title: Effects of aerobic, resistance, and combined exercise training on insulin resistance markers in overweight or obese children and adolescents: A systematic review and meta-analysis.
abstract: To assess the associations of aerobic, resistance, and combined exercise with changes in insulin resistance, fasting glucose, and fasting insulin in children and adolescents who are overweight or obese.
  
  
  
  MEDLINE via Pubmed, Cochrane-CENTRAL, SPORTDiscus, and LILACS.
  
  
  
  Randomized clinical trials of at least six weeks of duration that evaluated the ability of exercise training to lower at least one of the following outcomes: insulin resistance-HOMA, fasting glucose, and fasting insulin in children and/or adolescents classified as obese or overweight.
  
  
  
  Two independent reviewers extracted data and assessed the quality of the included studies. Differences (exercise training group minus control group) in the outcomes evaluated were analyzed using a random effects model.
  
  
  
  Of 1853 articles retrieved, 17 studies were included. The meta-analysis showed that physical training in general was not associated with a reduction in fasting glucose levels compared to the control, but it was associated with reductions in fasting insulin levels (-3.37μU/ml; CI 95%, -5.16μU/ml to -1.57μU/ml; I2, 54%, p=0.003) and HOMA (-0.61; CI 95%, -1.19 to -0.02; I2, 49%, p=0.040). In addition, each modality (aerobic, resistance, and combined) was compared to the control group. Aerobic exercise was associated with declines in fasting insulin levels (-4.52μU/ml; CI 95%, -7.40 to -1.65; I2, 65%, p=0.002) and in HOMA (-1.33; 95% confidence interval, -2.47 to -0.18; I2, 73%, p=0.005).
  
  
  
  Exercise training, especially aerobic training, is associated with the reduction of fasting insulin levels and HOMA in children and adolescents with obesity and overweight, and may prevent metabolic syndrome and type 2 diabetes.
authors: Universidade Federal do Rio Grande do Sul, Exercise Research Laboratory, Department of Physical Education, Felizardo Street, 750, Jardim Botânico, Physical Education School/Swimming Center, Room 18, 90690-200 Porto Alegre, RS, Brazil. Electronic address: elisa_marson@yahoo.com.br.
authors: Elisa Corrêa
authors: EC
authors: Marson
authors: Universidade Federal do Rio Grande do Sul, Exercise Research Laboratory, Department of Physical Education, Felizardo Street, 750, Jardim Botânico, Physical Education School/Swimming Center, Room 18, 90690-200 Porto Alegre, RS, Brazil; Faculdade Sogipa de Educação Física, Benjamin Constant Avenue, 80, São João, 90550-003 Porto Alegre, RS, Brazil. Electronic address: rsdrodrigo@hotmail.com.
authors: Rodrigo Sudatti
authors: RS
authors: Delevatti
authors: Universidade Federal do Rio Grande do Sul, Exercise Research Laboratory, Department of Physical Education, Felizardo Street, 750, Jardim Botânico, Physical Education School/Swimming Center, Room 18, 90690-200 Porto Alegre, RS, Brazil; Faculdade Cenecista de Osório. Jorge Dariva Avenue, 1042, Centro, 95520-000, Osório, RS, Brazil. Electronic address: konigg@ig.com.br.
authors: Alexandre Konig Garcia
authors: AK
authors: Prado
authors: Universidade Federal do Rio Grande do Sul, Exercise Research Laboratory, Department of Physical Education, Felizardo Street, 750, Jardim Botânico, Physical Education School/Swimming Center, Room 18, 90690-200 Porto Alegre, RS, Brazil. Electronic address: nettonathalie@gmail.com.
authors: Nathalie
authors: N
authors: Netto
authors: Universidade Federal do Rio Grande do Sul, Exercise Research Laboratory, Department of Physical Education, Felizardo Street, 750, Jardim Botânico, Physical Education School/Swimming Center, Room 18, 90690-200 Porto Alegre, RS, Brazil. Electronic address: kruel@esef.ufrgs.br.
authors: Luiz Fernando Martins
authors: LF
authors: Kruel
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control; D015444:Exercise / Q000502:physiology*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D063766:Pediatric Obesity / Q000378:metabolism / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic; D055070:Resistance Training / Q000379:methods*
chemical_list: D015415:Biomarkers
keywords: Childhood obesity; Exercise; Insulin resistance