Effects of Yijinjing combined with resistance training on body fat distribution and hepatic lipids in middle-aged and older people with prediabetes mellitus: A randomized controlled trial

Core Exercise as Non-Pharmacological Strategy for Improving Metabolic Health in Prediabetic Women

Background and Objectives: Prediabetes (PD) is characterized by impaired glucose metabolism and is associated with an elevated risk of type 2 diabetes and cardiovascular diseases. This study aimed to investigate the effects of an 8-week core exercise intervention on glycemic control, lipid profiles, insulin sensitivity, body composition, and physical performance in prediabetic women. Materials and Methods: Eighteen prediabetic women aged 20-55 years were randomly allocated to either a core exercise group (n = 9) or a control group (n = 9). The intervention group completed 24 supervised core exercise sessions over 8 weeks, whereas the control group remained sedentary. Pre- and post-intervention evaluations included anthropometric measurements, flexibility and strength tests, fasting and postprandial glucose levels, HbA1c, insulin, HOMA-IR, lipid profiles, and serum iron levels. Non-parametric tests were used for statistical analysis, and a Principal Component Analysis (PCA) and hierarchical clustering were conducted to explore multidimensional metabolic changes. Results: Core exercise significantly improved the body weight, BMI, fat percentage, and circumferences (shoulder, chest, and hip), along with an enhanced flexibility and back-leg strength (p < 0.05). Glycemic indices (FBG, PBG, and HbA1c), insulin, and HOMA-IR levels were significantly reduced, while serum iron and HDL-C increased (p < 0.05). Lipid markers, including the TG, LDL-C, CHOL, and TG/HDL-C ratio, showed significant improvements. The PCA and cluster analyses identified three clusters reflecting metabolic risk, body composition, and protective factors. Conclusions: This study demonstrates that an 8-week structured core exercise program significantly improves glycemic control, lipid profiles, insulin sensitivity, and body composition in women with prediabetes. Multivariate analyses (PCA and hierarchical clustering) corroborate a metabolic shift towards a reduced insulin resistance and a more favorable cardiometabolic profile, supporting core training as a viable, evidence-based non-pharmacological intervention to mitigate metabolic risk.

Efficacy of Yijinjing for Soft Tissue Improvement in Patients with Non-specific Chronic Neck Pain: Study Protocol for a Multicenter Randomized Controlled Trial

INTRODUCTION

As a mind-body exercise, Yijinjing has shown benefits in enhancing the effects of manual therapy for the treatment of pain, disability and soft tissue status associated with non-specific chronic neck pain (NCNP). The efficacy of Yijinjing as an independent exercise regimen for the treatment of NCNP has not been established. This study is designed to assess the efficacy of Yijinjing in patients with NCNP, compared with cervical function training (CFT).

METHODS AND ANALYSIS

A total of 132 consenting NCNP participants will be randomly assigned in a 1:1 ratio to either the Yijinjing group or the CFT group (three times a week for 8 weeks). Both groups will undergo an 8-week intervention phase. Outcome variables will be assessed at baseline and at 4-week, 8-week and 12-week follow-up. The primary outcome measure is the change in visual analogue scale scores at week 8. Secondary outcomes include neck disability index, cervical range of motion and soft tissue status parameters.

ETHICS AND DISSEMINATION

This study has been approved by an independent ethics committee and will be carried out according to the principles of the Declaration of Helsinki, local laws and regulations. The results of this study will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

ITMCTR2024000323.

Revisiting traditional Chinese exercise in prediabetes: effects on glycaemic and lipid metabolism - a systematic review and meta-analysis

BACKGROUND AND OBJECTIVES

Most existing studies have primarily focused on the effects of Traditional Chinese Exercises (TCEs) on glycemic control in individuals with prediabetes, while specific recommendations for managing dyslipidemia in this population remain insufficient. Moreover, there is a lack of systematic research and conclusive evidence regarding the optimal exercise dose required to achieve metabolic improvements in individuals with prediabetes. Therefore, this meta-analysis aims to comprehensively evaluate the efficacy of TCEs in improving glycemic and lipid profiles in individuals with prediabetes and to explore the potential impact of exercise dose on these metabolic parameters.

METHODS

A comprehensive search of six databases (PubMed, Web of Science, Cochrane Library, Embase, CNKI, and WanFang Data) followed PRISMA guidelines to identify randomized controlled trials (RCTs) on TCEs (e.g., "Tai Chi," "Yijinjing," "Baduanjin") and prediabetes (e.g., "impaired glucose tolerance," "impaired glucose regulation") published up to November 10, 2024. Three reviewers independently screened studies, extracted data, and assessed bias risk. Meta-analysis and subgroup/meta-regression analyses were conducted using Stata 17 software. The review protocol is registered in PROSPERO (CRD42024615150).

