Effects of exercise training on inflammatory and cardiometabolic health markers in overweight and obese adults: a systematic review and meta-analysis of randomized controlled trials

摘要

INTRODUCTION: The improvements in inflammation and cardiometabolic health play an important role in the prevention and treatment of obesity. However, the interactions between different exercise training (ET) modalities with inflammatory and cardiometabolic biomarkers are not completely understood. This systematic review and meta-analysis investigated the effects of ET on inflammatory and cardiometabolic health markers in overweight and obese adults. EVIDENCE ACQUISITION: A systematic search was conducted in PubMed, CINAHL, MEDLINE, Cochrane, Google Scholar, Scopus and Web of Science up to December 15, 2021. Thirty-five studies including 2752 participants were included and analyzed using a random-effects model to estimate weighted mean differences (MD) with 95% confidence intervals (CI). EVIDENCE SYNTHESIS: The meta-analysis found that ET significantly (P<0.05) increased adiponectin (WMD: 0.72 mu g/mL; 95% CI: 0.60 to 0.84; SMD=0.65) and maximal oxygen consumption levels (WMD: 5.26 mL.kg.min; 95% CI: 3.84, 6.69; SMD=1.21). Moreover, ET signifi-cantly (P<0.05) reduced fasting insulin (WMD:-2.40 mu IU/mL; 95% CI:-3.43 to-1.37; SMD=-0.87), fasting blood glucose (WMD:-5.41 mg/dL; 95% CI:-7.91,-2.91; SMD=-0.66), insulin resistance (WMD:-0.66; 95% CI:-1.08,-0.24; SMD=-0.66) and triglyceride levels (WMD:-10.88 mg/dL; 95% CI:-17.61,-4.15; SMD=-0.91). No significant changes were observed in interleukin-6, tumor necrosis factor-a, leptin, C-reactive protein and cholesterol concentrations. Subgroup analysis by type of training indicated that aerobic and resistance exercise had the most consis-tent beneficial effects as compared to other modalities. CONCLUSIONS: Our findings suggest that ET may improve inflammation and cardiometabolic health in overweight and obese adults. Aerobic and resistance training appear to be more beneficial for improving adiponectin, fasting insulin, fasting blood glucose, insulin resistance index and triglyceride levels as compared to other exercise modalities. Further long-term studies are required to confirm and expand on these findings.