Effect of Exercise Training on Some Anti-Inflammatory Adipokines, High Sensitivity C-Reactive Protein, and Clinical Outcomes in Sedentary Adults With Metabolic Syndrome

The efficacy of resistance exercise training on metabolic health, body composition, and muscle strength in older adults with type 2 diabetes: A systematic review and Meta-Analysis

This systematic review and meta-analysis evaluated the efficacy of Resistance Exercise Training (RET) on metabolic health, body composition, and muscle strength in older adults with type 2 diabetes (T2DM). Electronic databases were systematically searched and meta-analyses were conducted using random-effects models. Meta-regression analyses were also performed to explore potential sources of heterogeneity. Nineteen randomized controlled trials (RCTs) met the inclusion criteria. RET significantly improved hemoglobin A1c (MD: -0.51, P < 0.0001) and fasting blood glucose (mean differences: MD: -1.43 mg/dl, P = 0.04), though insulin levels remained unchanged. Lipid profile analysis revealed significant reductions in triglycerides (MD: -0.32, P = 0.03), total cholesterol (MD: -7.08, P = 0.005), and low-density lipoprotein (MD: -1.91, P = 0.05), without significant changes in high-density lipoprotein. RET increased lean mass and reduced waist circumference but had no effect on body weight and fat mass. Muscle strength improved significantly, but there was no impact on blood pressure or heart rate. These findings suggest that RET is beneficial for enhancing glycemic control, lipid profiles, lean mass, and muscle strength in older adults with T2DM, while its effects on body weight, fat mass, and cardiovascular health remain inconclusive. Further studies are needed to explore long-term effects.

Effects of resistance training on cardiovascular risk factors in patients with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials

AIMS

Type 2 diabetes mellitus (T2DM) is prevalent worldwide, often manageable through lifestyle changes like physical activity. This meta-analysis aimed to determine the effect of resistance training (RT) on cardiovascular risk factors in adults with T2DM.

METHODS

Four databases were searched up to March 2024. The mean difference (MD) was calculated by a random effect model with 95% confidence interval (CI).

RESULTS

Forty-eight articles were included in the review. There was a significant pooled effect size for the meta-analysis comparing RT vs. control on hemoglobin A1C (MD = -0.49, 95% CI: -0.66, -0.33; P < 0.00001), fasting blood sugar (MD = -11.58, 95% CI: -18.61, -4.55; P = 0.001), insulin (ES = -1.65, 95% CI: -2.87, -0.42; P = 0.008), HOMA-IR (MD = -1.20, 95% CI: -1.85, -0.55; P = 0.0003), triglyceride (MD = -18.14, 95% CI: -30.32, -5.96; P = 0.004), and high-density lipoprotein (MD = 2.71, 95% CI: 0.78, 4.64; P = 0.006). Moreover, RT was effective for reducing body weight (MD = -0.81, 95% CI: -1.50, -0.13; P = 0.02), fat percentage (MD = -0.92, 95% CI: -1.62, -0.22; P = 0.010), and waist circumference (MD = -2.14, 95% CI: -3.00, -1.28; P < 0.00001).

CONCLUSION

RT effectively improves cardiovascular risk factors in T2DM adults, suggesting potential as treatment or prevention. Future studies can consider investigating the optimal RT regimen to achieve effective T2DM management in adults.

Association of physical activity, sedentary behavior and stroke in older adults

Objective

The aim of this study was to investigate the relationship between physical activity, sedentary behavior and stroke in people aged 60 years and older.

Methods

The study included 3,010 participants aged 60 and older from the National Health and Nutrition Examination Survey (NHANES). Data on sedentary behavior, physical activity and stroke were obtained through questionnaires. Statistical analyses were performed using a complex multistage sampling design and weighted multivariate logistic regression. Smoothed curve fitting and threshold effects analyses were used to explore non-linear relationships between physical activity, sedentary behavior and stroke.

Results

There were 244 (7.53%) participants aged 60 years and older who had experienced a stroke. After adjusting for all covariates, physical activity, sedentary behavior and stroke were significantly associated [OR (95% CI) for physical activity: 0.622 (0.443, 0.875), p = 0.009; OR (95% CI) for sedentary behavior: 2.602 (1.557, 4.348), p = 0.003]. C-reactive protein mediated the association between sedentary behavior and stroke among older adults, with a mediation of 3.64%.

Conclusion

In people aged 60 years and older, sedentary behavior was positively associated with stroke, whereas physical activity was negatively associated with stroke, and C-reactive protein mediated the relationship between sedentary behavior and stroke.

