Effects of exercise on C-reactive protein, inflammatory cytokine and adipokine in patients with type 2 diabetes: A meta-analysis of randomized controlled trials

• Published in: Metabolism, clinical and experimental Vol. 63; no. 3; pp. 431 - 440
• Main Authors: Hayashino, Yasuaki, Jackson, Jeffrey L, Hirata, Takumi, Fukumori, Norio, Nakamura, Fumiaki, Fukuhara, Shunichi, Tsujii, Satoru, Ishii, Hitoshi
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.03.2014; Elsevier
• Subjects: Adipokine; Adipokines - metabolism; Biological and medical sciences; Biomarkers - metabolism; C-Reactive Protein - metabolism; Diabetes; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - physiopathology; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinology & Metabolism; Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Exercise; Exercise - physiology; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Humans; Inflammation; Inflammation - metabolism; Inflammation - physiopathology; Interleukin-6 - metabolism; Male; Medical sciences; Middle Aged; Vertebrates: anatomy and physiology, studies on body, several organs or systems; CRP; RCT; C-reactive protein; body mass index; CI; weighted mean difference; Inflammation; SMD; Adipokine; standardized mean difference; IL-6; interleukin-6; randomized controlled trial; WMD; SD; Exercise; confidence interval; Diabetes; standard deviation; BMI; Endocrinopathy; Type 2 diabetes; Physical exercise; Human; Cytokine; Metabolic diseases; Metaanalysis; Randomization; Clinical trial; C reactive protein; Endocrinology
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/j.metabol.2013.08.018

Abstract Objective C-reactive protein (CRP), inflammatory cytokines, and adipokines contribute to atherosclerosis, insulin resistance, and development of late-onset complication in patients with type 2 diabetes. We performed a systematic review to assess effects of exercise interventions on inflammatory markers/cytokines and adipokines. Materials/Methods We searched electronic databases (MEDLINE, EMBASE, and Cochrane Controlled Trials Registry) and reference lists in relevant papers for articles published in 1966–2013. We selected studies that evaluated the effects of exercise intervention on inflammatory markers/cytokines and adipokines in adult patients with type 2 diabetes. Weighted mean differences of exercise on outcomes were derived using fixed or random effect models; factors influencing heterogeneity were identified using meta-regression analysis. Results Fourteen randomized controlled trials (824 patients) were included in our meta-analysis. Exercise was associated with a significant in CRP = − 0.66 mg/l (95% CI, − 1.09 to − 0.23 mg/l; − 14% from baseline) and interleukin-6 (IL-6) = − 0.88 pg/ml (95% CI, − 1.44 to − 0.32 pg/ml; − 18% from baseline) but did not alter adiponectin or resistin levels; aerobic exercise program was associated with a significant change in leptin = − 3.72 ng/ml (95% CI, − 6.26 to − 1.18 ng/ml; − 24% from baseline). For IL-6, exercise was more effective in those with a longer duration in the program and larger number of sessions during study (p = 0.001). Conclusions Exercise decreases inflammatory cytokine (CRP and IL-6) in patients with type 2 diabetes. Exercise could be a therapeutic option for improving abnormalities in inflammation levels in patients with diabetes.