Diabetes Metab J.  2023 Jan;47(1):118-134. 10.4093/dmj.2022.0007.

Effectiveness of Resistance Exercise on Inflammatory Biomarkers in Patients with Type 2 Diabetes Mellitus: A Systematic Review with Meta-Analysis

• Fernández-Rodríguez R
• Monedero-Carrasco S
• Bizzozero-Peroni B
• Garrido-Miguel M
• Mesas AE
• Martínez-Vizcaíno V

• KMID: 2538936
• DOI: http://doi.org/10.4093/dmj.2022.0007

Abstract

Background
Type 2 diabetes mellitus (T2DM) is related to increased inflammatory processes. The effects of resistance exercise on inflammatory biomarkers in T2DM are controversial. Our purpose was to determine the effectiveness of resistance exercise on inflammatory biomarkers in patients diagnosed with T2DM.
Methods
We searched four databases until September 2021. We included randomized clinical trials (RCTs) of the effects of resistance exercise on inflammatory biomarkers (C-reactive protein [CRP], tumor necrosis factor alpha, interleukin-6, and interleukin-10) in patients with T2DM. A random effects meta-analysis was conducted to determine the standardized mean difference (SMD) and the raw mean difference (MD) for CRP.
Results
Thirteen RCTs were included in the review, and 11 in the meta-analysis for CRP. Lower CRP levels were observed when resistance exercise was compared with the control groups (SMD=–0.20; 95% confidence interval [CI], –0.37 to –0.02). When conducting the MD meta-analysis, resistance exercise showed a significant decrease in CRP of –0.59 mg/dL (95% CI, –0.88 to –0.30); otherwise, in the control groups, the CRP values increased 0.19 mg/dL (95% CI, 0.17 to 0.21).
Conclusion
Evidence supports resistance exercise as an effective strategy to manage systemic inflammation by decreasing CRP levels in patients with T2DM. The evidence is still inconclusive for other inflammatory biomarkers.

Keyword

Diabetes mellitus; Exercise; Inflammation; Resistance training

Figure

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  Fig. 1. Flow diagram of the studies through the review.

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  Fig. 2. Standardized mean difference meta-analysis for resistance exercise compared to control groups on C-reactive protein levels. n, sample size; T2DM (yr), years since the first diagnosis of type 2 diabetes mellitus; HbA1c, glycosylated hemoglobin; ES, effect size; CI, confidence interval; NR, not reported.

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  Fig. 3. Raw mean difference (MD) meta-analysis for resistance exercise and control groups on C-reactive protein levels (mg/dL). n, sample size; CI, confidence interval.

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  Fig. 4. Standardized mean difference meta-analysis for resistance exercise compared to control groups on tumor necrosis factor alpha. n, sample size; T2DM (yr), years since the first diagnosis of type 2 diabetes mellitus; HbA1c, glycosylated hemoglobin; ES, effect size; CI, confidence interval; NR, not reported.

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  Fig. 5. Standardized mean difference meta-analysis for resistance exercise compared to control groups on interleukin-6 levels. n, sample size; T2DM (yr), years since the first diagnosis of type 2 diabetes mellitus; HbA1c, glycosylated hemoglobin; ES, effect size; CI, confidence interval; NR, not reported.

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