High-intensity interval training for cardiometabolic health in adults with metabolic syndrome: a systematic review and meta-analysis of randomised controlled trials

OBJECTIVE

To assess the effectiveness of high-intensity interval training (HIIT) compared with traditional moderate-intensity continuous training (MICT) and/or non-exercise control (CON) for modification of metabolic syndrome (MetS) components and other cardiometabolic health outcomes in individuals with MetS.

DESIGN

Systematic review and meta-analysis DATA SOURCES: Five databases were searched from inception to March 2024.

STUDY APPRAISAL AND SYNTHESIS

Meta-analyses of randomised controlled trials (RCTs) comparing HIIT with MICT/CON were performed for components of MetS (waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), and fasting blood glucose (BG)) and clinically relevant cardiometabolic health parameters. Subgroup moderator analyses were conducted based on the intervention duration and HIIT volume.

RESULTS

Out of 4819 studies, 23 RCTs involving 1374 participants were included (mean age: 46.2-67.0 years, 55% male). HIIT significantly improved WC (weighted mean difference (WMD) -4.12 cm, 95% CI -4.71 to -3.53), SBP (WMD -6.05 mm Hg, 95% CI -8.11 to -4.00), DBP (WMD -3.68 mm Hg, 95% CI -5.70 to -1.65), HDL-C (WMD 0.12 mmol/L, 95% CI 0.04 to 0.20), TG (WMD -0.34 mmol/L, 95% CI -0.41 to -0.27) and BG (WMD -0.35 mmol/L, 95% CI -0.54 to -0.16) compared with CON (all p<0.01). HIIT approaches demonstrated comparable effects to MICT across all parameters. Subgroup analyses suggested that HIIT protocols with low volume (ie, <15 min of high-intensity exercise per session) were not inferior to higher volume protocols for improving MetS components.

CONCLUSION

This review supports HIIT as an efficacious exercise strategy for improving cardiometabolic health in individuals with MetS. Low-volume HIIT appears to be a viable alternative to traditional forms of aerobic exercise.

The Role of Adipose Tissue and Nutrition in the Regulation of Adiponectin

Adipose tissue (AT), composed mainly of adipocytes, plays a critical role in lipid control, metabolism, and energy storage. Once considered metabolically inert, AT is now recognized as a dynamic endocrine organ that regulates food intake, energy homeostasis, insulin sensitivity, thermoregulation, and immune responses. This review examines the multifaceted role of adiponectin, a predominant adipokine released by AT, in glucose and fatty acid metabolism. We explore the regulatory mechanisms of adiponectin, its physiological effects and its potential as a therapeutic target for metabolic diseases such as type 2 diabetes, cardiovascular disease and fatty liver disease. Furthermore, we analyze the impact of various dietary patterns, specific nutrients, and physical activities on adiponectin levels, highlighting strategies to improve metabolic health. Our comprehensive review provides insights into the critical functions of adiponectin and its importance in maintaining systemic metabolic homeostasis.

High-Intensity Interval Versus Moderate-Intensity Continuous Exercise Training on Glycemic Control, Beta Cell Function, and Aerobic Fitness in Women with Type 2 Diabetes

Objective: This study aimed to compare the effects of High-Intensity Interval Training (HIIT) and Moderate-Intensity Continuous Training (MICT) on glycemic control, beta-cell function, and aerobic fitness in women with Type 2 Diabetes Mellitus (T2DM). Methods: Thirty-six women with T2DM were assigned equally to HIIT, MICT, and control (CON) groups. Participants in the exercise cohorts underwent a 12-week training regimen (three sessions per week), while the CON group maintained an inactive lifestyle. Glycaemia variables, beta-cell function, maximal oxygen uptake (VO2max), lipid profiles, and body composition were assessed at baseline and post-intervention. Results: Both HIIT and MICT interventions led to significant improvements in glucose, insulin, HbA1c, and insulin resistance index. Moreover, visceral adiposity index (VAI), lipid accumulation product (LAP), total cholesterol (TC), and low-density lipoprotein (LDL) levels significantly decreased in the HIIT and MICT groups after 12 weeks. Triglyceride (TG) levels decreased only after MICT, while high-density lipoprotein (HDL) levels increased after both interventions. Maximal oxygen uptake (VO2max), body mass, body mass index (BMI), and waist circumference (WC) significantly improved in all exercise groups. Notably, the HIIT group showed greater reductions in body mass compared to MICT. Nevertheless, beta-cell function remained unaltered after these two exercise regimens. Conclusion: Both HIIT and MICT interventions effectively managed T2DM in women, regardless of exercise intensity. The HIIT regimen can be considered for time-efficient lifestyle interventions in people with T2DM.