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Biomedical subjects

Kristi S Kelley

Publications and source records attributed to Kristi S Kelley.

12 recordsLinked to original sources

Aerobic exercise and lipids and lipoproteins in children and adolescents: a meta-analysis of randomized controlled trials.

OBJECTIVE: Use the meta-analytic approach to examine the effects of aerobic exercise on total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) in children and adolescents. STUDY DESIGN: Randomized controlled trials which were limited to aerobic exercise >or=4 weeks in children and adolescents 5-19 years of age. RESULTS: Twelve outcomes representing 389 subjects were available for pooling. Using random-effects modeling, a trend for statistically significant decreases of 12% was found for TG (X +/-S.E.M., -11.0+/-6.1mg/dl; 95% CI, -22.8-0.8 mg/dl) with no statistically significant changes for TC, HDL-C, and LDL-C. Decreases in LDL-C were associated with increased training intensity (r=-0.89; 99% CI, -0.99 to -0.04) and older age (r=-0.90; 99% CI, -0.99 to -0.25) while increases in HDL-C were associated with lower initial HDL-C (r=-0.75; 99% CI, -0.94 to -0.80). Statistically significant decreases in TG were observed in overweight/obese subjects with a trend for increases in HDL-C (TG, X +/-S.E.M., -23.9+/-7.0mg/dl; 95% CI, -37.6 to -10.1mg/dl; HDL-C, X +/-S.E.M., 4.0+/-2.3mg/dl; 95% CI, -0.5-8.5mg/dl). CONCLUSIONS: Aerobic exercise decreases TG in overweight/obese children and adolescents.

Adolescent↗

Exercise and bone mineral density at the femoral neck in postmenopausal women: a meta-analysis of controlled clinical trials with individual patient data.

OBJECTIVE: We conducted a meta-analysis using individual patient data to examine the efficacy of exercise for improving bone mineral density at the femoral neck in postmenopausal women. STUDY DESIGN: Ten controlled clinical trials that included 595 subjects (aged 42-92 years) met our criteria for inclusion. Changes in femoral neck bone mineral density were examined by 2-way analysis of variance tests with repeated measures on 1 factor. RESULTS: Across all designs and categories, there was an increase in bone mineral density of 0.73% +/- 5.52% and 0.45% +/- 6.78%, respectively, in the exercise and control subjects. However, comparison of initial and final bone mineral density values between exercise and control subjects revealed no statistically significant effect of exercise on femoral neck bone mineral density (P > .05). CONCLUSION: Collectively, the exercise protocols that were used in this individual patient data meta-analysis do not improve femoral neck bone mineral density in postmenopausal women.

Aged↗

Effects of aerobic exercise on C-reactive protein, body composition, and maximum oxygen consumption in adults: a meta-analysis of randomized controlled trials.

The aim of the study was to use the meta-analytic approach to examine the effects of aerobic exercise on C-reactive protein (CRP) in adults. Secondary outcomes included changes in body weight in kilograms, percentage of body fat, and maximum oxygen consumption (VO2max) in mL kg(-1) min(-1). Studies were retrieved using computerized literature searches, cross-referencing, and hand searching. Inclusion criteria were assessment of CRP in randomized controlled trials published in the English language between January 1, 1990, and January 1, 2006. Studies were also limited to aerobic exercise interventions lasting 4 weeks or more in adults 18 years or older. Five studies representing 323 male and female subjects (171 exercise, 152 control) and 6 outcomes for CRP were available for pooling. A nonsignificant reduction of approximately 3% was observed for CRP in the exercise groups (mean +/- SEM, -0.11 +/- 0.14 mg/L; 95% confidence interval [CI], -0.39 to 0.17 mg/L) using a random-effects model. Statistically significant reductions of approximately 4% were found for body weight (mean +/- SEM, -3.4 +/- 1.0 kg; 95% CI, -5.3 to -1.5 kg) and percentage of body fat (mean +/- SEM, -1.4% +/- 0.4%; 95% CI, -2.3% to -0.6%), whereas a statistically significant increase of 12% was found for VO2max (mean +/- SEM, 3.3 +/- 0.9 mL kg(-1) min(-1); 95% CI, 1.5 to 5.1 mL kg(-1) min(-1)). The results of our study suggest that aerobic exercise does not reduce CRP levels in adults, but does improve measures of body composition and physical fitness.

