title: Effect of exercise training on C reactive protein: a systematic review and meta-analysis of randomised and non-randomised controlled trials.
abstract: OBJECTIVE
  C-reactive protein (CRP) is a marker of chronic systemic inflammation frequently used in cardiovascular disease risk assessment. The purpose of this meta-analysis was to provide a quantitative estimate of the magnitude of change in CRP following participation in physical exercise interventions.
  
  
  METHODS
  All studies included in the meta-analysis were peer reviewed and published in English. Human participants were assigned to a non-exercise comparison group or exercise training group, with the intervention lasting ≥2 weeks. CRP levels were measured at baseline, during and/or after completion of the exercise training programme. Random-effects models were used to aggregate a mean effect size (ES), 95% CIs and potential moderators.
  
  
  RESULTS
  83 randomised and non-randomised controlled trials met the inclusion criteria and resulted in 143 effects (n=3769). The mean ES of 0.26 (95% CI 0.18 to 0.34, p<0.001) indicated a decrease in CRP following exercise training. A decrease in body mass index (BMI; β=1.20, SE=0.25, p<0.0001) and %Fat (β=0.76, SE=0.21, p=0.0002) were associated with a decrease in CRP, independently accounting for 11.1% and 6.6% of the variation in response, respectively. Exercise training led to a greater reduction in CRP when accompanied by a decrease in BMI (ES=0.38, 95% CI 0.26 to 0.50); however, a significant improvement in CRP occurred in the absence of weight loss (ES=0.19, 95% CI 0.10 to 0.28; both p<0.001).
  
  
  CONCLUSIONS
  These results suggest that engaging in exercise training is associated with a decrease in CRP levels regardless of the age or sex of the individual; however, greater improvements in CRP level occur with a decrease in BMI or %Fat.
authors.affiliation: Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, USA.
authors.forename: Michael V
authors.identifier: http://orcid.org/0000-0002-2055-863X
authors.initials: MV
authors.lastname: Fedewa
authors.affiliation: Department of Kinesiology, The University of Georgia, Athens, Georgia, USA.
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Hathaway
authors.affiliation: Department of Kinesiology, The University of Rhode Island, Kingston, Rhode Island, USA.
authors.forename: Christie L
authors.initials: CL
authors.lastname: Ward-Ritacco
mesh_terms: D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis*; D015444:Exercise / Q000502:physiology*; D006801:Humans; D007249:Inflammation / Q000097:blood*; D065228:Non-Randomized Controlled Trials as Topic; D016032:Randomized Controlled Trials as Topic
chemical_list: D002097:C-Reactive Protein
keywords: Exercise training; Meta-analysis