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J Am Heart Assoc. 2015 Jun 26;4(7). pii: e002014. doi: 10.1161/JAHA.115.002014.

Effects of Exercise Training on Cardiorespiratory Fitness and Biomarkers of Cardiometabolic Health: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Author information

1
Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.).
2
Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN (X.Z., Y.S.).
3
Center for the Youth Sport Research and Development, China Institute of Sport Science, Beijing, China (J.G.).
4
Geriatrics, Research, Education and Clinical Centers, VA Greater Los Angeles Healthcare System, Los Angeles, CA (C.K.R.).
5
Department of Kinesiology, Center for Physical Activity in Wellness and Prevention, Indiana University-Purdue University at Indianapolis, IN (S.M.K.).
6
Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.) Division of Cardiology and Veterans Affairs Medical Center, Department of Medicine, Alpert Medical School, Brown University, Providence, RI (W.C.W., S.L.).
7
Department of Epidemiology, School of Public Health, Brown University, Providence, RI (X.L., W.C.W., S.L.) Division of Cardiology and Veterans Affairs Medical Center, Department of Medicine, Alpert Medical School, Brown University, Providence, RI (W.C.W., S.L.) Division of Endocrinology, Department of Medicine, Rhode Island Hospital, Providence, RI (S.L.).

Abstract

BACKGROUND:

Guidelines recommend exercise for cardiovascular health, although evidence from trials linking exercise to cardiovascular health through intermediate biomarkers remains inconsistent. We performed a meta-analysis of randomized controlled trials to quantify the impact of exercise on cardiorespiratory fitness and a variety of conventional and novel cardiometabolic biomarkers in adults without cardiovascular disease.

METHODS AND RESULTS:

Two researchers selected 160 randomized controlled trials (7487 participants) based on literature searches of Medline, Embase, and Cochrane Central (January 1965 to March 2014). Data were extracted using a standardized protocol. A random-effects meta-analysis and systematic review was conducted to evaluate the effects of exercise interventions on cardiorespiratory fitness and circulating biomarkers. Exercise significantly raised absolute and relative cardiorespiratory fitness. Lipid profiles were improved in exercise groups, with lower levels of triglycerides and higher levels of high-density lipoprotein cholesterol and apolipoprotein A1. Lower levels of fasting insulin, homeostatic model assessment-insulin resistance, and glycosylated hemoglobin A1c were found in exercise groups. Compared with controls, exercise groups had higher levels of interleukin-18 and lower levels of leptin, fibrinogen, and angiotensin II. In addition, we found that the exercise effects were modified by age, sex, and health status such that people aged <50 years, men, and people with type 2 diabetes, hypertension, dyslipidemia, or metabolic syndrome appeared to benefit more.

CONCLUSIONS:

This meta-analysis showed that exercise significantly improved cardiorespiratory fitness and some cardiometabolic biomarkers. The effects of exercise were modified by age, sex, and health status. Findings from this study have significant implications for future design of targeted lifestyle interventions.

KEYWORDS:

biomarker; cardiometabolic health; cardiovascular disease prevention; exercise training

PMID:
26116691
PMCID:
PMC4608087
DOI:
10.1161/JAHA.115.002014
[Indexed for MEDLINE]
Free PMC Article

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