Improvement of different resistance training regimens on blood lipids and insulin resistance in patients with type 2 diabetes mellitus: a network meta-analysis_West China Medical Journal

Authors：

LIANG Zhen ^1,2 , YUE Wenjing ³ , WANG Zhenyu ² , LI Yongjie ⁴ , WANG Zhu ^2,5 ,  FENG Changwu ⁵

1. Maritime College, Qingdao Harbour Vocational and Technical College, Qingdao, Shandong 266404, P. R. China;
2. School of Sports Medicine, Wuhan Sports University, Wuhan, Hubei 430079, P. R. China;
3. School of Safety Science and Emergency Management, Wuhan University of Technology, Wuhan, Hubei 430079, P. R. China;
4. Department of Rehabilitation Medicine, Beijing Jishuitan Hospital-Guizhou Hospital, Guiyang, Guizhou 550014, P. R. China;
5. Department of Rehabilitation Medicine, Huangshi Central Hospital, Huangshi, Hubei 435000, P. R. China;

Corresponding author：

FENG Changwu, Email: wwlbkxl@163.com

Keywords：

Resistance regimens; exercise intensity; exercise frequency; type 2 diabetes mellitus; glycolipid metabolism; network meta-analysis

DOI：

10.7507/1002-0179.202307162

Video：

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Objective To assess the improvement of different resistance training regimens on blood lipid metabolism and insulin resistance in patients with type 2 diabetes mellitus (T2DM). Methods PubMed, ProQuest, Embase, Web of Science, China National Knowledge Infrastructure, Wanfang, and VIP databases were searched to collect randomized controlled trials of resistance training intervention to improve blood lipids and insulin resistance in patients with T2DM. The search time range was from the establishment of the databases to May 2023. Two reviewers assessed the risk of bias of the included studies using the Physiotherapy Evidence Database scale, and performed a network meta-analysis of the extracted data using Stata 16.0 software. Results In the end, 24 articles were included, and a total of 983 participants were enrolled. The result of network meta-analysis showed that high-frequency and moderate-intensity resistance exercise significantly improved the levels of insulin resistance [standardized mean difference=−1.71, 95% confidence interval (CI) (−2.75, −0.67)], triglycerides [weighted mean difference (WMD)=−0.27 mmol/L, 95%CI (−0.51, −0.04) mmol/L], and total cholesterol [WMD=−0.16 mmol/L, 95%CI (−0.20, −0.12) mmol/L], but had no significant effect on improving the level of high-density lipoprotein [WMD=0.05 mmol/L, 95%CI (−0.02, 0.11) mmol/L] or low-density lipoprotein [WMD=−0.20 mmol/L, 95%CI (−0.42, 0.03) mmol/L]. The results of cumulative probability ranking showed that high-frequency and moderate-intensity resistance exercise was the best in improving insulin resistance, triglycerides, high-density lipoprotein and low-density lipoprotein levels. Conclusion Based on current evidence, high-frequency and moderate-intensity resistance exercise may be the best resistance exercise regimen to improve insulin resistance and lipid metabolism in patients with T2DM.

Citation： LIANG Zhen, YUE Wenjing, WANG Zhenyu, LI Yongjie, WANG Zhu, FENG Changwu. Improvement of different resistance training regimens on blood lipids and insulin resistance in patients with type 2 diabetes mellitus: a network meta-analysis. West China Medical Journal, 2024, 39(2): 259-267. doi: 10.7507/1002-0179.202307162 Copy

