Meta-analysis shows exercise interventions impact TNF-alpha but not IL-6 or CRP in older adults
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Key Takeaway
Note that exercise interventions significantly improve TNF-alpha concentrations but not IL-6 or CRP in older adults.
This meta-analysis evaluated the impact of exercise interventions on specific serum inflammatory biomarkers in older adults with frailty and/or sarcopenia. The analysis synthesized data from randomized controlled trials involving 1,297 participants, including 659 in the intervention group and 613 in the control group.
The researchers assessed changes in several key inflammatory markers. A significant improving effect was observed for tumor necrosis factor-alpha (TNF-alpha) concentrations, with a standardized mean difference (SMD) of -0.31 (95% CI: -0.44 to -0.18, p < 0.0001). However, exercise interventions did not significantly improve serum interleukin-6 (IL-6) concentrations, which showed an SMD of -0.04 (95% CI: -0.17 to 0.09, p = 0.52). Similarly, no significant improvement was found for C-reactive protein (CRP) concentrations, with an SMD of -0.08 (95% CI: -0.25 to 0.08, p = 0.32).
While the findings suggest a targeted effect on TNF-alpha, the clinical implications for broader inflammatory profiles remain to be fully determined. The study provides evidence that exercise may modulate specific pathways of inflammation in this population, though it does not appear to alter all measured systemic biomarkers.
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View Original Abstract ↓
ObjectiveExcessive secretion of inflammatory biomarkers exerts adverse effects on muscle strength and function, and is associated with the development and progression of sarcopenia and frailty. For the improvement of inflammatory biomarker concentrations, given the remaining limitations of current pharmacological and nutritional therapies, exercise intervention may serve as a potential non-pharmacological intervention. The purpose of this study is to systematically evaluate the effects of exercise interventions on serum inflammatory biomarker levels in older adults with frailty and/or sarcopenia by employing a meta-analysis approach.MethodsA systematic search was conducted in PubMed, Web of Science, Cochrane Library, EMBASE, and Scopus (from database inception to October 2025) to identify randomized controlled trials (RCTs) investigating the impact of exercise interventions on serum inflammatory biomarker levels in older adults with frailty and/or sarcopenia. Data were analyzed using RevMan 5.4 and Stata 15.1. A random-effects model was employed to calculate standardized mean differences (SMD) and 95% confidence intervals (95% CI). The study protocol was registered with PROSPERO (CRD420251160555).ResultsA total of 21 studies (comprising 26 RCTs) were included, involving 1,297 participants (intervention group: 659; control group: 613) with an age range of 63.6 to 86.7 years.Meta-analysis results revealed that exercise interventions did not significantly improve serum interleukin-6 (IL-6) (SMD = -0.04, 95% CI: -0.17 to 0.09, p = 0.52, I² = 10%) or C-reactive protein (CRP) concentrations (SMD = -0.08, 95% CI: -0.25 to 0.08, p = 0.32, I² = 0%) in older adults with sarcopenia and/or frailty. However, exercise interventions exerted a significant improving effect on tumor necrosis factor-α (TNF-α) (SMD = -0.31, 95% CI: -0.44 to -0.18, p < 0.0001, I² = 37%).ConclusionExercise interventions significantly improve TNF-α concentrations but do not exert a significant improving effect on IL-6 or CRP in older adults with frailty and/or sarcopenia. These findings may provide key evidence-based support for clinical non-pharmacological interventions.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251160555, identifier CRD420251160555.
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