Introduction
Methods
Data sources and search strategy
Study selection
Article | Country | Category | Aerobic exercise intensity | Participants | Intervention |
---|---|---|---|---|---|
Balducci 2010 small | Italy | Aerobic and combined | Moderate and vigorous | 82 subjects with T2DM and MetS according to IDF were enrolled. They were randomised into control (n = 20), moderate intensity aerobic (n = 20), vigorous aerobic (n = 20) and combined aerobic and resistance (n = 22) | Sessions consisted of the allocated exercise for 60 min, 3 sessions per week for 52 weeks |
Balducci 2010 large | Italy | Combined | Moderate | 606 subjects with MetS were included. They were randomised into control (n = 303) and combined aerobic and resistance exercise (n = 303) | Sessions consisted of 75 min of combined aerobic and resistance exercise, 2 sessions per week for 52 weeks |
Donley 2014 | USA | Aerobic | Vigorous to high | 21 healthy and 22 MetS were included. MetS participants were allocated to aerobic exercise | Sessions consisted of 60 min of aerobic exercise, 3 times per week for 8 weeks |
Irving 2008 | USA | Aerobic | Moderate and vigorous | 37 women with MetS were included. They were randomised into control (n = 9), moderate intensity exercise (n = 15) or high intensity exercise (n = 12) | Sessions consisted of 50 min of aerobic exercise, 5 sessions per week for 16 weeks |
Irving 2009 | USA | Aerobic | Moderate and vigorous | 34 adults with MetS were included. They were randomised into control (n = 10), moderate intensity exercise (n = 13) or high intensity exercise (n = 11) | Sessions consisted of 60 min of aerobic exercise, 5 sessions per week for 16 weeks |
Kim 2011 | Korea | Aerobic | Moderate | 43 patients with T2DM and MeTS were randomised into control (n = 22) and aerobic exercise (n = 21) | The intervention consisted of 150 min of aerobic exercise per week for 16 weeks |
Mager 2008 | Finland | Aerobic | Moderate | 75 patients with MetS were included. They were randomised into diet alone (n = 28), resistance training (n = 14), aerobic training (n = 15) and control (n = 18) | Sessions consisted 30 min of the allocated exercise, 2–3 times per week for 33 weeks |
Maresca 2013 | Italy | Aerobic | Vigorous | 20 male patients with MetS were included. They were randomised into Aerobic exercise + tadalafil (n = 10) or tadalafil alone (n = 10) | Sessions consisted of 40 min of aerobic exercise, 3 times per week for 2 months |
Oh 2010 | Korea | Combined | Light | 52 women with MetS were included. They were randomised into a combined aerobic and resistance exercise group (n = 31) or the control group (n = 21) | Sessions consisted of 40 min of combined aerobic and resistance exercise, 2–3 times per week for 6 months |
Okura 2007 | Japan | Aerobic | Vigorous | 67 patients with MetS were included. There were allocated into low calorie diet (n = 24) or diet + aerobic exercise (n = 43) | Sessions consisted of 45 min of aerobic exercise, 3 times per week for 14 weeks |
Reseland 2001 | Norway | Aerobic | Moderate | 186 men with MetS were included. They were allocated into diet alone (n = 44), diet + aerobic exercise (n = 57), exercise alone (n = 48) or control (n = 37) | Sessions consisted of 60 min of aerobic exercise, 3 times per week for 1 year |
Soares 2014 | Brazil | Aerobic | Moderate to Vigorous | 87 participants with Mets were included. They were randomised into dietary intervention (n = 24), dietary intervention + exercise (n = 17), dietary intervention + omega 3 supplementation (n = 23) or dietary intervention + omega 3 supplementation + exercise (n = 23) | Sessions consisted of 30 min of aerobic exercise, 3 times per week for 12 weeks |
Sonnenschein 2011 | Germany | Aerobic | Moderate to Vigorous | 24 subjects with MetS were included. They were randomised into aerobic exercise (n = 12) or control (n = 12) | Sessions consisted of 30 min of aerobic exercise, 5 times per week for 8 weeks |