Adult↗

Exercise, lipids, and lipoproteins in older adults: a meta-analysis.

The authors used the meta-analytic approach to examine the effects of aerobic exercise on lipids and lipoproteins in adults 50 years of age and older. Twenty-eight outcomes representing 1427 subjects (806 exercise, 621 control) were available for pooling. Random-effects modeling yielded statistically significant improvements of 1.1%, 5.6%, 2.5%, and 7.1%, respectively, for total cholesterol (mean +/- SEM in mg/dL, -3.3+/-1.7; 95% confidence interval [CI], -6.5 to -0.02; p=0.05), high-density lipoprotein cholesterol (2.5+/-1.0; 95% CI, 0.7-4.4; p=0.01), low-density lipoprotein cholesterol (-3.9+/-1.9; 95% CI, -7.7 to -0.08; p=0.05), ratio of total cholesterol to high-density lipoprotein cholesterol (-0.8+/-0.2; 95% CI, -1.2 to -0.4; p<0.001), but not triglycerides (-7.0+/-3.6; 95% CI, -14.0 to 0.1; p=0.06). After conducting sensitivity analyses, only the improvements in high-density lipoprotein cholesterol and the ratio of total cholesterol to high-density lipoprotein cholesterol remained statistically significant (p<0.05 for both). It was concluded that aerobic exercise increases high-density lipoprotein cholesterol and decreases the ratio of total cholesterol to high-density lipoprotein cholesterol in older adults.

Cholesterol, HDL↗

Walking and Non-HDL-C in adults: a meta-analysis of randomized controlled trials.

An elevated level of non-high-density lipoprotein cholesterol (non-HDL-C) is a major risk factor for cardiovascular disease. The purpose of this study was to use the meta-analytic approach to examine the effects of walking on non-HDL-C in adults. Twenty-two randomized controlled trials representing 30 outcomes from 948 subjects (573 exercise, 375 control) met our inclusion criteria. Across all designs and categories, random effects modeling resulted in a significantly greater decrease in the walking group when compared with the control group of approximately 4% for non-HDL-C (+/- standard error of the mean, -5.6+/-1.8 mg/dL, 95% confidence interval, -8.8 to -2.4 mg/dL). Meta-regression showed a statistically significant association between changes in non-HDL-C and the year of publication, with greater reductions associated with more recent publication year (R2 = 0.23, p = 0.005). The results of this meta-analytic review suggest that walking reduces non-HDL-C in adult humans.

Adult↗

Walking, lipids, and lipoproteins: a meta-analysis of randomized controlled trials.

BACKGROUND: The purpose of this study was to use the meta-analytic approach to examine the effects of walking on lipids and lipoproteins in adults. METHODS: Randomized controlled trials that examined the effects of walking on total cholesterol (TC), high- and low-density lipoprotein cholesterol (HDL-C and LDL-C), the ratio of TC/HDL, and triglycerides (TG) in adults ages 18 years and older were retrieved via computerized literature searches, cross-referencing, hand-searching, and expert review of our reference list. RESULTS: Twenty-five studies that included 1,176 subjects (692 walkers, 484 controls) and up to 33 outcomes were available for pooling. Using random-effects modeling, statistically significant, walking-induced decreases of 5% and 6% were observed for LDL-C and TC/HDL-C (LDL-C, mean +/- SE, -5.5 +/- 2.2 mg/dL, 95% CI, -9.9 to -1.2 mg/dL; TC/HDL-C, mean +/- SE, -0.3 +/- 0.1, 95% CI, -0.6 to -0.1). No statistically significant changes were observed for TC, HDL, or TG (P > 0.05), although changes were in the direction of benefit. No statistically significant changes occurred in body composition (P > 0.05). CONCLUSIONS: Walking reduces LDL-C and TC/HDL-C in adults independent of changes in body composition.

Adult↗

Retrieval of missing data for meta-analysis: a practical example.

