Exercise training-induced changes in exerkine concentrations may be relevant to the metabolic control of type 2 diabetes mellitus patients:A systematic review and meta-analysis of randomized controlled trials

Background:This study investigates the effects of exercise training on exerkines in patients with type 2 diabetes mellitus to determine the optimal exercise prescription.Methods:A systematic search for relevant studies was performed in 3 databases.Randomized controlled trials investigating the effects of exercise training on at least one of the following exerkines were included:adiponectin,apelin,brain-derived neurotrophic factor,fetuin-A,fibroblast growth factor-21,follistatin,ghrelin,interleukin(IL)-6,IL-8,IL-10,IL-15,IL-18,leptin,myostatin,omentin,resistin,retinol-binding protein 4,tumor necrosis factor-α,and visfatin.Results:Forty randomized controlled trials were selected for data extraction(n=2160).Exercise training induces changes in adiponectin,fetuin-A,fibroblast growth factor-21,IL-6,IL-10,leptin,resistin,and tumor necrosis factor-a levels but has no significant effects on apelin,IL-18,and ghrelin compared to controls.Physical exercise training favored large and positive changes in pooled exerkines(i.e.,an overall effect size calculated from several exerkine s)(Hedge’s g=1.02,95%confidence interval(95%CI):0.76-1.28),which in turn were related to changes in glycated hemoglobin(mean difference(MD)=-0.81%,95%CI:-0.95%to-0.67%),fasting glucose(MD=-23.43 mg/dL,95%CI:-30.07 mg/dL to-16.80 mg/dL),waist circumference(MD=-3.04 cm,95%CI:-4.02 cm to-2.07 cm),and body mass(MD=-1.93 kg,95%CI:-2.00 kg to-1.86 kg).Slightly stronger effects were observed with aerobic,resistance,or high-intensity interval protocols at moderate-to vigorous-intensity and with programs longer than 24 weeks that comprise at least 3 sessions per week and more than 60 min per session.Conclusion:Exercise training represents an anti-inflammatory therapy and metabolism-improving strategy with minimal side effects for patients with type 2 diabetes mellitus.

Twenty-four-hour movement guidelines during middle adolescence and their association with glucose outcomes and type 2 diabetes mellitus in adulthood

Purpose:The aim of the present study was to determine the association between adherence to the 24-h movement guidelines during middle adolescence and glucose outcomes(glycated hemoglobin and fasting glucose)and type 2 diabetes mellitus(T2DM)in adulthood,14 and 22 years later.Methods:We analyzed data from apparently healthy adolescents aged 12-18 years who participated in WavesⅠandⅡ(1994-1996,n=14,738),WaveⅣ(2008-2009,n=8913),and Wave V(2016-2018,n=3457)of the National Longitudinal Study of Adolescent to Adult Health(Add Health)in the United States.Physical activity,screen time,and sleep duration were measured using questionnaires,and the 24-h guidelines were defined as:5 or more times moderate-to-vigorous physical activity per week,≤2 h per day of screen time,and 9-11 h of sleep for 12-13 years and 8-10 h for 14-17 years.Capillary and venous whole blood was collected and analyzed to determine glycated hemoglobin and fasting glucose for WavesⅣandⅤ,respectively.Results:Only 2.1%of the adolescents met all the 3 guidelines,and 37.8%met none of them.In both wavesⅣandⅤ,adolescents who met physical activity and screen time guidelines had lower odds of T2DM in adulthood than those who did not meet any of these guidelines(WaveⅣ;prevalence ratio(PR)=0.57,95%confidence interval(95%CI):0.21-0.89;Wave V:PR=0.43,95%CI:0.32-0.74).Only for Wave V did adolescents who met all 3 guidelines have lower odds of T2DM at follow-up compared with those who did not meet any of these guidelines(PR=0.47,95%CI:0.24-0.91).Also,for each increase in meeting one of the 24-h recommendations,the odds of T2DM decreased by 18%(PR=0.82,95%CI:0.61-0.99)and 15%(PR=0.85,95%CI:0.65-0.98)in adulthood for WavesⅣandⅤ,respectively.Conclusion:Promoting all 24-h movement guidelines in adolescence,especially physical activity and screen time,is important for lowering the potential risk of T2DM in adulthood.

Cardiorespiratory fitness measured with cardiopulmonary exercise testing and mortality in patients with cardiovascular disease:A systematic review and meta-analysis