1.	Kankeu HT, Saksena P, Xu K, et al. The financial burden from non-communicable diseases in low- and middle-income countries: a literature review. Health Res Policy Syst, 2013, 11: 31.
2.	Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab, 2008, 93(11 Suppl 1): S9-S30.
3.	Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9(th) edition. Diabetes Res Clin Pract, 2019, 157: 107843.
4.	Abdul-Ghani MA, Jayyousi A, DeFronzo RA, et al. Insulin resistance the link between T2DM and CVD: basic mechanisms and clinical implications. Curr Vasc Pharmacol, 2019, 17(2): 153-163.
5.	Sampath Kumar A, Maiya AG, Shastry BA, et al. Exercise and insulin resistance in type 2 diabetes mellitus: a systematic review and meta-analysis. Ann Phys Rehabil Med, 2019, 62(2): 98-103.
6.	Jansson AK, Chan LX, Lubans DR, et al. Effect of resistance training on HbA1c in adults with type 2 diabetes mellitus and the moderating effect of changes in muscular strength: a systematic review and meta-analysis. BMJ Open Diabetes Res Care, 2022, 10(2): e002595.
7.	梁敏, 王海牛, 黄鹏, 等. 抗阻运动对 2 型糖尿病糖脂代谢异常患者干预效果的系统综述和 Meta 分析. 中国组织工程研究, 2019, 23(35): 5718-5726.
8.	Wang Z, Zan X, Li Y, et al. Comparative efficacy different resistance training protocols on bone mineral density in postmenopausal women: a systematic review and network meta-analysis. Front Physiol, 2023, 14: 1105303.
9.	Maher CG, Sherrington C, Herbert RD, et al. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther, 2003, 83(8): 713-721.
10.	Gordon PL, Vannier E, Hamada K, et al. Resistance training alters cytokine gene expression in skeletal muscle of adults with type 2 diabetes. Int J Immunopathol Pharmacol, 2006, 19(4): 739-749.
11.	Sigal RJ, Kenny GP, Boulé NG, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med, 2007, 147(6): 357-369.
12.	Shabkhiz F, Khalafi M, Rosenkranz S, et al. Resistance training attenuates circulating FGF-21 and myostatin and improves insulin resistance in elderly men with and without type 2 diabetes mellitus: a randomised controlled clinical trial. Eur J Sport Sci, 2021, 21(4): 636-645.
13.	Rezaeeshirazi R. Aerobic versus resistance training: leptin and metabolic parameters improvement in type 2 diabetes obese men. Res Q Exerc Sport, 2022, 93(3): 537-547.
14.	Hsieh PL, Tseng CH, Tseng YJ, et al. Resistance training improves muscle function and cardiometabolic risks but not quality of life in older people with type 2 diabetes mellitus: a randomized controlled trial. J Geriatr Phys Ther, 2018, 41(2): 65-76.
15.	Ranasinghe C, Devage S, Constantine GR, et al. Glycemic and cardiometabolic effects of exercise in South Asian Sri Lankans with type 2 diabetes mellitus: a randomized controlled trial Sri Lanka diabetes aerobic and resistance training study (SL-DARTS). Diabetes Metab Syndr, 2021, 15(1): 77-85.
16.	Kadoglou NP, Fotiadis G, Athanasiadou Z, et al. The effects of resistance training on ApoB/ApoA-I ratio, Lp(a) and inflammatory markers in patients with type 2 diabetes. Endocrine, 2012, 42(3): 561-569.
17.	Honkola A, Forsén T, Eriksson J. Resistance training improves the metabolic profile in individuals with type 2 diabetes. Acta Diabetol, 1997, 34(4): 245-248.
18.	AminiLari Z, Fararouei M, Amanat S, et al. The effect of 12 weeks aerobic, resistance, and combined exercises on omentin-1 levels and insulin resistance among type 2 diabetic middle-aged women. Diabetes Metab J, 2017, 41(3): 205-212.
19.	Amouzad Mahdirejei H, Fadaei Reyhan Abadei S, Abbaspour Seidi A, et al. Effects of an eight-week resistance training on plasma vaspin concentrations, metabolic parameters levels and physical fitness in patients with type 2 diabetes. Cell J, 2014, 16(3): 367-374.
20.	Mavros Y, Kay S, Anderberg KA, et al. Changes in insulin resistance and HbA1c are related to exercise-mediated changes in body composition in older adults with type 2 diabetes: interim outcomes from the GREAT2DO trial. Diabetes Care, 2013, 36(8): 2372-2379.
21.	Hameed UA, Manzar D, Raza S, et al. Resistance training leads to clinically meaningful improvements in control of glycemia and muscular strength in untrained middle-aged patients with type 2 diabetes mellitus. N Am J Med Sci, 2012, 4(8): 336-343.
22.	de Oliveira VN, Bessa A, Jorge ML, et al. The effect of different training programs on antioxidant status, oxidative stress, and metabolic control in type 2 diabetes. Appl Physiol Nutr Metab, 2012, 37(2): 334-344.
23.	Yavari A, Najafipoor F, Aliasgarzadeh A, et al. Effect of aerobic exercise, resistance training or combined training on glycaemic control and cardio-vascular risk factors in patients with type 2 diabetes. Biol Sport, 2012, 29(2): 135-143.
