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The anti-inflammatory effects of aerobic exercise training in patients with type 2 diabetes: A systematic review and meta-analysis.
Cytokine. 2023 04; 164:156157.C

Abstract

BACKGROUND

Type 2 diabetes mellitus (T2DM) is a low-grade, chronic inflammatory disease, associated with increased cardiovascular risk. The purpose of this systematic review/ meta-analysis was to evaluate the effects of aerobic exercise training (AET) on inflammatory markers in T2DM patients.

METHODS

The literature search was conducted utilizing PubMed, Web of Science, Embase, and the Cochrane Library from their inception up to April 2022. We screened only for randomized controlled trials (RCTs) investigating the effects of AET on C-reactive protein (CRP) and adipokines: adiponectin, resistin, interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-a), along with changes in anthropometric indices and glycemic control in adult T2DM patients. Pooled post-exercise weighted mean differences (WMDs) with 95% Confidence Intervals (CIs) were calculated for all outcomes of interest between exercise-treated patients and controls.

RESULTS

Twenty-six RCTs involving 1239 T2DM patients were retrieved from the databases for meta-analysis. The cumulative results showed that post-AET inflammatory markers were lower in exercise-treated patients compared to controls regarding CRP (mg/L): WMD: -0.91; 95%CIs: -1.43, -0.40; p < 0.001 resistin (mg/ml): (WMD: -2.08; 95%CIs: -3.32, -0.84; p < 0.001); TNF-a (pg/ml): (WMD: -2.70; 95%CIs: -4.26, -1.14; p < 0.001), and IL-6 (pg/ml): (WMD: -1.05; 95%CIs: -1.68, -0.43; p < 0.001). Those effects were accompanied by significant amelioration of fasting glucose (mg/dl) (WMD: -13.02; 95%CIs: -25.39, -0.66; p = 0.04), HbA1c (%) (WMD: -0.51; 95%CIs: -0.73, -0.28, p < 0.001), and fat mass (%) (WMD: -3.14; 95%CI: -4.71, -1.58; p < 0.001). Our meta-analysis demonstrated less-consistent results for adiponectin (μg/ml), (WMD: 1.00; 95%CI: -0.12, 2.12; p = 0.08) and body-mass index (kg/m2) (WMD: -1.34; 95%CI: -2.76, 0.08; p = 0.06) tending to differ between AET and control group.

CONCLUSIONS

AET can significantly reduce the inflammatory burden in T2DM patients. by ameliorating the circulating levels of CRP, resistin, TNF-a and IL-6, even without accompanied significant weight-loss. The clinical impact of those anti-inflammatory effects of AET needs to be determined.

Authors+Show Affiliations

Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.Medical School, University of Cyprus, Nicosia, Cyprus.Medical School, University of Cyprus, Nicosia, Cyprus.Medical School, University of Cyprus, Nicosia, Cyprus.Department of Vascular Surgery, Athens University Medical School, Attikon University General Hospital, Athens, Greece.Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.2nd Department of Internal Medicine, Research Institute and Diabetes Centre, Athens University Medical School, Attikon University General Hospital, Athens, Greece.Medical School, University of Cyprus, Nicosia, Cyprus. Electronic address: kadoglou.nikolaos@ucy.ac.cy.

Pub Type(s)

