Resistance Exercise And Cardiometabolic Risk In Prediabetes: A Systematic Review And Meta-analysis

Abstract

Prediabetes is a highly prevalent precursor to type 2 diabetes, and is also associated with an increased risk of morbidity and mortality. Resistance exercise (RE) is an effective method of reducing cardiometabolic risk factors in persons with a diagnosis of type 2 diabetes, but its efficacy in individuals with prediabetes is unclear. Determining the cardiometabolic impact of RE in prediabetes is necessary for evidence-based exercise prescription for diabetes prevention. PURPOSE: To undertake a systematic review and meta-analysis of randomized and non-randomized control trials examining the effect of RE on cardiometabolic risk factors in individuals with prediabetes. METHODS: PubMed, Cochrane, Web of Science, and Embase databases were searched for published studies of adults at risk for diabetes and who participated in a RE intervention. All studies included randomized or non-randomized control trials. The database search and data extraction were performed by two separate reviewers. A systematic review and meta-analysis were conducted to determine changes in adiposity, glycemic control, insulin resistance, blood lipids/lipoproteins, and blood pressure (BP) following the interventions using a random effects model to assess standardized mean differences (SMD) between RE and control. RESULTS: 10 studies comprising 404 participants were included in the analysis. For RE compared to controls, there were significant improvements in glycosylated hemoglobin (SMD = -0.688; 95% confidence interval [CI] -1.178 to -0.198; p=0.006), fasting plasma glucose (SMD = -0.747; 95% CI -1.003 to -0.460; p<0.001), and total cholesterol (SMD = -0.723; 95% CI -1.177 to -0.27; p=0.002). No changes in waist circumference (SMD = -0.232, 95% CI -.526 to 0.062; p=0.122), insulin resistance (SMD = -0.597, 95% CI -1.65 to 0.457; p=0.267), high-density lipoprotein (SMD = -0.287, 95% CI -0.748 to 0.174; p=0.223) or low-density lipoprotein (SMD = -0.398, 95% CI -1.027 to 0.231; p=0.215) cholesterol, triglycerides (SMD = -0.400, 95% CI -0.850 to 0.050; p=0.081), systolic BP (SMD = -0.16, 95% CI -0.491 to 0.158; p=0.315), or diastolic BP (-0.476, 95% CI -1.05 to 0.105; p=0.108) were found. CONCLUSION: RE appears to be an effective method of improving glucose control, but is less effective in improving blood lipids or blood pressure.