Impact of aerobic exercise on cardiometabolic health in patients with diabesity: A systematic review and meta-analysis of randomized controlled trials

IF 3.2 3区医学 Q3 ENDOCRINOLOGY & METABOLISM

Journal of diabetes and its complications Pub Date : 2025-12-01 Epub Date: 2025-10-19 DOI:10.1016/j.jdiacomp.2025.109203

Sameer Badri Al-Mhanna , Barry A. Franklin , John M. Jakicic , Emmanuel Stamatakis , Linda S. Pescatello , Deborah Riebe , Walter R. Thompson , James S. Skinner , Sheri R. Colberg , Jonathan K. Ehrman , George S. Metsios , Norsuhana Omar , Nouf H. Alkhamees , Bodor Bin Sheeha , Abdullah F. Alghannam , Alexios Batrakoulis

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引用次数: 0

Abstract

Purpose

This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to evaluate the effects of aerobic exercise on cardiometabolic health-related indices in patients with type 2 diabetes and concurrent overweight/obesity (diabesity).

Methods

PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar databases were searched from inception to October 2024. The search strategy included the following keywords: diabetes, aerobic exercise, and endurance training. RCTs comparing aerobic exercise training ≥2 weeks in duration to standard treatment were considered eligible. Participants were adults with diabesity.

Results

A total of 1391 middle-aged/older adult patients (55 % females) were included in 34 RCTs. Body mass index [standardized mean differences (SMD) -0.18 kg/m², 95 % confidence intervals (CI) -0.36 to −0.01]. waist circumference (SMD -0.23 cm, 95 % CI -0.44 to −0.03), body fat (SMD -0.30 %, 95 % CI -0.59 to −0.01), fasting blood glucose (SMD -0.49 mmol/L, 95 % CI -0.72 to −0.27), glycated hemoglobin (SMD -0.79 %, 95 % CI -1.17 to −0.41), fasting insulin (SMD -0.44 mIU/L, 95 % CI -0.72 to −0.15), homeostatic model assessment for insulin resistance (SMD -0.72, 95 % CI -1.09 to −0.35), high-density lipoprotein cholesterol (SMD 0.32 mg/dL, 95 % CI 0.01 to 0.63), triglycerides (SMD -0.33 mg/dL, 95 % CI -0.63 to −0.04), and total cholesterol (SMD -0.28 mg/dL, 95 % CI -0.47 to −0.10) improved compared with standard treatment.

Conclusions

These results underscore the beneficial role of aerobic exercise as a non-pharmacological intervention in managing and treating patients with diabesity when compared to standard treatment, despite the presence of considerable uncertainty in several outcomes.

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有氧运动对糖尿病患者心脏代谢健康的影响：随机对照试验的系统回顾和荟萃分析

目的对随机对照试验（RCTs）进行系统回顾和荟萃分析，旨在评估有氧运动对2型糖尿病合并超重/肥胖（糖尿病）患者心脏代谢相关指标的影响。方法检索spubmed、Web of Science、Scopus、Science Direct、Cochrane Library和谷歌Scholar数据库，检索时间为建库至2024年10月。搜索策略包括以下关键词：糖尿病、有氧运动和耐力训练。比较持续时间≥2周的有氧运动训练与标准治疗的rct被认为是合格的。参与者是患有糖尿病的成年人。结果34项随机对照试验共纳入1391例中老年患者，其中女性占55%。体重指数[标准化平均差(SMD) -0.18 kg/m2, 95%置信区间(CI) -0.36至- 0.01]。腰围(SMD -0.23厘米,95% CI -0.44−0.03),脂肪(SMD -0.30%, 95% CI -0.59−0.01)、空腹血糖(SMD -0.49更易/ L, 95%置信区间-0.72 - 0.27−)、糖化血红蛋白(SMD -0.79%, 95% CI -1.17−0.41)、空腹胰岛素(SMD -0.44个人/ L, 95% CI -0.72−0.15),稳态模型评估胰岛素抵抗(SMD -0.72, 95% CI -1.09−0.35),高密度脂蛋白胆固醇(SMD 0.32 mg / dL, 95%可信区间0.01到0.63),甘油三酯(SMD -0.33 mg / dL,95% CI -0.63至- 0.04)，总胆固醇（SMD -0.28 mg/dL, 95% CI -0.47至- 0.10）与标准治疗相比有所改善。结论：与标准治疗相比，这些结果强调了有氧运动作为一种非药物干预在管理和治疗糖尿病患者方面的有益作用，尽管在一些结果中存在相当大的不确定性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of diabetes and its complications 医学-内分泌学与代谢

CiteScore

5.90

自引率

3.30%

发文量

153

审稿时长

16 days

期刊介绍： Journal of Diabetes and Its Complications (JDC) is a journal for health care practitioners and researchers, that publishes original research about the pathogenesis, diagnosis and management of diabetes mellitus and its complications. JDC also publishes articles on physiological and molecular aspects of glucose homeostasis. The primary purpose of JDC is to act as a source of information usable by diabetes practitioners and researchers to increase their knowledge about mechanisms of diabetes and complications development, and promote better management of people with diabetes who are at risk for those complications. Manuscripts submitted to JDC can report any aspect of basic, translational or clinical research as well as epidemiology. Topics can range broadly from early prediabetes to late-stage complicated diabetes. Topics relevant to basic/translational reports include pancreatic islet dysfunction and insulin resistance, altered adipose tissue function in diabetes, altered neuronal control of glucose homeostasis and mechanisms of drug action. Topics relevant to diabetic complications include diabetic retinopathy, neuropathy and nephropathy; peripheral vascular disease and coronary heart disease; gastrointestinal disorders, renal failure and impotence; and hypertension and hyperlipidemia.