title: Effects of exercise on C-reactive protein, inflammatory cytokine and adipokine in patients with type 2 diabetes: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  C-reactive protein (CRP), inflammatory cytokines, and adipokines contribute to atherosclerosis, insulin resistance, and development of late-onset complication in patients with type 2 diabetes. We performed a systematic review to assess effects of exercise interventions on inflammatory markers/cytokines and adipokines.
  
  
  METHODS
  We searched electronic databases (MEDLINE, EMBASE, and Cochrane Controlled Trials Registry) and reference lists in relevant papers for articles published in 1966-2013. We selected studies that evaluated the effects of exercise intervention on inflammatory markers/cytokines and adipokines in adult patients with type 2 diabetes. Weighted mean differences of exercise on outcomes were derived using fixed or random effect models; factors influencing heterogeneity were identified using meta-regression analysis.
  
  
  RESULTS
  Fourteen randomized controlled trials (824 patients) were included in our meta-analysis. Exercise was associated with a significant in CRP=-0.66mg/l (95% CI, -1.09 to -0.23mg/l; -14% from baseline) and interleukin-6 (IL-6)=-0.88pg/ml (95% CI, -1.44 to -0.32pg/ml; -18% from baseline) but did not alter adiponectin or resistin levels; aerobic exercise program was associated with a significant change in leptin=-3.72ng/ml (95% CI, -6.26 to -1.18ng/ml; -24% from baseline). For IL-6, exercise was more effective in those with a longer duration in the program and larger number of sessions during study (p=0.001).
  
  
  CONCLUSIONS
  Exercise decreases inflammatory cytokine (CRP and IL-6) in patients with type 2 diabetes. Exercise could be a therapeutic option for improving abnormalities in inflammation levels in patients with diabetes.
authors.affiliation: Department of Endocrinology, Tenri Hospital, Nara, Japan; Department of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan. Electronic address: hayasino-y@umin.net.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Hayashino
authors.affiliation: Department of General Medicine, Zablocki VA Medical Center, Milwaukee, WI, USA.
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Jackson
authors.affiliation: Department of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Hirata
authors.affiliation: Department of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Fukumori
authors.affiliation: Department of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Nakamura
authors.affiliation: Department of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan.
authors.forename: Shunichi
authors.initials: S
authors.lastname: Fukuhara
authors.affiliation: Department of Endocrinology, Tenri Hospital, Nara, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Tsujii
authors.affiliation: Department of Endocrinology, Tenri Hospital, Nara, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ishii
mesh_terms: D054392:Adipokines / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism* / Q000503:physiopathology*; D015444:Exercise / Q000502:physiology*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000378:metabolism* / Q000503:physiopathology; D015850:Interleukin-6 / Q000378:metabolism*; D008297:Male; D008875:Middle Aged
chemical_list: D054392:Adipokines; D015415:Biomarkers; D015850:Interleukin-6; D002097:C-Reactive Protein
keywords: Adipokine; Diabetes; Exercise; Inflammation