Sains Malaysiana 50(7)(2021): 1997-2006

http://doi.org/10.17576/jsm-2021-5007-14

The Effect of Type, Duration and Intensity of Exercise on Inflammatory Markers CRP, IL-6 and IL-18 in Metabolic Syndrome Patients: A Systematic Review

(Kesan Jenis, Tempoh dan Keamatan Senaman terhadap Penanda Radang CRP, IL-6 and IL-18 pada Pesakit Sindrom Metabolik: Suatu Tinjauan Sistematik)

SRIJIT DAS¹, ISA NAINA-MOHAMED², MOHAMED S ZULFARINA², HAZWAN HAZRIN SALIM³, AZWANI ZAWAWI³, TARRSINI THEVARAJ³, KU NURMAHIRAH KU-AHMAD-NASIR³ & DENNIS KHENG ZHOU³ & SEONG LIN TEOH^3*

¹Department of Human & Clinical Anatomy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat 123, Sultanate of Oman

²Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Federal Territory, Malaysia

³Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000 Cheras, Kuala Lumpur, Federal Territory, Malaysia

  Received: 27 November 2019/Accepted: 11 November 2020

  ABSTRACT

Metabolic syndrome (MetS) has become a major clinical challenge worldwide due to rise of urbanisation, surplus energy intake, increasing obesity and sedentary lifestyle. C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-18 (IL-18) are associated with MetS. We performed a systematic review to investigate the effects of exercise on these markers in MetS patients and therefore to determine the best exercise regime for them. We searched Medline (Pubmed and Ovid), Scopus and CINAHL databases. The searches were standardized by using the same search strategy which included the terms such as ‘metabolic syndrome’, ‘CRP’, ‘IL-6’, ‘IL-18’ and ‘exercise’. Only clinical human studies published from Jan 2007 to May 2018 were included. A total of 11 clinical trials (466 participants) were selected. Majority of the studies were randomized controlled studies (90.9%). All studies showed a decrease in serum levels of the biomarkers. However, not all were statistically significant. The main type of exercise in most of the studies was aerobic. Aerobic-resistance exercise was more effective rather than aerobic alone, but aerobic exercise was the only effective as a sole intervention. Aerobic exercise showed promising role as the main lifestyle intervention in MetS. It is concluded that patients with MetS should have combined aerobic-resistance exercise.

Keywords: c-reactive protein; exercise; IL-6; IL-18; metabolic syndrome

ABSTRAK

Sindrom metabolik (MetS) telah menjadi cabaran klinikal utama di seluruh dunia akibat kemajuan perbandaran, pengambilan tenaga yang berlebihan, peningkatan kadar obesiti dan gaya hidup yang tidak aktif. Penanda seperti protein C-reaktif (CRP), interleukin-6 (IL-6) dan interleukin-18 (IL-18) telah dikaitkan dengan MetS. Kami menjalankan ulasan sistematik untuk mengkaji kesan senaman kepada penanda ini pada pesakit MetS dan juga untuk mengetahui rejim senaman yang terbaik untuk mereka. Carian telah dijalankan melalui pangkalan data Medline (Pubmed dan Ovid), Scopus dan CINAHL. Carian telah diseragamkan dengan menggunakan strategi pencarian yang sama termasuk istilah seperti ‘sindrom metabolik’, ‘CRP’, ‘IL-6’, ‘IL-18’ dan ‘senaman’. Hanya kajian klinikal yang diterbitkan dari Jan 2007 hingga Mei 2018 termasuk dalam kajian ini. Sebanyak 11 kajian klinikal (466 peserta) telah dipilih. Majoriti kajian adalah kajian terkawal rawak (90.9%). Semua kajian menunjukkan penurunan kadar penanda dalam serum. Walau bagaimanapun, tidak semuanya menunjukkan perbezaan yang signifikan. Jenis utama senaman dalam kajian terlibat adalah senaman aerobik. Senaman rintangan-aerobik adalah lebih berkesan berbanding senaman aerobik, tetapi hanya senaman aerobik merupakan intervensi yang berkesan jika dilakukan secara tunggal. Senaman aerobik berpotensi dijadikan intervensi gaya hidup utama dalam MetS. Disimpulkan bahawa pesakit MetS memerlukan gabungan senaman rintangan-aerobik.

Kata kunci: IL-6; IL-18; senaman; sindrom metabolik; protein c-reaktif

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*Corresponding author; email: teohseonglin@ppukm.ukm.edu.my