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Review
. 2018 Oct 30;6(4):97.
doi: 10.3390/medsci6040097.

Exercise Increases Adiponectin and Reduces Leptin Levels in Prediabetic and Diabetic Individuals: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Tarik Becic  1 , Christian Studenik  2 , Georg Hoffmann  3
Affiliations
Review

Exercise Increases Adiponectin and Reduces Leptin Levels in Prediabetic and Diabetic Individuals: Systematic Review and Meta-Analysis of Randomized Controlled Trials

Tarik Becic et al. Med Sci (Basel). .

Abstract

It is speculated that lifestyle interventions known to improve diabetic metabolic state may exert their effects via adipokines. The aim of this systematic review and meta-analysis was to evaluate the chronic effects of physical exercise on adiponectin and leptin levels in adult prediabetic and diabetic individuals. PubMed, Embase, Scopus, The Cochrane Library, clinicaltrials.gov, and WHO Clinical Trials Registry were searched for randomized controlled trials. Pooled effects of interventions were assessed as mean difference (MD) with random effects model. Sensitivity analysis was conducted to test data robustness and subgroup analysis for study heterogeneity. Twenty-two trials with 2996 individuals were included in the meta-analysis. Physical exercise increased levels of adiponectin (MD: 0.42 µg/mL; 95% confidence interval (CI), 0.23, 0.60, p < 0.00001, n = 19 trials) and reduced leptin levels (MD: -1.89 ng/mL; 95% CI, -2.64, -1.14, p < 0.00001, n = 14 trials). These results were robust and remained significant after sensitivity analysis. Study heterogeneity was generally high. As for physical exercise modalities, aerobic exercise, but not other modalities, increased adiponectin and reduced leptin levels. In conclusion, physical exercise and, specifically, aerobic exercise, leads to higher adiponectin and lower leptin levels in prediabetic and diabetic adults. However, cautious interpretation of current findings is warranted.

Keywords: adipokines; diabetes mellitus; exercise.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Effects of physical exercise, including different modalities, on adiponectin levels (µg/mL). Forest plot shows pooled mean differences with 95% confidence intervals (CI) for 24 effect sizes pooled from 19 trials (two separate effect sizes were pooled for different exercise modalities from Jorge [40] and Ku [51], and three from Balducci [39]). The green colored square represents the point estimate of the effect of the intervention for each trial. The horizontal line joins the upper and lower limits of the 95% CI of the effects. The square area represents the relative weight of the trial in the meta-analysis. The black colored diamond at the bottom represents the pooled mean difference with 95% CI for all study groups.
Figure 2
Figure 2
Effects of physical exercise, including different modalities, on leptin levels (ng/mL). Forest plot shows pooled mean differences with 95% confidence intervals (CI) for 17 pooled effect sizes from 14 trials (two separate effect sizes were pooled for different exercise modalities from Ku [51] and three from Balducci [39]). The green colored square represents the point estimate of the effect of the intervention for each trial. The horizontal line joins the upper and lower limits of the 95% CI of the effects. The square area represents the relative weight of the trial in the meta-analysis. The black colored diamond at the bottom represents the pooled mean difference with 95% CI for all study groups.
Figure 3
Figure 3
Funnel plot showing study precision against the mean difference effect estimate with 95% confidence interval for (A) adiponectin and (B) leptin. SE—standard error, MD—mean difference.
See this image and copyright information in PMC

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