Effects of exercise training on Fetuin-a in obese, type 2 diabetes and cardiovascular disease in adults and elderly: A systematic review and Meta-analysis
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BACKGROUND: Elevated levels of fetuin-A are associated with increased risks of metabolic syndrome, type 2 diabetes and nonalcoholic fatty liver disease. This meta-analysis investigated whether exercise interventions can reduce fetuin-A in adults. METHODS: We searched clinical trials that objectively assessed fetuin-A and included study arms with exercise intervention. The pre-intervention and post-intervention data were used for meta-analysis. The effect sizes were calculated as standardized mean differences or changes in fetuin-A and expressed as Hedges' g using random-effects models. RESULTS: The overall Hedges' g for fetuin-A in all included interventions was - 0.640 (95%CI - 1.129 to - 0.151; n = 9), but this effect was not observed in obese (g = - 0.096; 95%CI, - 0.328 to 0.135) and type 2 diabetes/dysglycemia (g = - 0.56; 95%CI, - 1.348 to 0.236) individuals. Additionally, the random-effects meta-regression analysis showed that there was not a greater decrease in fetuin-A in individuals who achieved greater body mass index reductions (regression coefficient = 0.065; 95%CI, - 0.185 to 0.315). CONCLUSION: Supervised exercise is associated with reductions in fetuin-A levels in adults and elderly. However, the results of the present meta-analysis should be interpreted with caution because of the variety of type of exercises and individual obesity related-disorders involve. Therefore, additional high-quality randomized controlled trials describing the effect of supervised exercise interventions on fetuin-A in adults are still needed. .
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Modulation of fetuin A by exercise partially depends on pre-existing metabolic status.
“Regarding exercise, a recent meta-analysis found decreased fetuin A levels following completion of aerobic exercise regimes of varying frequency and duration (e.g., 1–12 weeks, 3–5 sessions per week of 40–70 min each) and intensity (e.g., 60–85% maximum heart rate), except in patients with T2DM, suggesting that modulation of fetuin A by exercise partially depends on the pre-existing metabolic stat”
From The Role of Exercise in the Interplay between Myokines, Hepatokines, Osteokines, Adipokines, and Modulation of Inflammation for Energy Substrate Redistribution and Fat Mass Loss: A Review (2020) · cites this paper as [138]
The Results (Additional analysis; page unavailable) and Discussion report no significant fetuin-A reduction in the type 2 diabetes/dysglycemia subgroup, which supports the suggestion that response may vary with metabolic status. But the obese subgroup also showed no significant reduction, and the Discussion says it is unclear whether the divergent findings are due to health status rather than other factors. The source therefore does not establish metabolic status as an explanation or support diabetes as the sole exception. (LLM, conf=0.86)
Experimental — accuracy not yet measuredA recent meta-analysis found decreased fetuin A levels following completion of aerobic exercise regimes of varying frequency and duration and intensity, except in patients with T2DM.
“Regarding exercise, a recent meta-analysis found decreased fetuin A levels following completion of aerobic exercise regimes of varying frequency and duration (e.g., 1–12 weeks, 3–5 sessions per week of 40–70 min each) and intensity (e.g., 60–85% maximum heart rate), except in patients with T2DM, suggesting that modulation of fetuin A by exercise partially depends on the pre-existing metabolic stat”
From The Role of Exercise in the Interplay between Myokines, Hepatokines, Osteokines, Adipokines, and Modulation of Inflammation for Energy Substrate Redistribution and Fat Mass Loss: A Review (2020) · cites this paper as [138]
The Results (Synthesis of results) report an overall reduction in fetuin-A after supervised exercise, and the Results (Study selection) describe varied exercise durations, frequencies, and intensities. The Results (Additional analysis) found no statistically significant reduction in the type 2 diabetes/dysglycemia subgroup, but also found none in the obesity subgroup. Thus, presenting T2DM as the sole exception overstates the findings. (LLM, conf=0.85)
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Hazrati, F., Safarzade, A., Talebi-Garakani, E., & Hamedchaman, N. (2025) · Research Square · doi:10.21203/rs.3.rs-7285688/v1
Bernard, D., Sultan, A., & Bouzakri, K. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26178182
Lionardi, S. K., Prihadi, J. C., Hengky, A., Secodiningrat, R. H. P. S., Widjanarko, N. D., Alvianto, S., & Lionardi, S. (2025) · Journal of Clinical Urology · doi:10.1177/20514158251364038
Hazrati, F., Safarzade, A., Talebi-Garakani, E., & Hamedchaman, N. (2025) · Nutrire · doi:10.1186/s41110-025-00376-w
- Authors
- Ramírez-Vélez, R., García-Hermoso, A., Hackney, A. C., & Izquierdo, M.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- Lipids in Health and Disease
- Published
- 2019-01-22
- Volume
- 18
- Issue
- 1
- Pages
- 23-23
- ISSN
- 1476-511X (ISSN-L)
- PMC
- PMC6343360
- OpenAlex
- W2918805195
- Cited by
- 37
- References
- 53
- Citations by year
- 2026: 2 · 2025: 11 · 2024: 5 · 2023: 3 · 2022: 6 · 2021: 3 · 2020: 5 · 2019: 2
- FWCI
- 0.58
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Lipids in Health and Disease (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, other-oa)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Academica-e (Universidad Pública de Navarra) (acceptedVersion, cc-by)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- UNC Libraries
- Topics
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- fetuin-A, exercise training, obesity, type 2 diabetes, cardiovascular disease, metabolic syndrome, non-alcoholic fatty liver disease, body mass index reduction, supervised exercise, older adults
- MeSH terms
- Adult, Aged, Diabetes Mellitus, Type 2, Humans, Middle Aged, Obesity, Regression Analysis, Risk Factors, Exercise, Randomized Controlled Trials as Topic, Publication Bias, alpha-2-HS-Glycoprotein
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