Meta-Analysis of the Effect of Different Exercise Mode on Carotid Atherosclerosis

Abstract

(1) Background: There is increasing evidence showing the health benefits of exercise on carotid atherosclerosis. However, little is known about the different exercise modes for carotid atherosclerosis. This study was designed to perform a meta-analysis of effect of different exercise modes on carotid atherosclerosis so as to provide evidence-based suggestions for the prevention and management of cardiovascular and cerebrovascular diseases. (2) Methods: Six databases were systematically searched to identify randomized trials that compared exercise to a non-exercise intervention in patient with carotid atherosclerosis. We a priori specified changes in cIMT, TC, LDL-C, and HDL-C biomarkers as outcomes. (3) Results: Thirty-four trials met the eligibility criteria, comprising 2420 participants. The main analyses showed pronounced differences on cIMT (MD = -0.06, 95%CI (-0.09, -0.04), p < 0.00001, TC (MD = -0.41, 95%CI (-0.58, -0.23), p < 0.00001), LDL-C (MD = -0.31, 95%CI (-0.43, -0.20), p < 0.00001), and HDL-C (MD = 0.11, 95%CI (0.04, 0.19), p = 0.004), which significantly reduced the risk factors of carotid atherosclerosis disease. In the different exercise modes, the effect was pronounced for aerobic exercise for all outcomes except TC; high-intensity interval exercise also showed significance for all outcomes except TC and HDL-C; aerobic exercise combined with resistance exercise did not affect any outcome except HDL-C; (4) Conclusions: Exercise has a prominent prevention and improvement effect on carotid atherosclerosis. In the perspective of exercise pattern, aerobic exercise and high-intensity intermittent exercise can improve carotid atherosclerosis; however, aerobic exercise has a more comprehensive improvement effect.

Keywords: carotid atherosclerosis; carotid intima-media thickness; exercise; high-density lipoprotein; low-density lipoprotein; total cholesterol.

Figure 1

The flow diagram of the selection process.

Figure 2

Risk of bias summary: review authors’ judgments of bias items for each included study [12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45].

Figure 3

Risk of bias graph: reviewers’ judgments of each bias item, presented as percentages.

Figure 4

Meta−analyses of the effect of exercise on cIMT compared with the control group [12,13,14,15,17,18,19,20,22,23,26,27,28,29,30,31,33,34,35,37,38,39,40,41,43,44].

Figure 5

Subgroup analysis of cIMT effect size under different modes of exercise [12,13,14,15,17,18,19,20,22,23,26,27,28,29,30,31,33,34,35,37,38,39,40,41,43,44].

Figure 6

Meta−analyses of the effect of exercise on TC compared with the control groups [12,13,16,17,18,19,20,21,23,24,25,26,27,28,32,34,36,38,39,40,42,43].

Figure 7

Subgroup analysis of TC effect size under different modes of exercise [12,13,16,17,18,19,20,21,23,24,25,26,27,28,32,34,36,38,39,40,42,43].

Figure 8

Meta−analyses of the effect of exercise on LDL−C compared with the control group [12,13,16,17,18,19,20,21,22,23,24,26,27,28,29,31,32,34,35,36,39,42,43,45].

Figure 9

Subgroup analysis of LDL−C effect size under different modes of exercise [12,13,16,17,18,19,20,21,22,23,24,26,27,28,29,31,32,34,35,36,39,42,43,45].

Figure 10

Meta−analyses of the effect of exercise on HDL−C compared with the control group [12,13,16,17,18,19,21,22,23,24,25,26,27,28,29,31,32,34,35,36,39,42,43].

Figure 11

Subgroup analysis of HDL−C effect size under different modes of exercise [12,13,16,17,18,19,21,22,23,24,25,26,27,28,29,31,32,34,35,36,39,42,43].

Figure 12

Egger’s test for evaluating the publication bias of cIMT.

Figure 13

Egger’s test for evaluating the publication bias of TC.

Figure 14

Funnel plot for evaluating the publication bias of LDL−C.

Figure 15

Funnel plot for evaluating the publication bias of HDL−C.