Volume 14, Issue 1 (3-2026)
jmsthums 2026, 14(1): 86-104 |
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Khalafi M, Hovsepian P, Ghasemi F, HosseinKhah M. The effect of exercise training on fibroblast growth factor 21 in type 2 diabetes patients: A systematic review and meta-analysis. jmsthums 2026; 14 (1) :86-104
URL: http://jms.thums.ac.ir/article-1-1406-en.html
URL: http://jms.thums.ac.ir/article-1-1406-en.html
1- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran
2- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran
2- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran
Abstract: (15 Views)
Background & Aim: FGF21 is a hepatic hormone produced by liver that plays a crucial role in regulating glucose and lipid metabolism. The aim of this study was to investigate the effect of exercise training on FGF21 levels in individuals with type 2 diabetes.
Methods: A search in was conducted PubMed, Scopus, Web of Science, and Google Scholar using the keywords "exercise," "fibroblast growth factor 21," and "type 2 diabetes" from the inception of database indexing to June 30, 2023. To ensure the most up-to-date results, the search was extended to December 19, 2023. The effect size was determined using the standardized mean difference (SMD) and 95% confidence intervals (CIs).
Results: A total of 20 studies, including 28 intervention arms and 683 patients with type 2 diabetes, were included in the meta-analysis. The age of the subjects ranged from 26 to 72 years, and their body mass index ranged from 23 to 32 kg/m2. The results showd that exercise training led to a significant increase in FGF21 (SMD: 1.46, CI: 0.77 to 2.15, p=0.001). However, the I2 test revealed high and significant heterogeneity (I2=93.47, p=0.001), and Egger's test showed evidence of publication bias (p=0.001). Subgroup analysis based on the type of training also showed that both aerobic (SMD: 2.69, p=0.001) and resistance (SMD: 2.94, p=0.002) training led to a significant increase in FGF-21. However, the effects of combined exercise (SMD: -0.01, p=0.92) and HIIT (SMD: 0.73, p=0.50) were not significant.
Conclusion: The results of this study suggest that both aerobic and resistance training have a significant impact on increasing circulating levels of FGF21 in patients with type 2 diabetes. This finding has important implications for improving insulin resistance in this population.
Methods: A search in was conducted PubMed, Scopus, Web of Science, and Google Scholar using the keywords "exercise," "fibroblast growth factor 21," and "type 2 diabetes" from the inception of database indexing to June 30, 2023. To ensure the most up-to-date results, the search was extended to December 19, 2023. The effect size was determined using the standardized mean difference (SMD) and 95% confidence intervals (CIs).
Results: A total of 20 studies, including 28 intervention arms and 683 patients with type 2 diabetes, were included in the meta-analysis. The age of the subjects ranged from 26 to 72 years, and their body mass index ranged from 23 to 32 kg/m2. The results showd that exercise training led to a significant increase in FGF21 (SMD: 1.46, CI: 0.77 to 2.15, p=0.001). However, the I2 test revealed high and significant heterogeneity (I2=93.47, p=0.001), and Egger's test showed evidence of publication bias (p=0.001). Subgroup analysis based on the type of training also showed that both aerobic (SMD: 2.69, p=0.001) and resistance (SMD: 2.94, p=0.002) training led to a significant increase in FGF-21. However, the effects of combined exercise (SMD: -0.01, p=0.92) and HIIT (SMD: 0.73, p=0.50) were not significant.
Conclusion: The results of this study suggest that both aerobic and resistance training have a significant impact on increasing circulating levels of FGF21 in patients with type 2 diabetes. This finding has important implications for improving insulin resistance in this population.
Keywords: Exercise training, Aerobic Exercise, Resistance Training, Fibroblast Growth Factor 21 (FGF21), Type 2 diabetes
Type of Study: Research |
Subject:
Special
Received: 2025/08/17 | Accepted: 2025/12/16 | Published: 2026/06/29
Received: 2025/08/17 | Accepted: 2025/12/16 | Published: 2026/06/29
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