OBJECTIVES: To examine the feasibility of retrieving missing outcome data for summary meta-analyses using an example dealing with the effects of aerobic exercise on lipids and lipoproteins in adults. METHODS: Missing lipid and/or lipoprotein data from a currently developed meta-analytic data base were requested by means of electronic mail from 39 of 174 (22.4 percent) eligible studies. Binary logistic regression was used to examine whether year of publication and country were significant predictors for whether data would be provided. RESULTS: Of the thirty-nine studies from which data were requested, usable data were received for thirteen (33.3 percent) of the studies. The addition of these previously missing data decreased the percentage of eligible studies that would have had to be excluded by 33.5 percent (from 22.4 percent to 14.9 percent). Neither year of publication nor country in which the study was conducted (United States versus other) were significant predictors of whether missing data would be provided or not (p > .05). CONCLUSIONS: Moderate success was achieved in the acquisition of missing outcome data dealing with the effects of aerobic exercise on lipids and lipoproteins in adults. However, whether this level of response is true in other areas of research needs to be determined by additional research.

Clinical Trials as Topic↗

Efficacy of resistance exercise on lumbar spine and femoral neck bone mineral density in premenopausal women: a meta-analysis of individual patient data.

BACKGROUND: Osteoporosis and osteopenia are major public health problems. The purpose of this study was to conduct an individual patient data (IPD) meta-analysis to examine the efficacy of resistance exercise on lumbar spine and femoral neck bone mineral density (BMD) in premenopausal women. METHODS: Studies were retrieved via (1). computerized literature searches, (2). review of reference lists from previous studies, (3). hand searching selected journals, and (4). expert review of the reference list. Two x two analysis of covariance (ANCOVA) tests with repeated measures on one factor (time) and study as a covariate were used to analyze changes in BMD. RESULTS: One hundred forty-three subjects (74 exercise, 69 control) were included in the analysis. Changes in lumbar spine BMD averaged 0.006 +/- 0.035 g/cm(2) (0.64 +/- 2.99%) in the exercise group and 0.008 +/- 0.091 g/cm(2) (0.74 +/- 7.58%) in the control group, and changes in femoral neck BMD averaged 0.005 +/- 0.031 g/cm(2) (0.46 +/- 3.10%) in the exercise group and 0.003 +/- 0.031 g/cm(2) (0.31 +/- 2.97%) in the control group. No statistically significant differences in lumbar spine or femoral neck BMD were found within or between the exercise and control groups (p > 0.05). CONCLUSIONS: Based on existing evidence, our results do not support the efficacy of resistance exercise for increasing or maintaining lumbar spine and femoral neck BMD in premenopausal women.

Adult↗

Aerobic exercise and lipids and lipoproteins in women: a meta-analysis of randomized controlled trials.

BACKGROUND: Cardiovascular disease (CVD) in women is the leading cause of mortality in the United States, and less than optimal lipid and lipoprotein levels are major risk factors for CVD. The purpose of this study was to use the meta-analytic approach to examine the effects of aerobic exercise on lipids and lipoproteins in women. METHODS: Studies were retrieved via computerized literature searches, review of reference lists, hand searching selected journals, and expert review of our reference list. The inclusion of studies was limited to randomized controlled trials published in the English language literature between January 1955 and January 2003 in which aerobic exercise was used as the primary intervention in adult women aged > or =18 years. One or more of the following lipids and lipoproteins were assessed: total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG). RESULTS: Using a random effects model, statistically significant improvements were observed for all lipids and lipoproteins (TC, +/- SEM, -4.3 +/- 1.3 mg/dl, 95% CI -6.9 to -1.7 mg/dl; HDL-C, +/- SEM, 1.8 +/- 0.9 mg/dl, 95% CI 0.1 to 3.5 mg/dl; LDL-C, +/- SEM, -4.4 +/- 1.1 mg/dl, 95% CI -6.5 to -2.2 mg/dl; TG, +/- SEM, -4.2 +/- 2.1 mg/dl, 95% CI -8.4 to -0.1 mg/dl). Reductions of approximately 2%, 3%, and 5%, respectively, were observed for TC, LDL-C, and TG, whereas an increase of 3% was observed for HDL-C. CONCLUSIONS: Aerobic exercise is efficacious for increasing HDL-C and decreasing TC, LDL-C, and TG in women.

Cardiovascular Diseases↗

The effects of exercise on resting blood pressure in children and adolescents: a meta-analysis of randomized controlled trials.

