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Hopewell S, Chan AW, Collins GS, Hróbjartsson A, Moher D, Schulz KF, Tunn R, Aggarwal R, Berkwits M, Berlin JA, Bhandari N, Butcher NJ, Campbell MK, Chidebe RCW, Elbourne D, Farmer A, Fergusson DA, Golub RM, Goodman SN, Hoffmann TC, Ioannidis JPA, Kahan BC, Knowles RL, Lamb SE, Lewis S, Loder E, Offringa M, Ravaud P, Richards DP, Rockhold FW, Schriger DL, Siegfried NL, Staniszewska S, Taylor RS, Thabane L, Torgerson D, Vohra S, White IR, Boutron I. CONSORT 2025 explanation and elaboration: updated guideline for reporting randomised trials. BMJ 2025; 389:e081124. [PMID: 40228832 PMCID: PMC11995452 DOI: 10.1136/bmj-2024-081124] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/21/2025] [Indexed: 04/16/2025]
Affiliation(s)
- Sally Hopewell
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford OX3 7LD, UK
| | - An-Wen Chan
- Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, ON, Canada
| | - Gary S Collins
- UK EQUATOR Centre, Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Asbjørn Hróbjartsson
- Centre for Evidence-Based Medicine Odense and Cochrane Denmark, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Open Patient data Explorative Network, Odense University Hospital, Odense, Denmark
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Programme, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Kenneth F Schulz
- Department of Obstetrics and Gynecology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ruth Tunn
- Oxford Clinical Trials Research Unit, Centre for Statistics in Medicine, University of Oxford, Oxford OX3 7LD, UK
| | - Rakesh Aggarwal
- Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Michael Berkwits
- Office of Science Dissemination, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jesse A Berlin
- Department of Biostatistics and Epidemiology, School of Public Health, Center for Pharmacoepidemiology and Treatment Science, Rutgers University, New Brunswick, NJ, USA
- JAMA Network Open, Chicago, IL, USA
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nancy J Butcher
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Marion K Campbell
- Aberdeen Centre for Evaluation, University of Aberdeen, Aberdeen, UK
| | - Runcie C W Chidebe
- Project PINK BLUE - Health & Psychological Trust Centre, Utako, Abuja, Nigeria
- Department of Sociology and Gerontology, Miami University, OH, USA
| | - Diana Elbourne
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Robert M Golub
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Steven N Goodman
- Department of Epidemiology and Population Health, Stanford University, Palo Alto, CA, USA
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, University Drive, Robina, QLD, Australia
| | - John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - Brennan C Kahan
- MRC Clinical Trials Unit at University College London, London, UK
| | - Rachel L Knowles
- University College London, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Sarah E Lamb
- NIHR Exeter Biomedical Research Centre, Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
| | - Steff Lewis
- Edinburgh Clinical Trials Unit, Usher Institute-University of Edinburgh, Edinburgh BioQuarter, Edinburgh, UK
| | - Elizabeth Loder
- The BMJ, BMA House, London, UK
- Harvard Medical School, Boston, MA, USA
| | - Martin Offringa
- Child Health Evaluation Services, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| | - Philippe Ravaud
- Université Paris Cité, Inserm, INRAE, Centre de Recherche Epidémiologie et Statistiques, Université Paris Cité, Paris, France
| | | | - Frank W Rockhold
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA
| | - David L Schriger
- Department of Emergency Medicine, University of California, Los Angeles, CA, USA
| | | | - Sophie Staniszewska
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Coventry, UK
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit & Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Lehana Thabane
- Department of Health Research Methods Evidence and Impact, McMaster University, Hamilton, ON, Canada
- St Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - David Torgerson
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Sunita Vohra
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ian R White
- MRC Clinical Trials Unit at University College London, London, UK
| | - Isabelle Boutron
- Université Paris Cité and Université Sorbonne Paris Nord, Inserm, INRAE, Centre for Research in Epidemiology and Statistics (CRESS), Paris, France
- Centre d'Epidémiologie Clinique, Hôpital Hôtel Dieu, AP-HP, Paris, France
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Khalafi M, Dinizadeh F, Rosenkranz SK, Symonds ME, Fatolahi S. The Effects of Exercise Training on Body Composition and Cardiometabolic Risk Factors in Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2025; 13:246. [PMID: 39942435 PMCID: PMC11816365 DOI: 10.3390/healthcare13030246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Revised: 12/31/2024] [Accepted: 01/22/2025] [Indexed: 02/16/2025] Open
Abstract
INTRODUCTION AND AIM We performed a systematic review and meta-analysis to investigate the effects of exercise training on body composition and cardiometabolic health in patients with Type 1 diabetes (T1D). METHOD A search in three main databases including PubMed, Web of Science, and Scopus was conducted from the inception of this review until June 2024 to identify randomized control trials investigating the effects of exercise training compared to a control on body composition and cardiometabolic risk factors in patients with T1D. The data were pooled using random effects models to calculate weighted mean differences (WMDs), standardized mean differences (SMDs), and 95% confidence intervals (CIs). RESULTS Overall, 25 studies involving 1120 patients with T1D were included in the meta-analysis. Exercise training decreased body mass index (BMI) [WMD: -0.18 kg.m2, p = 0.02], fasting glucose [WMD: -14.97 mg/dl, p = 0.01], and HbA1c [WMD: -0.49%, p = 0.003], and increased VO2max/peak [WMD: 2.76 mL/kg/min, p = 0.001] as compared with controls. Exercise training had no effect on body fat percentage or lean body mass, lipid profiles, or blood pressure. Subgroup analysis indicated that age, exercise mode, and intervention duration were the main moderators for the beneficial effects of exercise training. CONCLUSIONS In patients with T1D, exercise training is effective for decreasing body weight and cardiometabolic risk factors.
