Exercise training and inflammatory adipokines in patients with type 2 diabetes: a systematic review, meta-analysis, and meta-regression

<p dir="ltr">Background: Improvements in adipocytes levels can reduce the risk of diabetes and cardiovascular disease, indicating adipocytes to be a hopeful remedial target in type 2 diabetes mellitus (T2DM) and other related diseases. However, there is no consensus on the role of various exercise training on adipokines in T2DM and the results are contradictory. Therefore, this systematic review, meta-analysis, and meta-regression investigated the effects of different types of exercise training on some inflammatory adipokines concentrations in T2DM.</p><p dir="ltr">Methods: A systematic search was conducted in PubMed/MEDLINE, Web of Science, Embase, Google Scholar, and Cochrane up to September 2024. Studies investigating the effects of exercise training on Resistin, apelin, visfatin, and vaspin were included. Meta-analysis was performed using a random-effect model (DerSimonian-Laird method) to calculate weighted means differences with 95% confidence intervals (CIs). The Cochrane Collaboration's tool was also used to asses risk of bias of studies.</p><p dir="ltr">Results: Analysis of 36 studies (50 intervention arms, n = 1811) demonstrated that exercise training significantly decreased resistin (mean difference [MD]: −1.02 ng/ml, 95% CI −1.48 to −0.57, p < 0.0001) and visfatin (MD: −0.70 ng/ml, 95% CI −1.07 to −0.32, p = 0.0002) levels but had no significant effect on Apelin (MD: 0.02 ng/ml, 95% CI −0.04 to 0.08, p = 0.55) and vaspin (MD: 0.00 ng/ml, 95% CI −0.0 to 0.0, p = 0.69) levels compared to control in T2DM. Stronger effects were observed in combined training in men and more than 8 weeks of intervention. Meta-regression analysis also showed that there is a significant linear relation between changes in resistin with BMI changes but other variables were not observed to have significant linear relationships with changes of BMI, glucose, Insulin, and HOMA-IR.</p><p dir="ltr">Conclusions: Overall, aerobic and combined training decreased inflammatory adipokines with a positive supplementary effect for patient with T2DM.Registration: PROSPERO registration no. CRD42024617538.</p>