Effect of physical activity promotion on adiponectin, leptin and other inflammatory markers in prediabetes: a systematic review and meta-analysis of randomized controlled trials

Abstract

Aims: Inflammatory stage in prediabetes is associated with increase in level of adipokines and pro-inflammatory cytokines. Physical activity promotion considered as a first-line therapeutic strategy to treat prediabetes. We have conducted the systematic review and meta-analysis to strengthen the evidence on the impact of physical activity promotion on inflammatory markers in prediabetes.

Methods: Studies were identified using electronic search and manual search techniques by choosing keywords for prediabetes, physical activity and inflammatory marker. Randomized controlled trials on individuals diagnosed with prediabetes and provided intervention in the form of physical activity were included in this review. Adiponectin, leptin, C-reactive protein, interleukin-6 and tumour necrosis factor-α were the considered outcome measures.

Results: Our search retrieved 1,688 citations, 31 full-text articles assessed for eligibility of inclusion. Nine studies satisfied the pre-specified criteria for inclusion. Meta-analysis found that physical activity with or without dietary or lifestyle modification reduces level of leptin (MD-2.11 ng/mL, 95% CI -3.81 - -0.42) and interleukin-6 (MD -0.15 pg/mL, 95% CI -0.25--0.04). It has no effect on level of adiponectin (MD 0.26 µg/mL, 95% CI -0.42- 0.93), C-reactive protein (MD -0.05 mg/L, 95% CI -0.33-0.23) and tumour necrosis factor-α (MD 0.67 pg/mL, 95% CI -2.56-3.89).

Conclusions: This review suggests that physical activity promotion with dietary and lifestyle modification may reduce the level of leptin and interleukin-6 but are uncertain if there is any effect on levels of adiponectin, C-reactive protein and tumour necrosis factor-α in the individuals with prediabetes.

Keywords: Adipokines; Cytokines; Diabetes; Inflammation; Lifestyle.

Fig. 1

PRISMA flow chart

Fig. 2

Analysis 1.1: effect of physical activity with or without dietary or lifestyle modification versus usual care on adiponectin

Fig. 3

Analysis 1.2: effect of physical activity with or without dietary or lifestyle modification versus usual care on leptin

Fig. 4

Analysis 1.3: effect of physical activity with or without dietary or lifestyle modification versus usual care on CRP

Fig. 5

Analysis 1.4: effect of physical activity with or without dietary or lifestyle modification versus usual care on IL-6

Fig. 6

Analysis 1.5: effect of physical activity with or without dietary or lifestyle modification versus usual care on TNF-α