RESULTS

A total of 15 studies involving 1,839 participants were included. The meta-analysis revealed that TCEs significantly improved HbA1c (MD = -0.28%; 95% CI: -0.38% to -0.18%; P = 0.001), FBG (MD = -0.44 mmol/L; 95% CI: -0.53 to -0.34 mmol/L; P < 0.001), 2hPG (MD = -1.16 mmol/L; 95% CI: -1.48 to -0.85 mmol/L; P < 0.001), TC (MD = -0.31 mmol/L; 95% CI: -0.50 to -0.11 mmol/L; P = 0.002), TG (MD = -0.28 mmol/L; 95% CI: -0.50 to -0.06 mmol/L; P = 0.012), and HDL (MD = -0.28 mmol/L; 95% CI: -0.50 to -0.06 mmol/L; P = 0.012) compared to control groups.

CONCLUSIONS

TCEs significantly improve prediabetics' blood glucose and lipid levels. The recommended exercise regimen is 30-50 min per session, 2-3 times per week, for at least three months.

Effects of resistance training, Yijinjing and Baduanjin exercise with oral caltrate D on bone mineral density and bone metabolism in older women: a randomised controlled trial

BACKGROUND

The literature lacks studies comparing the effects of traditional Chinese exercises, Qigong Yijinjing (YJJ) and Baduanjin (BDJ), with resistance training (RT) on bone mineral density (BMD) and bone metabolism in older adults.

OBJECTIVE

This study investigated the effects of regular RT, YJJ, and BDJ exercises training, combined with oral Caltrate D supplementation, on lumbar spine and proximal femur BMD and serum bone metabolism indices in older women.

METHODS

Eighty-four older women were randomly divided into the RT group (RG, n = 21), YJJ group (YG, n = 22), BDJ group (BG, n = 21) and control group (CG, n = 20). These groups performed the assigned exercises for 24 weeks (3 times/week, 60 min/time). The BMD of the lumbar L2-4 and proximal femur, as well as serum bone metabolism indices, were measured using dual-energy X-ray absorptiometry and an automatic chemiluminescence apparatus, respectively.

RESULTS

At week 24, compared to the CG, the RG, YG, and BG had significantly higher BMD and procollagen type I N-terminal propeptide (PINP) levels in the lumbar L2-4 region (BMD: p = 0.049, p = 0.016, p = 0.040; PINP: p = 0.026, p = 0.029, p = 0.020), and lower β-carboxy-terminal cross-linked telopeptide of type 1 collagen (β-CTX) levels (p = 0.001, p = 0.012, p = 0.042). Intragroup comparison between baseline and week 24 data revealed that in RG, YG, and BG, lumbar L2-4 BMD (RG: p = 0.036, YG: p = 0.002, BG: p = 0.022) and PINP (RG: p = 0.020, YG: p = 0.001, BG: p = 0.001) increased, whereas β-CTX (RG: p = 0.003, YG: p < 0.001, BG: p = 0.008) decreased.

CONCLUSIONS

RT, YJJ and BDJ combined with Caltrate D for 24 weeks can increase lumbar BMD, increase the bone formation marker PINP and decrease the bone resorption marker β-CTX in older women but had no significant effect on the BMD of the proximal femur. YJJ and BDJ had the same effect on improving BMD in the older adults as RT with the same exercise cycle and frequency.

Combined face-to-face and online exercise program reduces medical expenses and medication in the Asian elderly with type 2 diabetes: A randomized controlled trial

To determine the impact of a combined face-to-face (f2f) and online training program on type 2 diabetes mellitus (T2DM) in elderly patients, a single-blinded randomized clinical trial was conducted from April 2021 to April 2023 at a tertiary public hospital in China. Participants aged 60+ were randomly allocated to intervention (n=20) and control (n=20) groups. After a six-month f2f program followed by 18 months of online guidance, intervention participants achieved significantly greater reductions in annual medical expenses (mean difference [SD], -946.39[244.75]; p=0.001), FBG (mean difference [SD], -0.64[0.20]; p=0.003), and 2hPBG (mean difference [SD], -2.68[0.87]; p=0.004) compared to the control group at 24 months. A greater proportion had reduced diabetes medications (RR,7.82; p=0.043). Self-management ability improved in the intervention group (mean difference [SD], 10.11[4.39]; p=0.028). HbA1c remained unchanged in the intervention group but increased in the control group (mean difference [SD], -0.68[0.14]; p<0.001). The combined f2f and online program reduces medical expenses and improves various health outcomes in elderly T2DM patients.

