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چکیده
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Exercise training can reduce chronic low-grade inflammation; however, the most effective mode 40 of exercise for lowering inflammation in patients with type 2 diabetes mellitus (T2D) is unknown. 41 Therefore, we performed a systematic review with pairwise and network meta-analyses to 42 determine the efficacy of different modes of exercise training for improving inflammation in 43 patients with T2D. A systematic literature search was conducted in the PubMed, Web of Science, 44 and Scopus from inception to May 2024 using four main key words including "exercise", 45 "cytokines", "type 2 diabetes" and "randomization". Randomized control or clinical trials 46 investigating the effects of any exercise training mode, including aerobic training (AT), resistance 47 training (RT), AT+RT, high-intensity interval training (HIIT) and HIIT+RT on inflammatory 48 markers including IL-6, TNF-α, CRP, leptin, or adiponectin in patients with T2D were included. 49 Standardized mean differences (SMD) and 95% confidence intervals (CIs) were calculated using 50 random effects models. Overall, 61 studies involving 3,382 patients with T2D were included. 51 Compared to control, exercise training effectively reduced IL-6 [SMD: -0.58], TNF-α [SMD: -52 0.62], CRP [SMD: -0.78], and leptin [SMD: -0.27], and increased adiponectin [SMD: 0.35]. Based 53 on network meta-analysis, AT reduced IL-6, TNF-α, and leptin and increased adiponectin; and 54 AT+RT reduced IL-6, TNF-α, and CRP, and increased adiponectin. However, RT, HIIT, and 55 HIIT+RT did not change any inflammatory markers as compared with controls. Exercise training 56 is an effective approach for lowering chronic low-grade inflammation in patients with T2D, 57 specifically, AT and AT+RT appear to be more effective than RT, HIIT or HIIT+RT.
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