24.	Kwon HR, Min KW, Ahn HJ, et al. Effects of aerobic exercise vs. resistance training on endothelial function in women with type 2 diabetes mellitus. Diabetes Metab J, 2011, 35(4): 364-373.
25.	Hazley L, Ingle L, Tsakirides C, et al. Impact of a short-term, moderate intensity, lower volume circuit resistance training programme on metabolic risk factors in overweight/obese type 2 diabetics. Res Sports Med, 2010, 18(4): 251-262.
26.	Plotnikoff RC, Eves N, Jung M, et al. Multicomponent, home-based resistance training for obese adults with type 2 diabetes: a randomized controlled trial. Int J Obes (Lond), 2010, 34(12): 1733-1741.
27.	Wycherley TP, Noakes M, Clifton PM, et al. A high-protein diet with resistance exercise training improves weight loss and body composition in overweight and obese patients with type 2 diabetes. Diabetes Care, 2010, 33(5): 969-976.
28.	Arora E, Shenoy S, Sandhu JS. Effects of resistance training on metabolic profile of adults with type 2 diabetes. Indian J Med Res, 2009, 129(5): 515-519.
29.	Brooks N, Layne JE, Gordon PL, et al. Strength training improves muscle quality and insulin sensitivity in Hispanic older adults with type 2 diabetes. Int J Med Sci, 2006, 4(1): 19-27.
30.	Dunstan DW, Vulikh E, Owen N, et al. Community center-based resistance training for the maintenance of glycemic control in adults with type 2 diabetes. Diabetes Care, 2006, 29(12): 2586-2591.
31.	Kadoglou NP, Fotiadis G, Kapelouzou A, et al. The differential anti-inflammatory effects of exercise modalities and their association with early carotid atherosclerosis progression in patients with type 2 diabetes. Diabet Med, 2013, 30(2): e41-e50.
32.	Botton CE, Umpierre D, Rech A, et al. Effects of resistance training on neuromuscular parameters in elderly with type 2 diabetes mellitus: a randomized clinical trial. Exp Gerontol, 2018, 113: 141-149.
33.	Dunstan DW, Daly RM, Owen N, et al. High-intensity resistance training improves glycemic control in older patients with type 2 diabetes. Diabetes Care, 2002, 25(10): 1729-1736.
34.	Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, et al. Type 2 diabetes and cardiovascular disease: have all risk factors the same strength?. World J Diabetes, 2014, 5(4): 444-470.
35.	Kaze AD, Santhanam P, Musani SK, et al. Metabolic dyslipidemia and cardiovascular outcomes in type 2 diabetes mellitus: findings from the Look AHEAD Study. J Am Heart Assoc, 2021, 10(7): e016947.
36.	Garber CE, Blissmer B, Deschenes MR, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc, 2011, 43(7): 1334-1359.
37.	Kahn BB. Lilly lecture 1995. Glucose transport: pivotal step in insulin action. Diabetes, 1996, 45(11): 1644-1654.
38.	Schulze MB, Hu FB. Primary prevention of diabetes: what can be done and how much can be prevented?. Annu Rev Public Health, 2005, 26: 445-467.
39.	Holten MK, Zacho M, Gaster M, et al. Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes, 2004, 53(2): 294-305.
40.	李颖, 林文弢, 翁锡全. 不同运动强度干预 2 型糖尿病模型大鼠的内脂素及糖代谢变化. 中国组织工程研究, 2020, 24(26): 4196-4200.
41.	Fan T, Lin MH, Kim K. Intensity differences of resistance training for type 2 diabetic patients: a systematic review and meta-analysis. Healthcare (Basel), 2023, 11(3): 440.
42.	Pessler D, Rudich A, Bashan N. Oxidative stress impairs nuclear proteins binding to the insulin responsive element in the GLUT4 promoter. Diabetologia, 2001, 44(12): 2156-2164.
43.	Sarangi R, Padhi S, Mohapatra S, et al. Serum high sensitivity C-reactive protein, nitric oxide metabolites, plasma fibrinogen, and lipid parameters in Indian type 2 diabetic males. Diabetes Metab Syndr, 2012, 6(1): 9-14.
44.	Rehman K, Akash MSH, Liaqat A, et al. Role of interleukin-6 in development of insulin resistance and type 2 diabetes mellitus. Crit Rev Eukaryot Gene Expr, 2017, 27(3): 229-236.
45.	Miller EG, Sethi P, Nowson CA, et al. Effects of progressive resistance training and weight loss versus weight loss alone on inflammatory and endothelial biomarkers in older adults with type 2 diabetes. Eur J Appl Physiol, 2017, 117(8): 1669-1678.
46.	Wang L. Genetic and dietary effects on physical properties, assembly and secretion of apob-containing lipoproteins. College Station, TX: Texas A&M University, 2003.
47.	Shultz SP, Dahiya R, Leong GM, et al. Muscular strength, aerobic capacity, and adipocytokines in obese youth after resistance training: a pilot study. Australas Med J, 2015, 8(4): 113-120.
48.	Fatone C, Guescini M, Balducci S, et al. Two weekly sessions of combined aerobic and resistance exercise are sufficient to provide beneficial effects in subjects with type 2 diabetes mellitus and metabolic syndrome. J Endocrinol Invest, 2010, 33(7): 489-495.