Lifestyle Intervention in Reducing Insulin Resistance and Preventing type 2 Diabetes in Asia Pacific Region: A Systematic Review and Meta-Analysis

PURPOSE OF REVIEW

To update the evidence of lifestyle interventions for the prevention of type 2 diabetes mellites (T2DM) in adults, particularly in the Asia Pacific region. The key questions to ask are: 1) How effective are lifestyle interventions in preventing T2DM among at-risk adults in the Asia Pacific Region? 2)What are the key characteristics of the implementation of lifestyle interventions for diabetes prevention?

RECENT FINDINGS

Lifestyle interventions for the prevention of T2DM have been suggested to be effective. There is evidence of ethnic differences in some glycaemic and anthropometric outcomes. The meta-analysis suggested a significant result in reducing waist circumference (standardised mean difference - 019, 95%CI ( -0.31, -0.06)), and no significant effects in other outcomes. However, the implementation outcomes suggested lifestyle intervention might be a cost-effective and sustainable approach in T2DM particularly in countries in the Asia Pacific Region. The focus of lifestyle intervention in the Asia Pacific Region should not only lie in the effectiveness of the trial but a thorough evaluation of the implementation outcomes, as well as cultural adaptations, with the support of all stakeholders through all stages of the implementation.

The Effects of Exercise Interventions on Ectopic and Subcutaneous Fat in Patients with Type 2 Diabetes Mellitus: A Systematic Review, Meta-Analysis, and Meta-Regression

Background/Objectives: The aim of the present study was to determine the effects of exercise training on ectopic and subcutaneous fat in patients with type 2 diabetes mellitus (T2DM). Methods: Web of Science, PubMed, and Scopus were searched for original articles published through November 2023 that included exercise versus control interventions on body mass (BM), liver fat percentage, visceral fat area (VFA), subcutaneous fat area (SFA), and intramuscular fat volume or mass (IMF) in patients with T2DM. Weighted mean differences (WMDs) for liver fat and BM, standardized mean differences (SMDs) for VFA, SFA, and IMF, and 95% confidence intervals (95% CIs) were determined using random-effects models. Results: Thirty-six studies comprising 2110 patients with T2DM were included in the present meta-analysis. Exercise training effectively reduced BM [WMD = -2.502 kg, p = 0.001], liver fat% [WMD = -1.559%, p = 0.030], VFA [SMD = -0.510, p = 0.001], and SFA [SMD = -0.413, p = 0.001] in comparison to the control. The IMF [SMD = 0.222, p = 0.118] remained unchanged compared to the controls. Subgroup analyses showed that the type of exercise, duration, and body mass index (BMI) of participants were sources of heterogeneity. Conclusions: The current meta-analysis provides strong evidence that exercise training, particularly aerobic and combined (aerobic and resistance) exercise programs, is effective for reducing BM, VFA, and SFA in patients with T2DM. However, aerobic exercise was more effective for reducing liver fat than combined exercise. The beneficial effects of exercise on VFA and SFA reduction, but not liver fat, are associated with weight loss. These findings highlight the importance of including consistent exercise as a key management component for T2DM and associated ectopic fat deposition, with potential long-term benefits for metabolic health.

The Effects of 12-Week Traditional Thai Exercise (Ruesi Dadton) on Glycemic Control and Inflammatory Markers in Prediabetes: A Randomized Controlled Trial

Hyperglycemia and inflammation are hallmarks of the prediabetes stage, which has the potential to develop into diabetes mellitus. In this stage, lifestyle changes and exercise are recommended and have been shown to be effective. However, there has been insufficient study investigating the impact of Ruesi Dadton (RD) exercise on prediabetes. Therefore, this study aimed to investigate the effect of RD exercise on biomarkers of glycemic level including fasting plasma glucose (FPG), the 2 h oral glucose tolerance test (OGTT), hemoglobin A1C (HbA1C), the biomarkers of inflammation C-reactive protein (CRP) and interleukin 6 (IL-6), and body mass index (BMI) on prediabetes during 12-week RD exercise. A total of 64 participants were randomly assigned into two groups, RD and control (CON), and were tested by measuring their glycemic levels to screen for prediabetes. The RD group was instructed to perform 10 postures of RD exercise in 60 min, three times a week. The CON group received standard lifestyle recommendations that were not pharmacologically managed. The results reveal that the RD group experienced a significant decrease in FPG, OGTT, HbA1C, and IL-6 (p < 0.01), and BMI and CRP (p < 0.05) compared to the CON group. In addition, the CON group had considerably higher glycemic levels, BMI and IL-6 levels (p < 0.01). Our study demonstrates that RD could decrease the biomarkers of glycemic level and inflammation during 12 weeks of RD exercise in prediabetes. These findings suggest that RD exercise is an effective approach for reducing systemic inflammation and controlling glycemic levels in prediabetic patients.