Exercise as a modulator of systemic inflammation and oxidative stress biomarkers across clinical and healthy populations: an umbrella meta-analysis

运动作为临床和健康人群中系统性炎症和氧化应激生物标志物的调节剂:一项综合性荟萃分析

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Abstract

OBJECTIVE: Inflammation is a condition that trigger an immune response and oxidative stress refers to an imbalance between production and elimination of reactive oxygen species (ROS). However, several non-pharmacological approaches have been proposed to improve health outcomes, among which exercise programs have shown promising effects on inflammatory and oxidative biomarkers across various health conditions. AIM: In this regard, the present umbrella meta-analysis aimed to evaluate the potential of exercise interventions to modulate inflammatory and oxidative stress biomarkers across different population. METHODS: A comprehensive systematic search was carried out in on Scopus, PubMed, Embase, Web of Science, and Google Scholar up to March 2025. The overall effect size (ESs) was calculated using random effect model. Also, subgroup analyses were performed regarding ESs, health status, ad type of exercise program. RESULTS: Our comprehensive systematic search initially identified 1246 studies, of which twenty-nine meta-analyses, were included in the present umbrella meta-analysis. Finding revealed that training program could significantly reduce C-reactive protein (CRP) (ES: -0.50; 95% CI: -0.65, -0.36, P < 0.001), interleukin-6 (IL-6) (E: -0.29; 95% CI: -0.41, -0.18; P < 0.001), IL-8 (ES: -1.20; 95% CI: -2.19, -0.21, P = 0.018), tumor necrosis factor-α (TNF-α) (ES: -0.47, 95% CI: -0.60, -0.34; P < 0.001). In addition, it was accompanied with an improvement in malondialdehyde (MDA) (ES: -1.26; 95% CI: -1.60, -0.93, P < 0.001) and glutathione peroxidase (GPx) (ES: 0.88, 95% CI: 0.25, 1.51; P = 0.006) level too. Subgroup analyses indicated that all aerobic, resistance and combined exercise could improve inflammatory state significantly. Also, exercise favorable properties were evident in most health state to affect CRP, IL-6, and TNF-α level. CONCLUSION: Exercise program could attenuate the CRP, IL-6, IL-8 and TNF-α level. Additionally, exercise demonstrated a beneficial impact on oxidative status, as evidenced by decreased MDA levels and increased GPx activity.

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