Network Meta-analysis of optimal exercise modalities and evidence-based practice recommendations for improving adipokines in children and adolescents

Abstract

Objective To systematically evaluate the effects of different exercise modalities and doses on adipokines in children and adolescents, so as to provide precise evidence-based practice recommendations for alleviating obesity in this population. Methods Six databases were searched from inception to November 2024 for randomized controlled trials (RCTs) investigating the effects of various exercise modalities on adipokines in children and adolescents. Bayesian network meta-analysis was conducted using R software. Risk of bias and certainty of evidence were assessed using the Cochrane risk-of-bias tool and CINeMA framework. Results A total of 46 RCTs involving 2 105 children and adolescents (48.32% female) were included. Compared with the non-exercise group, combined aerobic and resistance exercise was the most effective modality for reducing leptin levels (MD=-7.34, 95%CrI: -11.17 to -3.73, SUCRA=94.37) and increasing adiponectin levels (MD=1.79, 95%CrI: 0.92 to 2.65, SUCRA=95.42). High-intensity interval training was the most effective exercise modality for reducing interleukin-6 levels (MD=-3.98, 95%CrI:-10.57 to -0.19, SUCRA=95.27) and tumor necrosis factor-α levels (MD=-6.61, 95%CrI:-9.96 to -3.15, SUCRA=99.98). Conclusion High-intensity interval training and combined aerobic and resistance exercise appear to be the most effective exercise modalities for improving adipokines in children and adolescents.

Keywords

exercise / adipokines / children and adolescents / bayes analysis / dose-response