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Affiliation(s)
- Mousa Khalafi
- Department of Sport Sciences, Faculty of Humanities, University of Kashan, Kashan 87317-53153, Iran
| | - Farnaz Dinizadeh
- Department of Sport Sciences, Tabriz Branch, Azad University, Tabriz 51579-44533, Iran;
| | - Sara K. Rosenkranz
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA;
| | - Michael E. Symonds
- Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham NG7 2UH, UK;
| | - Saeid Fatolahi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, Tarbiat Modares University, Tehran 14117-13116, Iran
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Luo B, Xiang D, Ji X, Chen X, Li R, Zhang S, Meng Y, Nieman DC, Chen P. The anti-inflammatory effects of exercise on autoimmune diseases: A 20-year systematic review. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:353-367. [PMID: 38341137 PMCID: PMC11117003 DOI: 10.1016/j.jshs.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 01/08/2024] [Accepted: 01/16/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND The anti-inflammatory effect of exercise may be an underlying factor in improving several autoimmune diseases. The aim of this systematic review was to examine the evidence on the role of exercise training in mitigating inflammation in adolescents and adults with autoimmune disease. METHODS PubMed, Web of Science, and Embase databases were systematically reviewed for related studies published between January 1, 2003, and August 31, 2023. All randomized and non-randomized controlled trials of exercise interventions with autoimmune disease study participants that evaluated inflammation-related biomarkers were included. The quality of evidence was assessed using the Tool for the assEssment of Study qualiTy and reporting in EXercise scale and Cochrane bias risk tool. RESULTS A total of 14,565 records were identified. After screening the titles, abstracts, and full texts, 87 were eligible for the systematic review. These studies were conducted in 25 different countries and included a total of 2779 participants (patients with autoimmune disease, in exercise or control groups). Overall, the evidence suggests that inflammation-related markers such as C-reactive protein, interleukin 6, and tumor necrosis factor α were reduced by regular exercise interventions. Regular exercise interventions combined with multiple exercise modes were associated with greater benefits. CONCLUSION Regular exercise training by patients with autoimmune disease exerts an anti-inflammatory influence. This systematic review provides support for the promotion and development of clinical exercise intervention programs for patients with autoimmune disease. Most patients with autoimmune disease can safely adopt moderate exercise training protocols, but changes in inflammation biomarkers will be modest at best. Acute exercise interventions are ineffective or even modestly but transiently pro-inflammatory.
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Affiliation(s)
- Beibei Luo
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; Shanghai Key Laboratory of Human Performance, Shanghai University of Sport, Shanghai 200438, China
| | - Dao Xiang
- Department of Diving and Hyperbaric Medicine, Naval Medical Center, Shanghai 200433, China; National Key Laboratory of Immunity and Inflammation, Naval Medical University, Shanghai 200433, China
| | - Xiaorong Ji
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - Xuan Chen
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - Rui Li
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - Shuxin Zhang
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - Yujun Meng
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China
| | - David C Nieman
- Human Performance Laboratory, Appalachian State University, North Carolina Research Campus, Kannapolis, NC 28081, USA.
| | - Peijie Chen
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; Research Institute for Doping Control, Shanghai University of Sport, Shanghai 200438, China.
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