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The effects of exercise on vascular endothelial function in type 2 diabetes: a
systematic review and meta-analysis
#MMPMID29541164
Lee JH
; Lee R
; Hwang MH
; Hamilton MT
; Park Y
Diabetol Metab Syndr
2018[]; 10
(?): 15
PMID29541164
show ga
BACKGROUND: Vascular endothelial dysfunction induced by hyperglycemia and
elevated insulin resistance is a potent risk factor for cardiovascular disease
and likely contributes to multiple chronic disease complications associated with
aging. The aim of this study was to systematically review and quantify the
effects of exercise on endothelial function (EF) in type 2 diabetes (T2D).
METHODS: Five electronic databases were searched (until June 2017) for studies
that met the following criteria: (i) randomized controlled trials; (ii) T2D aged
??18 years; (iii) measured EF by brachial artery flow-mediated dilation (FMD);
(iv) structured and supervised exercise intervention for ??8 weeks. RESULTS:
Thirteen cohorts, selected from eight studies (306 patients, average age
59 years), met the inclusion criteria. Exercise training significantly increased
FMD (mean ES?=?0.41, 95% CI 0.21-0.62, P?0.001). Low to moderate intensity
subgroups and aerobic exercise (AE) subgroups significantly increased FMD more
than moderate to high intensity subgroups and combined AE and resistance exercise
subgroups respectively (P?0.01, P?0.05). The Grading of Recommendations
Assessment, Development and Evaluation (GRADE) assessments reported that quality
of evidence for all outcomes was moderate except shear rate showing low. Egger's
test showed no significant publication bias for all outcomes. CONCLUSION: Our
results suggest that in patients with T2D, lower intensity exercise has
physiological meaningful effects on EF, in support of the emerging concept that
the lower efforts of exercise are not necessarily less cardioprotective than
higher intensity training.