Resting blood pressure in children and adolescents can track into adulthood. The purpose of this study was to use the meta-analytic approach to examine the effects of exercise on resting systolic and diastolic blood pressure in children and adolescents. Twelve randomized, controlled trials representing 16 outcomes in 1,266 subjects met the inclusion criteria. Reductions in blood pressure were approximately 1% and 3% for resting systolic and diastolic blood pressures, respectively. However, random-effects modeling using 5000 bootstrap confidence intervals revealed that neither result was statistically significant (systolic, x-bar (x);+/-SEM=-1+/-2; 95% bootstrap confidence intervals=-2 to 0 mm Hg; diastolic, x+/-SEM=-2+/-1; 95% bootstrap confidence intervals=-3 to 0 mm Hg). The results of this study suggest that short-term exercise does not appear to reduce resting systolic and diastolic blood pressure in children and adolescents. However, a need exists for additional studies, especially in hypertensive children and adolescents.

Adolescent↗

Exercise and lumbar spine bone mineral density in postmenopausal women: a meta-analysis of individual patient data.

BACKGROUND: Low bone mineral density (BMD) at the lumbar spine is a major public health problem among postmenopausal women. We conducted a meta-analysis of individual patient data (IPD) to examine the effects of exercise on lumbar spine BMD in postmenopausal women. METHODS: IPD were requested from a previously developed database of summary means from randomized and nonrandomized trials dealing with the effects of exercise on BMD. Two-way analysis of variance tests with pairwise comparisons (p < or =.05) and 95% confidence intervals (CIs) were used to determine the statistical significance for changes in lumbar spine BMD. RESULTS: Across 13 trials that included 699 subjects (355 exercise, 344 control), a statistically significant interaction was found between test and group (F = 15.232, p =.000). Pairwise comparisons (Bonferroni t tests) revealed a statistically significant increase in final minus initial BMD for the exercise group ( +/- SD = 0.005 +/- 0.043 g/cm(2), t = 2.46, p =.014, 95% CI = 0.001-0.009) and a statistically significant decrease in final minus initial BMD for the control group ( +/- SD = -0.007 +/- 0.045 g/cm(2), t = -3.051, p =.002, 95% CI = -0.012--0.002). Changes were equivalent to an approximate 2% benefit in lumbar spine BMD (exercise, +1%, control, -1%). CONCLUSIONS: The results of this IPD meta-analysis suggest that exercise helps to improve and maintain lumbar spine BMD in postmenopausal women.

Bone Density↗

Aerobic exercise and lipids and lipoproteins in patients with cardiovascular disease: a meta-analysis of randomized controlled trials.

PURPOSE: Use the meta-analytic approach to examine the effects of aerobic exercise on lipids and lipoproteins in adults with cardiovascular disease (CVD). METHODS: Studies were retrieved via electronic databases, review of reference lists from retrieved articles, including reviews, and hand searching. Inclusion criteria were: (1) randomized controlled trials, (2) aerobic exercise >or=4 weeks as an intervention, (3) studies published in English language only between January 1, 1955 and January 1, 2005, (4) studies published in journals or as dissertations or master's theses, (5) human subjects >or=18 years, (6) all subjects diagnosed with some type of CVD, and (7) pre and post data available for total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and/or triglycerides (TG). Random-effects models were used for data analysis. RESULTS: Of the more than 3,000 studies reviewed, a total of 10 representing 1,260 subjects (580 exercise, 680 control) were included in our analysis. There was a statistically significant increase of 9% in HDL-C (mean +/- SEM, 3.7 +/- 1.3 mg/dL; 95% CI, 1.2 to 6.1 mg/dL) and a statistically significant decrease of 11% in TG (-19.3 +/- 5.4 mg/dL; 95% CI, -30.1 to -8.5 mg/dL), but no statistically significant decreases in TC or LDL-C (TC, -8.8 +/- 6.8 mg/dL; 95% CI, -22.3 to 4.7 mg/dL; LDL-C, -7.7 +/- 6.0 mg/dL; 95% CI, -19.5 to 4.2 mg/dL). CONCLUSIONS: The present findings suggest that chronic aerobic exercise increases HDL-C and decreases TG in adults, especially men, with CVD.

Biomarkers↗