Effects of exercise on C-reactive protein, inflammatory cytokine and adipokine in patients with type 2 diabetes: A meta-analysis of randomized controlled trials
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=-0.66mg/l (95% CI, -1.09 to -0.23mg/l; -14% from baseline) and interleukin-6 (IL-6)=-0.88pg/ml (95% CI, -1.44 to -0.32pg/ml; -18% from baseline) but did not alter adiponectin or resistin levels; aerobic exercise program was associated with a significant change in leptin=-3.72ng/ml (95% CI, -6.26 to -1.18ng/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.
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Some studies have shown a reduction in resistin levels following aerobic or resistance exercise interventions, while others have shown no change.
“Some have either shown a reduction in resistin levels [233] or no change [227] following aerobic or resistance exercise interventions.”
A meta-analysis focusing specifically on individuals with T2DM has described decreased levels of IL-6 and CRP with aerobic exercise interventions.
“A meta-analysis focusing specifically on individuals with T2DM has also described decreased levels of IL-6 and CRP with aerobic exercise interventions [227], which emphasizes that the anti-inflammatory properties of exercise are strong regardless of preexisting metabolic status.”
Absolute changes in CRP or IL-6 with healthy diet or aerobic exercise are comparable to the absolute difference associated with sleep disturbance.
“Alternatively, the absolute change in levels of CRP or IL-6 with a healthy diet intervention (Neale et al, 2016), or aerobic exercise (Hayashino et al, 2014), is comparable to the absolute difference found in association with sleep disturbance.”
From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Hayashino et al, 2014
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- Authors
- Hayashino, Y., Jackson, J. L., Hirata, T., Fukumori, N., Nakamura, F., Fukuhara, S., Tsujii, S., & Ishii, H.
- Affiliations
- Kyoto University (JP)
- Milwaukee VA Medical Center (US)
- Tenri Hospital (JP)
- ORCID
- Venue
- Metabolism
- Publisher
- Elsevier BV
- Published
- 2014-03
- Volume
- 63
- Issue
- 3
- Pages
- 431-440
- ISSN
- 0026-0495 (ISSN-L)
- OpenAlex
- W2143812909
- Cited by
- 244
- References
- 53
- Citations by year
- 2026: 6 · 2025: 14 · 2024: 11 · 2023: 28 · 2022: 29 · 2021: 20 · 2020: 15 · 2019: 34 · 2018: 22 · 2017: 21 · 2016: 20 · 2015: 18 · 2014: 5
- FWCI
- 1.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- physical activity, type 2 diabetes, C-reactive protein, interleukin-6, adipokines, leptin, adiponectin, resistin, inflammation, aerobic exercise, insulin resistance
- MeSH terms
- C-Reactive Protein, Diabetes Mellitus, Type 2, Female, Humans, Inflammation, Male, Middle Aged, Biomarkers, Exercise, Interleukin-6, Adipokines
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