Straznicky 2010 | Australia | Aerobic | Moderate | 58 MetS subjects were included. The were randomised into low calorie diet (n = 20), diet + exercise (n = 20) or control (n = 19) | Sessions consisted of 40 min of aerobic exercise, 3–4 times per week for 12 weeks |
Stensvold 2010 | Norway | Aerobic and Combined | High | 43 patients with MetS were included. They were randomised into aerobic interval training (n = 11), resistance training (n = 11), combination aerobic and resistance (n = 10) and control (n = 11) | Sessions consisted of 40 to 50 min of the allocated exercise, 3 times per week for 12 weeks |
Tjonna 2008 | Norway | Aerobic | Moderate | 32 participants with the MetS were included. They were randomised into aerobic interval training (n = 12), continuous moderate exercise (n = 10) or control (n = 10) | Sessions consisted of 40 min of the allocated exercise, 3 times per week for 16 weeks |
Outcome measures
Data synthesis
Assessment of study quality
Data analysis
Heterogeneity
Publication bias
Results
Comparison of all aerobic exercise studies versus control
Body composition outcome measures
Outcome | Aerobic exercise versus control | Combined aerobic and resistance exercise versus control | ||||||
---|---|---|---|---|---|---|---|---|
No. studies | N | MD (95% CI), p value | I2 (%) | No. studies | N | MD (95% CI), p value | I2
| |
BMI (kg m−2) | 14 | 385 | −0.29 (−0.44, −0.15) p < 0.0001 | 79 | 3 | 652 | −0.40 (−0.88, 0.07) p = 0.10 | 100% |
Body weight (kg) | 11 | 217 | −1.16 (−1.83, −0.48) p = 0.0008 | 43 | 2 | 46 | −0.03 (−0.51, 0.46) p = 0.92 | 24% |
Waist (cm) | 13 | 261 | −1.37 (−2.02, −0.71) p < 0.0001 | 61 | 3 | 652 | −3.80 (−5.65, −1.95) p < 0.0001 | 59% |
Total fat mass (kg) | 5 | 176 | −1.19 kg (−1.79,−0.59) = 0.0001 | 0 | 0 | 0 | N/A | N/A |
Peak VO2 (mL kg−1 min−1) | 13 | 294 | 3.00 (1.92, 4.08) p < 0.000001 | 60 | 3 | 652 | 4.64 (2.42, 6.87) p < 0.0001 | 48% |
SBP (mmHg) | 15 | 364 | −2.54 (−4.34, −0.75) p = 0.006 | 78 | 3 | 652 | −3.79 (−6.18, −1.40, p = 0.002) | 0% |
DBP (mmHg) | 14 | 337 | −2.27 (−3.47, −1.06) p = 0.0002 | 61 | 3 | 652 | −0.23 (−3.53, 1.55) p = 0.85 | 68% |
FBG (mmol L−1) | 15 | 378 | −0.16 (−0.32, −0.01) p = 0.04 | 81 | 2 | 623 | −0.18 (−0.47, 0.25) p = 0.21 | 0% |
HDL (mmol L−1) | 15 | 265 | 0.03 (−0.01, 0.08) p = 0.19 | 71 | 2 | 623 | 0.14 (0.04, 0.25) p = 0.009 | 61% |
TG (mmol L−1) | 13 | 308 | −0.21 (−0.29, −0.13) p < 0.00001 | 57 | 1 | 606 |
−0.01 (−0.04, 0.02) p = 0.50 | 0% |
LDL (mmol L−1) | 2 | 44 | −0.03 (−0.05, −0.00) p = 0.02 | 0 | 1 | 722 | −0.30 (−0.61, 0.01) p = 0.06 | 0% |
Cardiovascular outcome measures
Metabolic outcome measures
Combined aerobic and resistance exercise versus control
Comparison of outcome measures according to exercise intensity and type
Body composition outcome measures
Moderate | Vigorous | High | |||
---|---|---|---|---|---|
Aerobic | Combined | Aerobic | Aerobic | Combined | |
BMI (kg m−2) | −0.34* (−0.55,−0.14) | −0.57* (−0.86, −0.27) | −0.23 (−0.57,0.1) | −0.5* (−0.86,−0.14) | −0.10* (−0.14, −0.06) |
Waist circum. (cm) | −0.80* (−1.49, −0.12) | −3.99* (−4.91, −3.06) | −1.59* (−2.39,−0.79) | −3.00* (−4.65,−1.35) | −2.40* (−3.83, −0.97) |
Total fat mass (kg) | −1.03* (−1.69, −0.37) | N/A | −2.50* (−4.97, −0.03) | −1.80 (−3.76, 0.16) | N/A |
VO2 max (mL kg−1 min−1) | 2.52* (0.99, 4.40) | 4.83* (1.10, 8.55) | 3.20* (1.71, 4.69) | 5.5* (1.55, 9.45) | 4.20* (1.35, 7.05) |
SBP (mmHg) | −3.64 (−9.50, 2.22) | −3.35 (−7.06, 0.37) | −1.33* (−1.88, −0.77) | −6.40* (−11.52, −1.28) | −4.10* (−7.21, −0.99) |
DBP(mmHg) | −3.35* (−5.50, −1.19) | −1.68 (−3.96, 0.60) | −1.27 (−2.79, 0.25) | −3.40 (−6.94, 0.14) | 1.40* (0.56, 2.24) |
FBG (m mol L−1) | −0.41* (−0.70, −0.11) | 0.00 (−0.45, 0.45) | −0.06 (−0.21, 0.08) | 0.20* (0.09, 0.31) | −0.30 (−0.66, 0.06) |
HDL (m mol L−1) | 0.06 (−0.01, 0.13) | 0.10* (0.04, 0.16) | −0.02 (−0.05, 0.01) | 0.16* (0.07, 0.25) | 0.21* (0.09, 0.33) |
TG (m mol L−1) | −0.18* (−0.28, −0.09) | −0.01* (−0.04, 0.02) | −0.25* (−0.42, −0.08) | −0.50* (−0.94, −0.06) | N/A |