1. Kankeu HT, Saksena P, Xu K, et al. The financial burden from non-communicable diseases in low- and middle-income countries: a literature review. Health Res Policy Syst, 2013, 11: 31.
2. Misra A, Khurana L. Obesity and the metabolic syndrome in developing countries. J Clin Endocrinol Metab, 2008, 93(11 Suppl 1): S9-S30.
3. Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9(th) edition. Diabetes Res Clin Pract, 2019, 157: 107843.
4. Abdul-Ghani MA, Jayyousi A, DeFronzo RA, et al. Insulin resistance the link between T2DM and CVD: basic mechanisms and clinical implications. Curr Vasc Pharmacol, 2019, 17(2): 153-163.
5. Sampath Kumar A, Maiya AG, Shastry BA, et al. Exercise and insulin resistance in type 2 diabetes mellitus: a systematic review and meta-analysis. Ann Phys Rehabil Med, 2019, 62(2): 98-103.
6. Jansson AK, Chan LX, Lubans DR, et al. Effect of resistance training on HbA1c in adults with type 2 diabetes mellitus and the moderating effect of changes in muscular strength: a systematic review and meta-analysis. BMJ Open Diabetes Res Care, 2022, 10(2): e002595.
7. 梁敏, 王海牛, 黄鹏, 等. 抗阻运动对 2 型糖尿病糖脂代谢异常患者干预效果的系统综述和 Meta 分析. 中国组织工程研究, 2019, 23(35): 5718-5726.
8. Wang Z, Zan X, Li Y, et al. Comparative efficacy different resistance training protocols on bone mineral density in postmenopausal women: a systematic review and network meta-analysis. Front Physiol, 2023, 14: 1105303.
9. Maher CG, Sherrington C, Herbert RD, et al. Reliability of the PEDro scale for rating quality of randomized controlled trials. Phys Ther, 2003, 83(8): 713-721.
10. Gordon PL, Vannier E, Hamada K, et al. Resistance training alters cytokine gene expression in skeletal muscle of adults with type 2 diabetes. Int J Immunopathol Pharmacol, 2006, 19(4): 739-749.
11. Sigal RJ, Kenny GP, Boulé NG, et al. Effects of aerobic training, resistance training, or both on glycemic control in type 2 diabetes: a randomized trial. Ann Intern Med, 2007, 147(6): 357-369.
12. Shabkhiz F, Khalafi M, Rosenkranz S, et al. Resistance training attenuates circulating FGF-21 and myostatin and improves insulin resistance in elderly men with and without type 2 diabetes mellitus: a randomised controlled clinical trial. Eur J Sport Sci, 2021, 21(4): 636-645.
13. Rezaeeshirazi R. Aerobic versus resistance training: leptin and metabolic parameters improvement in type 2 diabetes obese men. Res Q Exerc Sport, 2022, 93(3): 537-547.
14. Hsieh PL, Tseng CH, Tseng YJ, et al. Resistance training improves muscle function and cardiometabolic risks but not quality of life in older people with type 2 diabetes mellitus: a randomized controlled trial. J Geriatr Phys Ther, 2018, 41(2): 65-76.
15. Ranasinghe C, Devage S, Constantine GR, et al. Glycemic and cardiometabolic effects of exercise in South Asian Sri Lankans with type 2 diabetes mellitus: a randomized controlled trial Sri Lanka diabetes aerobic and resistance training study (SL-DARTS). Diabetes Metab Syndr, 2021, 15(1): 77-85.
16. Kadoglou NP, Fotiadis G, Athanasiadou Z, et al. The effects of resistance training on ApoB/ApoA-I ratio, Lp(a) and inflammatory markers in patients with type 2 diabetes. Endocrine, 2012, 42(3): 561-569.
17. Honkola A, Forsén T, Eriksson J. Resistance training improves the metabolic profile in individuals with type 2 diabetes. Acta Diabetol, 1997, 34(4): 245-248.
