Abstract
Objectives
To examine the effect of aerobic and resistant exercise intervention on inflammaging
in middle-aged and older adults with type 2 diabetes mellitus (T2DM) using inflammatory
cytokines, such as interleukin (IL)-1 β, IL-6, tumor necrosis factor-α (TNF-α), and
C-reactive protein (CRP) as biomarkers.
Design
Systematic review and meta-analysis.
Setting and Participants
Middle-aged and older adults with T2DM in the community.
Methods
Articles were searched from 8 electronic databases. Randomized control trials (RCTs)
published in English, from inception to October 31, 2021, were included in this review.
Two authors conducted data extraction and quality appraisal independently following
guidelines in the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analysis
was conducted using Review Manager. Heterogeneity was investigated using subgroup
and sensitivity analysis.
Results
This review included 14 RCTs. The meta-analysis showed significant improvement in
IL-6 [Z = 3.05; 95% confidence interval (CI): −3.60 to −0.79; P = .002], CRP (Z = 2.44; 95% CI: −0.55 to −0.06; P = .01) and TNF-α levels (Z = 2.96; 95% CI: −2.21 to −0.45; P = .003) post-exercise programs. Subgroup analysis revealed that combined aerobic
and resistance exercises and long-term exercises have more significant improvement
to the outcomes than usual care. Based on the Grades of Recommendation, Assessment,
Development and Evaluation system, considerable risk of bias and low level of certainty
were revealed in all biomarker outcomes.
Conclusions and Implications
Exercise intervention is effective in improving inflammatory, metabolic, and lipid
markers in middle-aged and older adults with T2DM. By modifying the levels of these
markers with exercise, inflammation and insulin resistance can be improved. Long-term,
combined aerobic and resistance exercise interventions have more significant effect
on biomarkers. The small sample size of this meta-analysis limited the generalizability
of the results. Future studies can consider adopting a more optimized exercise regimen
to achieve effective T2DM management in middle-aged and older adults. Similar studies
should expand to other populations and larger sample sizes to explore replicability
of these effects.
Keywords
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Article info
Publication history
Published online: February 17, 2022
Footnotes
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
The authors declare no conflicts of interest.
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