Meta-Analysis
Systematic Review
Journal Article
Review

Language

eng

PubMed ID

36842369

Citation

Papagianni, Georgia, et al. "The Anti-inflammatory Effects of Aerobic Exercise Training in Patients With Type 2 Diabetes: a Systematic Review and Meta-analysis." Cytokine, vol. 164, 2023, p. 156157.
Papagianni G, Panayiotou C, Vardas M, et al. The anti-inflammatory effects of aerobic exercise training in patients with type 2 diabetes: A systematic review and meta-analysis. Cytokine. 2023;164:156157.
Papagianni, G., Panayiotou, C., Vardas, M., Balaskas, N., Antonopoulos, C., Tachmatzidis, D., Didangelos, T., Lambadiari, V., & Kadoglou, N. P. E. (2023). The anti-inflammatory effects of aerobic exercise training in patients with type 2 diabetes: A systematic review and meta-analysis. Cytokine, 164, 156157. https://doi.org/10.1016/j.cyto.2023.156157
Papagianni G, et al. The Anti-inflammatory Effects of Aerobic Exercise Training in Patients With Type 2 Diabetes: a Systematic Review and Meta-analysis. Cytokine. 2023;164:156157. PubMed PMID: 36842369.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The anti-inflammatory effects of aerobic exercise training in patients with type 2 diabetes: A systematic review and meta-analysis. AU - Papagianni,Georgia, AU - Panayiotou,Chrystalla, AU - Vardas,Michail, AU - Balaskas,Nikolaos, AU - Antonopoulos,Constantinos, AU - Tachmatzidis,Dimitrios, AU - Didangelos,Triantafyllos, AU - Lambadiari,Vaia, AU - Kadoglou,Nikolaos P E, Y1 - 2023/02/25/ PY - 2022/08/03/received PY - 2023/01/07/revised PY - 2023/02/03/accepted PY - 2023/2/27/pubmed PY - 2023/3/17/medline PY - 2023/2/26/entrez KW - Adipokines KW - Adiponectin KW - CRP KW - Exercise KW - IL-6 KW - Inflammation KW - Resistin KW - TNF-a KW - Type 2 diabetes mellitus SP - 156157 EP - 156157 JF - Cytokine JO - Cytokine VL - 164 N2 - BACKGROUND: Type 2 diabetes mellitus (T2DM) is a low-grade, chronic inflammatory disease, associated with increased cardiovascular risk. The purpose of this systematic review/ meta-analysis was to evaluate the effects of aerobic exercise training (AET) on inflammatory markers in T2DM patients. METHODS: The literature search was conducted utilizing PubMed, Web of Science, Embase, and the Cochrane Library from their inception up to April 2022. We screened only for randomized controlled trials (RCTs) investigating the effects of AET on C-reactive protein (CRP) and adipokines: adiponectin, resistin, interleukin 6 (IL-6), tumor necrosis factor-alpha (TNF-a), along with changes in anthropometric indices and glycemic control in adult T2DM patients. Pooled post-exercise weighted mean differences (WMDs) with 95% Confidence Intervals (CIs) were calculated for all outcomes of interest between exercise-treated patients and controls. RESULTS: Twenty-six RCTs involving 1239 T2DM patients were retrieved from the databases for meta-analysis. The cumulative results showed that post-AET inflammatory markers were lower in exercise-treated patients compared to controls regarding CRP (mg/L): WMD: -0.91; 95%CIs: -1.43, -0.40; p < 0.001 resistin (mg/ml): (WMD: -2.08; 95%CIs: -3.32, -0.84; p < 0.001); TNF-a (pg/ml): (WMD: -2.70; 95%CIs: -4.26, -1.14; p < 0.001), and IL-6 (pg/ml): (WMD: -1.05; 95%CIs: -1.68, -0.43; p < 0.001). Those effects were accompanied by significant amelioration of fasting glucose (mg/dl) (WMD: -13.02; 95%CIs: -25.39, -0.66; p = 0.04), HbA1c (%) (WMD: -0.51; 95%CIs: -0.73, -0.28, p < 0.001), and fat mass (%) (WMD: -3.14; 95%CI: -4.71, -1.58; p < 0.001). Our meta-analysis demonstrated less-consistent results for adiponectin (μg/ml), (WMD: 1.00; 95%CI: -0.12, 2.12; p = 0.08) and body-mass index (kg/m2) (WMD: -1.34; 95%CI: -2.76, 0.08; p = 0.06) tending to differ between AET and control group. CONCLUSIONS: AET can significantly reduce the inflammatory burden in T2DM patients. by ameliorating the circulating levels of CRP, resistin, TNF-a and IL-6, even without accompanied significant weight-loss. The clinical impact of those anti-inflammatory effects of AET needs to be determined. SN - 1096-0023 UR - https://www.unboundmedicine.com/medline/citation/36842369/The_anti_inflammatory_effects_of_aerobic_exercise_training_in_patients_with_type_2_diabetes:_A_systematic_review_and_meta_analysis_ DB - PRIME DP - Unbound Medicine ER -