Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jun 15, 2024; 15(6): 1353-1366
Published online Jun 15, 2024. doi: 10.4239/wjd.v15.i6.1353
Effects of exercise training on glucose metabolism indicators and inflammatory markers in obese children and adolescents: A meta-analysis
Le-Yang Li, Song-Mei Li, Bo-Xian Pang, Jun-Ping Wei, Qiu-Hong Wang
Le-Yang Li, Song-Mei Li, Jun-Ping Wei, Qiu-Hong Wang, Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
Bo-Xian Pang, Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China
Co-first authors: Le-Yang Li and Song-Mei Li.
Co-corresponding authors: Jun-Ping Wei and Qiu-Hong Wang.
Author contributions: Wang QH and Wei JP designed the study; Li LY and Li SM searched databases, performed the selection of studies, and analyzed the data; Pang BX helped perform the data analysis and complete table and figure presentation; Li LY wrote the manuscript. The final version was confirmed by all authors for submission. Wang QH and Wei JP contributed to the revised version. Li LY and Li SM independently completed the process of database search, screening research, data collection and data analysis. They have made crucial and indispensable contributions equally towards the completion of the project and thus qualified as the co-first authors of the paper. Wang QH and Wei JP offered critical insights and design perspectives, contributed equally to the revised version, they are co-corresponding authors for their equal and significant contributions, and there is no conflict of interest between them. We believe that designating Wang QH and Wei JP as co-corresponding authors of is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity. All authors contributed to the article. The final version was confirmed by all authors for submission.
Conflict-of-interest statement: The authors have nothing to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiu-Hong Wang, MD, Associate Professor, Department of Endocrinology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, No. 5 Beixiange Road, Beijing 100053, China. qiuhongforture@126.com
Received: December 30, 2023
Revised: February 7, 2024
Accepted: March 26, 2024
Published online: June 15, 2024
Processing time: 164 Days and 2.5 Hours
Abstract
BACKGROUND

Obesity in children and adolescents is a serious problem, and the efficacy of exercise therapy for these patients is controversial.

AIM

To assess the efficacy of exercise training on overweight and obese children based on glucose metabolism indicators and inflammatory markers.

METHODS

The PubMed, Web of Science, and Embase databases were searched for ran-domized controlled trials related to exercise training and obese children until October 2023. The meta-analysis was conducted using RevMan 5.3 software to evaluate the efficacy of exercise therapy on glucose metabolism indicators and inflammatory markers in obese children.

RESULTS

In total, 1010 patients from 28 studies were included. Exercise therapy reduced the levels of fasting blood glucose (FBG) [standardized mean difference (SMD): -0.78; 95% confidence interval (CI): -1.24 to -0.32, P = 0.0008], fasting insulin (FINS) (SMD: -1.55; 95%CI: -2.12 to -0.98, P < 0.00001), homeostatic model assessment for insulin resistance (HOMA-IR) (SMD: -1.58; 95%CI: -2.20 to -0.97, P < 0.00001), interleukin-6 (IL-6) (SMD: -1.31; 95%CI: -2.07 to -0.55, P = 0.0007), C-reactive protein (CRP) (SMD: -0.64; 95%CI: -1.21 to -0.08, P = 0.03), and leptin (SMD: -3.43; 95%CI: -5.82 to -1.05, P = 0.005) in overweight and obese children. Exercise training increased adiponectin levels (SMD: 1.24; 95%CI: 0.30 to 2.18, P = 0.01) but did not improve tumor necrosis factor-alpha (TNF-α) levels (SMD: -0.80; 95%CI: -1.77 to 0.18, P = 0.11).

CONCLUSION

In summary, exercise therapy improves glucose metabolism by reducing levels of FBG, FINS, HOMA-IR, as well as improves inflammatory status by reducing levels of IL-6, CRP, leptin, and increasing levels of adiponectin in overweight and obese children. There was no statistically significant effect between exercise training and levels of TNF-α. Additional long-term trials should be conducted to explore this therapeutic perspective and confirm these results.

Keywords: Exercise training; Obesity; Children and adolescents; Glucose metabolism; Inflammatory markers; Meta-analysis

Core Tip: It has been reported that exercise training therapy have a potential role in the development of obesity of children and adolescents. This meta-analysis aimed to resolve some contradictory conclusions in recent related studies.