18. AminiLari Z, Fararouei M, Amanat S, et al. The effect of 12 weeks aerobic, resistance, and combined exercises on omentin-1 levels and insulin resistance among type 2 diabetic middle-aged women. Diabetes Metab J, 2017, 41(3): 205-212.
19. Amouzad Mahdirejei H, Fadaei Reyhan Abadei S, Abbaspour Seidi A, et al. Effects of an eight-week resistance training on plasma vaspin concentrations, metabolic parameters levels and physical fitness in patients with type 2 diabetes. Cell J, 2014, 16(3): 367-374.
20. Mavros Y, Kay S, Anderberg KA, et al. Changes in insulin resistance and HbA1c are related to exercise-mediated changes in body composition in older adults with type 2 diabetes: interim outcomes from the GREAT2DO trial. Diabetes Care, 2013, 36(8): 2372-2379.
21. Hameed UA, Manzar D, Raza S, et al. Resistance training leads to clinically meaningful improvements in control of glycemia and muscular strength in untrained middle-aged patients with type 2 diabetes mellitus. N Am J Med Sci, 2012, 4(8): 336-343.
22. de Oliveira VN, Bessa A, Jorge ML, et al. The effect of different training programs on antioxidant status, oxidative stress, and metabolic control in type 2 diabetes. Appl Physiol Nutr Metab, 2012, 37(2): 334-344.
23. Yavari A, Najafipoor F, Aliasgarzadeh A, et al. Effect of aerobic exercise, resistance training or combined training on glycaemic control and cardio-vascular risk factors in patients with type 2 diabetes. Biol Sport, 2012, 29(2): 135-143.
24. Kwon HR, Min KW, Ahn HJ, et al. Effects of aerobic exercise vs. resistance training on endothelial function in women with type 2 diabetes mellitus. Diabetes Metab J, 2011, 35(4): 364-373.
25. Hazley L, Ingle L, Tsakirides C, et al. Impact of a short-term, moderate intensity, lower volume circuit resistance training programme on metabolic risk factors in overweight/obese type 2 diabetics. Res Sports Med, 2010, 18(4): 251-262.
26. Plotnikoff RC, Eves N, Jung M, et al. Multicomponent, home-based resistance training for obese adults with type 2 diabetes: a randomized controlled trial. Int J Obes (Lond), 2010, 34(12): 1733-1741.
27. Wycherley TP, Noakes M, Clifton PM, et al. A high-protein diet with resistance exercise training improves weight loss and body composition in overweight and obese patients with type 2 diabetes. Diabetes Care, 2010, 33(5): 969-976.
28. Arora E, Shenoy S, Sandhu JS. Effects of resistance training on metabolic profile of adults with type 2 diabetes. Indian J Med Res, 2009, 129(5): 515-519.
29. Brooks N, Layne JE, Gordon PL, et al. Strength training improves muscle quality and insulin sensitivity in Hispanic older adults with type 2 diabetes. Int J Med Sci, 2006, 4(1): 19-27.
30. Dunstan DW, Vulikh E, Owen N, et al. Community center-based resistance training for the maintenance of glycemic control in adults with type 2 diabetes. Diabetes Care, 2006, 29(12): 2586-2591.
31. Kadoglou NP, Fotiadis G, Kapelouzou A, et al. The differential anti-inflammatory effects of exercise modalities and their association with early carotid atherosclerosis progression in patients with type 2 diabetes. Diabet Med, 2013, 30(2): e41-e50.
32. Botton CE, Umpierre D, Rech A, et al. Effects of resistance training on neuromuscular parameters in elderly with type 2 diabetes mellitus: a randomized clinical trial. Exp Gerontol, 2018, 113: 141-149.