Background Cardiorespiratory fitness(CRF)is inversely associated with mortality in apparently healthy subjects and in some clinical populations,but evidence for the association between CRF and all-cause and/or cardiovascular disease(CVD)mortality in patients with established CVD is lacking.This study aimed to quantify this association.Methods We searched for prospective cohort studies that measured CRF with cardiopulmonary exercise testing in patients with CVD and that examined all-cause and CVD mortality with at least 6 months of follow-up.Pooled hazard ratios(HRs)were calculated using random-effect inverse-variance analyses.Results Data were obtained from 21 studies and included 159,352 patients diagnosed with CVD(38.1%female).Pooled HRs for all-cause and CVD mortality comparing the highest vs.lowest category of CRF were 0.42(95%confidence interval(95%CI):0.28–0.61)and 0.27(95%CI:0.16–0.48),respectively.Pooled HRs per 1 metabolic equivalent(1-MET)increment were significant for all-cause mortality(HR=0.81;95%CI:0.74–0.88)but not for CVD mortality(HR=0.75;95%CI:0.48–1.18).Coronary artery disease patients with high CRF had a lower risk of all-cause mortality(HR=0.32;95%CI:0.26–0.41)than did their unfit counterparts.Each 1-MET increase was associated with lower all-cause mortality risk among coronary artery disease patients(HR=0.83;95%CI:0.76–0.91)but not lower among those with heart failure(HR=0.69;95%CI:0.36–1.32).Conclusion A better CRF was associated with lower risk of all-cause mortality and CVD.This study supports the use of CRF as a powerful predictor of mortality in this population.

The effects of plyometric jump training on physical fitness attributes in basketball players:A meta-analysis`

Background:There is a growing body of experimental evidence examining the effects of plyometric jump training(PJT)on physical fitness attributes in basketball players;however,this evidence has not yet been comprehensively and systematically aggregated.Therefore,our objective was to meta-analyze the effects of PJT on physical fitness attributes in basketball players,in comparison to a control condition.Methods:A systematic literature search was conducted in the databases PubMed,Web of Science,and Scopus,up to July 2020.Peer-reviewed controlled trials with baseline and follow-up measurements investigating the effects of PJT on physical fitness attributes(muscle power,i.e.,jumping performance,linear sprint speed,change-of-direction speed,balance,and muscle strength)in basketball players,with no restrictions on their playing level,sex,or age.Hedge’s g effect sizes(ES)were calculated for physical fitness variables.Using a random-effects model,potential sources of heterogeneity were selected,including subgroup analyses(age,sex,body mass,and height)and single training factor analysis(program duration,training frequency,and total number of training sessions).Computation of metaregression was also performed.Results:Thirty-two studies were included,involving 818 total basketball players.Significant(p<0.05)small-to-large effects of PJT were evident on vertical jump power(ES=0.45),countermovement jump height with(ES=1.24)and without arm swing(ES=0.88),squat jump height(ES=0.80),drop jump height(ES=0.53),horizontal jump distance(ES=0.65),linear sprint time across distances≤10 m(ES=1.67)and>10 m(ES=0.92),change-of-direction performance time across distances≤40 m(ES=1.15)and>40 m(ES=1.02),dynamic(ES=1.16)and static balance(ES=1.48),and maximal strength(ES=0.57).The meta-regression revealed that training duration,training frequency,and total number of sessions completed did not predict the effects of PJT on physical fitness attributes.Subgroup analysis indicated greater improvements in older compared to younger players in horizontal jump distance(>17.15 years,ES=2.11;≤17.15 years,ES=0.10;p<0.001),linear sprint time>10 m(>16.3 years,ES=1.83;≤16.3 years,ES=0.36;p=0.010),and change-of-direction performance time≤40 m(>16.3 years,ES=1.65;≤16.3 years,ES=0.75;p=0.005).Greater increases in horizontal jump distance were apparent with>2 compared with≤2 weekly PJT sessions(ES=2.12 and ES=0.39,respectively;p<0.001).Conclusion:Data from 32 studies(28 of which demonstrate moderate-to-high methodological quality)indicate PJT improves muscle power,linear sprint speed,change-of-direction speed,balance,and muscle strength in basketball players independent of sex,age,or PJT program variables.However,the beneficial effects of PJT as measured by horizontal jump distance,linear sprint time>10 m,and change-of-direction performance time≤40 m,appear to be more evident among older basketball players.

Effects of a long-term physical exercise program with and without diet on obese boys after six-month detraining

Background:Most studies on physical fitness and detraining have been conducted on normal-weight children.Their results indicate that any gains regress to the untrained control values during the detraining period.It,therefore,seems necessary to determine how detraining affects the different fitness parameters in obese children.The aim of the present study was to evaluate the effects of detraining(6 months)on kinanthropometry and the components of physical fitness after an intervention(31 months)consisting of a program of exercise and/or diet for obese boys.Methods:The participants were 18 boys,aged between 8 and 11 years,divided into E and E+D groups according to the program they followed.The E group followed a physical exercise program(three 90-minute sessions/week),and the E+D group the same physical exercise program plus a low calorie diet.Physical fitness was assessed by the European physical fitness test battery including flamingo balance,plate tapping,sit-andreach,standing broad jump,hand-grip strength,sit-ups,bent-arm hang,10×5-metre shuttle run,and 20-metre endurance shuttle run.The Kruskal-Wallis test was applied to reveal overall intergroup differences(E and E+D groups),and measurements showing significant differences were further analysed for differences between individual groups by the Mann-Whitney U test.Results:In both groups,changes were observed in various physical fitness parameters,especially limb speed(E group,P=0.001;E+D group,P=0.002),agility(E group,P<0.001;E+D group,P<0.001),and aerobic fitness(E group,P=0.009;E+D group,P=0.002).Conclusion:Detraining after a long-term intervention based on the combination of exercise program and exercise program plus diet in obese boys does not affect the changes attained during the intervention.