTR" style="font-size:11.0pt">=</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""> ، (111/1- الی 245/0-) </span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">678</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">/0- </span></span><span dir="LTR" style="font-size:11.0pt">=</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""></span></span><span dir="LTR" style="font-size:11.0pt"> [</span><span dir="LTR" style="font-size:11.0pt">SMD</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">و</span></span> <span dir="LTR" style="font-size:11.0pt">BF</span> <span dir="LTR" style="font-size:11.0pt">]</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">001</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">/0 </span></span><span dir="LTR" style="font-size:11.0pt">P=</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""> ، (271/1- الی 692/0-) </span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">982</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">/0- </span></span><span dir="LTR" style="font-size:11.0pt">=</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""></span></span><span dir="LTR" style="font-size:11.0pt"> [</span><span dir="LTR" style="font-size:11.0pt">SMD</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">نسبت</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""> به گروه شاهد </span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">در بزرگسالان با و بدون بیماری مزمن</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""> همراه است</span></span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">.</span></span></span></span></span></span><br>
<span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">نتیجهگیری:</span></span></b> <span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">تمرینات هوازی در بزرگسالان با و بدون بیماری مزمن، منجر به کاهش </span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">معنادار</span></span><span dir="LTR" style="font-size:11.0pt">HCY</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">، </span></span><span dir="LTR" style="font-size:11.0pt">BMI</span><span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">،</span></span><span dir="LTR" style="font-size:11.0pt">WHR</span><span style="font-size:11.0pt"><span style="font-family:"B Nazanin""> و</span></span> <span dir="LTR" style="font-size:11.0pt">BF</span> <span lang="AR-SA" style="font-size:11.0pt"><span style="font-family:"B Nazanin"">میشود. این یافتهها نشان میدهند که اجرای منظم تمرینات هوازی <strong><span style="font-family:"B Nazanin"">میتواند در بهبود پروفایل متابولیکی</span></strong> افراد مؤثر باشد و نقش مهمی در برنامههای پیشگیری و مدیریت چاقی و بیماریهای مزمن مرتبط ایفا کند.</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span><br>
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<span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span></span>
<span style="font-size:9pt"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:11.0pt">Introduction:</span></b><span style="font-size:11.0pt"> Homocysteine (HCY) is an important risk factor for chronic diseases and is associated with an unfavorable body composition status. Aerobic exercise can serve as a non-pharmacological intervention affecting these indicators; however, the available evidence is limited and inconsistent. The aim of this study was to conduct a systematic review and meta-analysis of the effects of aerobic exercise on HCY levels and body composition indices in adults with and without chronic disease.</span><span dir="RTL" lang="FA" style="font-size:12.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span><br>
<span style="font-size:9pt"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:11.0pt">Materials and Methods:</span></b><b> </b><span style="font-size:11.0pt">The databases PubMed, Web of Science, Scopus, Magiran, IranDoc, NoorMags, and SID were systematically searched up to (19 March 2025). To calculate effect sizes, the standardized mean difference (SMD) with 95% confidence intervals was analyzed using a random-effects model in CMA2 software. Statistical heterogeneity was assessed using the I² index, and publication bias was evaluated using funnel plot analysis and Egger’s test.</span></span></span></span><br>
<span style="font-size:9pt"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:11.0pt">Results:</span></b> <span style="font-size:11.0pt">A total of 22 studies with 609 adult participants, both with and without chronic diseases, were included in the meta-analysis. The results showed that aerobic exercise interventions were associated with a significant reduction in </span><span style="font-size:11.0pt">HCY</span><span style="font-size:11.0pt"> [P=0.001, SMD=-0.784 (95% CI: -1.322 to -0.246)], BMI [P=0.004, SMD=-0.379 (95% CI: -1.120 to -0.639)], WHR [P=0.002, SMD=-0.678 (95% CI: -1.111 to -0.245)] and BF [P=0.001, SMD=-0.982 (95% CI: -1.692 to -0.271)] compared to the control group in adults with and without chronic diseases.</span><span dir="RTL" lang="FA" style="font-size:12.0pt"><span style="font-family:"B Nazanin""></span></span></span></span></span><br>
<span style="font-size:9pt"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span style="font-size:11.0pt">Conclusion: </span></b><span style="font-size:11.0pt">Aerobic training in adults, with or without chronic disease, leads to a significant reduction in </span><span style="font-size:11.0pt">HCY</span><span style="font-size:11.0pt">, BMI, WHR, and BF. These findings suggest that regular aerobic exercise can be effective in improving individuals’ metabolic profile and plays an important role in the prevention and management programs for obesity and related chronic diseases.</span><b><span dir="RTL" lang="FA" style="font-size:12.0pt"><span style="font-family:"B Nazanin""></span></span></b></span></span></span><br>
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<span style="font-size:9pt"><span style="direction:rtl"><span style="unicode-bidi:embed"><span new="" roman="" style="font-family:" times=""><b><span dir="LTR" style="font-size:11.0pt"><span style="color:black"></span></span></b></span></span></span></span><br>
<span style="font-size:9pt"><span new="" roman="" style="font-family:" times=""><b><span lang="FA" dir="RTL" style="font-size:12.0pt"></span></b></span></span>
تمرین هوازی, هموسیستئین, ترکیب بدن, بزرگسال, فراتحلیل
Aerobic exercise, homocysteine, body composition, adults, Meta-Analysis
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93
http://tkj.ssu.ac.ir/browse.php?a_code=A-10-1424-1&slc_lang=fa&sid=1
Omid
Zafarmand
امید
ظفرمند
omidzafarmand2202@gmil.com