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Meta-Analysis
. 2024 Mar 26:15:1347399.
doi: 10.3389/fendo.2024.1347399. eCollection 2024.

The effect of exercise on flow-mediated dilation in people with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials

Bopeng Qiu #  1 , Yilun Zhou #  1 , Xifeng Tao  1   2 , Xiao Hou  3 , Liwen Du  1 , Yuanyuan Lv  4 , Laikang Yu  1
Affiliations
Meta-Analysis

The effect of exercise on flow-mediated dilation in people with type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials

Bopeng Qiu et al. Front Endocrinol (Lausanne). .

Abstract

Introduction: An increasing number of studies have investigated the effect of exercise on flow-mediated dilation (FMD) in people with type 2 diabetes mellitus (T2DM), while the findings were controversial. The primary aim of this systematic review and meta-analysis was to investigate the effect of exercise on FMD in T2DM patients, and the secondary aim was to investigate the optimal type, frequency, session duration, and weekly time of exercise for T2DM patients.

Methods: Searches were conducted in PubMed, Cochrane Library, Scopus, Web of Science, Embase and EBSCO databases. The Cochrane risk of bias tool (RoB2) in randomized trial and Physiotherapy Evidence Database (PEDro) scale were used to assess the methodological quality of the included studies.

Results: From the 3636 search records initially retrieved, 13 studies met the inclusion criteria. Our meta-analysis revealed that exercise had a significant effect on improving FMD in T2DM patients [WMD, 2.18 (95% CI, 1.78-2.58), p < 0.00001, I2 = 38%], with high-intensity interval training (HIIT) being the most effective intervention type [HIIT, 2.62 (1.42-3.82); p < 0.0001; aerobic exercise, 2.20 (1.29-3.11), p < 0.00001; resistance exercise, 1.91 (0.01-3.82), p = 0.05; multicomponent training, 1.49 (0.15-2.83), p = 0.03]. In addition, a higher frequency [> 3 times, 3.06 (1.94-4.19), p < 0.00001; ≤ 3 times, 2.02 (1.59-2.45), p < 0.00001], a shorter session duration [< 60 min, 3.39 (2.07-4.71), p < 0.00001; ≥ 60 min, 1.86 (1.32-2.40), p < 0.00001], and a shorter weekly time [≤ 180 min, 2.40 (1.63-3.17), p < 0.00001; > 180 min, 2.11 (0.82-3.40), p = 0.001] were associated with larger improvements in FMD.

Conclusion: This meta-analysis provides clinicians with evidence to recommended that T2DM patients participate in exercise, especially HIIT, more than 3 times per week for less than 60 min, with a target of 180 min per week being reached by increasing the frequency of exercise.

Systematic review registration: https://www.crd.york.ac.uk/prospero, identifier CRD42023466575.

Keywords: endothelial function; exercise; flow-mediated dilation; meta-analysis; systematic review; type 2 diabetes mellitus.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart of study selection.
Figure 2
Figure 2
Results of Cochrane risk of bias tool.
Figure 3
Figure 3
Meta-analysis results of the effect of exercise on FMD in T2DM patients.
Figure 4
Figure 4
Meta-analysis results of the effect of different types of intervention on FMD in T2DM patients.
Figure 5
Figure 5
Meta-analysis results of the effect of the frequency of intervention on FMD in T2DM patients.
Figure 6
Figure 6
Meta-analysis results of the effect of the duration of intervention per session on FMD in T2DM patients.
Figure 7
Figure 7
Meta-analysis results of the effect of the duration of intervention per week on FMD in T2DM patients.
Figure 8
Figure 8
Funnel plot.
See this image and copyright information in PMC

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