33. Dunstan DW, Daly RM, Owen N, et al. High-intensity resistance training improves glycemic control in older patients with type 2 diabetes. Diabetes Care, 2002, 25(10): 1729-1736.
34. Martín-Timón I, Sevillano-Collantes C, Segura-Galindo A, et al. Type 2 diabetes and cardiovascular disease: have all risk factors the same strength?. World J Diabetes, 2014, 5(4): 444-470.
35. Kaze AD, Santhanam P, Musani SK, et al. Metabolic dyslipidemia and cardiovascular outcomes in type 2 diabetes mellitus: findings from the Look AHEAD Study. J Am Heart Assoc, 2021, 10(7): e016947.
36. Garber CE, Blissmer B, Deschenes MR, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc, 2011, 43(7): 1334-1359.
37. Kahn BB. Lilly lecture 1995. Glucose transport: pivotal step in insulin action. Diabetes, 1996, 45(11): 1644-1654.
38. Schulze MB, Hu FB. Primary prevention of diabetes: what can be done and how much can be prevented?. Annu Rev Public Health, 2005, 26: 445-467.
39. Holten MK, Zacho M, Gaster M, et al. Strength training increases insulin-mediated glucose uptake, GLUT4 content, and insulin signaling in skeletal muscle in patients with type 2 diabetes. Diabetes, 2004, 53(2): 294-305.
40. 李颖, 林文弢, 翁锡全. 不同运动强度干预 2 型糖尿病模型大鼠的内脂素及糖代谢变化. 中国组织工程研究, 2020, 24(26): 4196-4200.
41. Fan T, Lin MH, Kim K. Intensity differences of resistance training for type 2 diabetic patients: a systematic review and meta-analysis. Healthcare (Basel), 2023, 11(3): 440.
42. Pessler D, Rudich A, Bashan N. Oxidative stress impairs nuclear proteins binding to the insulin responsive element in the GLUT4 promoter. Diabetologia, 2001, 44(12): 2156-2164.
43. Sarangi R, Padhi S, Mohapatra S, et al. Serum high sensitivity C-reactive protein, nitric oxide metabolites, plasma fibrinogen, and lipid parameters in Indian type 2 diabetic males. Diabetes Metab Syndr, 2012, 6(1): 9-14.
44. Rehman K, Akash MSH, Liaqat A, et al. Role of interleukin-6 in development of insulin resistance and type 2 diabetes mellitus. Crit Rev Eukaryot Gene Expr, 2017, 27(3): 229-236.
45. Miller EG, Sethi P, Nowson CA, et al. Effects of progressive resistance training and weight loss versus weight loss alone on inflammatory and endothelial biomarkers in older adults with type 2 diabetes. Eur J Appl Physiol, 2017, 117(8): 1669-1678.
46. Wang L. Genetic and dietary effects on physical properties, assembly and secretion of apob-containing lipoproteins. College Station, TX: Texas A&M University, 2003.
47. Shultz SP, Dahiya R, Leong GM, et al. Muscular strength, aerobic capacity, and adipocytokines in obese youth after resistance training: a pilot study. Australas Med J, 2015, 8(4): 113-120.
48. Fatone C, Guescini M, Balducci S, et al. Two weekly sessions of combined aerobic and resistance exercise are sufficient to provide beneficial effects in subjects with type 2 diabetes mellitus and metabolic syndrome. J Endocrinol Invest, 2010, 33(7): 489-495.

West China Medical Journal

Improvement of different resistance training regimens on blood lipids and insulin resistance in patients with type 2 diabetes mellitus: a network meta-analysis

Abstract Full text Figures/Tables Video References Cited by

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