| Reference | Study type | Population | Intervention and comparison | Outcomes | Risk of bias «Additional comments for included studies...»2 |
|---|---|---|---|---|---|
| «Chen Z, Zhou R, Liu X, ym. Effects of Aerobic Exer...»1 | SR, MA | All participants were overweight or obese. Included females and males, age 11–75.
Studies from Asia, Europe, South America |
All studies were RCTs of aerobic exercise (AE). Low intensity AE: 20-40% VO₂max /40-55% HRmax/ 1,6-3 MET/RPE 8-10. Moderate-intensity AE: n. 40–60 % VO₂max / 55–70 % HRmax / 3–6 MET / RPE 11–13. Vigorous-intensity AE: n. 60–85 % VO₂max / 70–90 % HRmax / 6–9 MET / RPE 14–16. Comparison: control / usual care |
Total Cholesterol (TC) HDL Cholesterol (HDL) LDL Cholesterol (LDL) Triglycerides (TG) |
Low |
| «Kelley GA, Kelley KS. Impact of progressive resist...»2 | MA | Adults ≥18 years, sedentary or insufficiently active, healthy or with overweight/obese,
type 2 diabetes, CVD history, metabolic abnormalities. United States, China, UK, Brazil, Canada, Chile, Finland, and Turkey |
RCTs. Intervention: progressive resistance training: duration 8–78 weeks (mean ~24 weeks), frequency 2–3 sessions/week, intensity 50–87% of 1RM, number of exercises 3–16, sets 1–5. Comparison: non-exercising control groups. |
Primary fasting lipid outcomes: Total cholesterol (TC) HDL-C LDL-C Triglycerides (TG) Non-HDL-C TC/HDL-C ratio |
Moderate |
| «Lin X, Zhang X, Guo J, ym. Effects of Exercise Tra...»3 | Active or sedentary healthy or with overweight, dyslipidemia, prediabetes, type 2
diabetes or hypertension Aged ≥18 years. North America, South America, Europe, Asia, and Australia |
RCTs. Interventions included structured exercise training, categorized as aerobic exercise training (walking, running, cycling, swimming, ergometer work, cross-training),resistance training,combined aerobic + resistance training. Training duration 4-52 weeks, at intensities aligned with ACSM guidelines. Comparison: non-exercising control groups. |
Total cholesterol (TC) Triglycerides (TG) High-density lipoprotein cholesterol (HDL-C) Low-density lipoprotein cholesterol (LDL-C) |
Low | |
| «Masmoum MD, Khan S, Usmani WA, ym. The Effectivene...»4 | SR, MA | Adults ≥18 years with or without cardiovascular risk factors. United States, Portugal, Korea, the UK, Switzerland, Denmark, Canada, Sweden, the Philippines, Norway, Brazil, and Germany |
11 RCTs and 6 cohort studies. Interventions included aerobic exercise, resistance exercise, or combined training, with durations 6-12 months (RCTs) or follow-up from 8 weeks to 1 year (cohort studies). Comparison: no exercise, usual care. |
Primary: reduction in cardiovascular events (heart attack, stroke); secondary: changes in cardiovascular risk factors (blood pressure, cholesterol levels, body mass index) | Moderate |
| «de Oude KI, Elbers RG, Gerger H, ym. The effect of...»5 | SR, MA | Participants had one of the following cardiometabolic risk conditions: type 2 diabetes,
metabolic syndrome, hypercholesterolemia, hypertension, obesity. Included females
and males, age 21–87. Studies from Asia, North America, South America, Europe, Oceania, Africa. |
All studies were RCTs of resistance training. Interventions were categorized by intensity (the main theme of the review): low intensity: <60% 1RM, moderate intensity: 60–80% 1RM, high intensity: >80% 1RM, progressive intensity: 50–100% 1RM. Comparison: control / usual care |
Low-Density Lipoprotein (LDL) | Moderate |
| «Liang L, Peng F, Wang L, ym. Effects of exercise o...»6 | Adults (≥45 years). with or without stable chronic conditions (e.g., obesity, diabetes,
hypertension, coronary artery disease). United States, Brazil, Japan, Korea, China, European. |
Interventions included aerobic exercise, resistance training, stretching, or combined
training. Duration 4-52 weeks, 1-6 times/week, delivered in structured supervised or unsupervised formats. Comparison: non-exercise control groups. |
HDL-cholesterol | Low | |
| «Kodama S, Tanaka S, Saito K, ym. Effect of aerobic...»7 | MA | Adults ≥18 years with or without cardiovascular risk factors. North America, Europe, and Japan |
RCTs. Intervention: aerobic exercise training (i.e.walking, jogging, cycling, continuous swimming). Mean 3.7 sessions per week, session duration of 40.5 minutes, mean relative intensity ~65% of maximal aerobic capacity, and absolute intensity ~5.3 METs, corresponding to an estimated weekly energy expenditure ~1019 kcal. Comparison: non-exercising control groups. |
HDL-C | Moderate |
| RCT=randomized controlled trial; SR=systematic review; MA=meta-analysis; VO₂max=; HRmax=maximal heart rate; MET=metabolic equivalents. RPE=rating of perceived exertion; TC=total cholesterol; LDL-C=low-density lipoprotein cholesterol; HDL-C=high-density lipoprotein cholesterol; TG=triglycerides; ACSM=American College of Sports Medicine | |||||
| Reference | Comments |
|---|---|
| «Kelley GA, Kelley KS. Impact of progressive resist...»2 | Risk of bias due to limitations in study quality and methodological assessment. Total participants in 31 exercise groups were 1329 (676 exercise, 653 control). |
| «Lin X, Zhang X, Guo J, ym. Effects of Exercise Tra...»3 | Exercise frequency varied across the 160 trials, but study did not summarize or report the weekly training frequency across studies |
| «Masmoum MD, Khan S, Usmani WA, ym. The Effectivene...»4 | Risk of bias due to inconsistent study quality, very high heterogeneity, and lack of sensitivity analyses comparing low-risk studies with the full dataset. |
| «de Oude KI, Elbers RG, Gerger H, ym. The effect of...»5 | Risk of bias assessment showed concerns due to bias within the randomization process, missing outcome data, high variability between studies and reported results. The heterogeneity for moderate and high intensity resistance training was high; therefore, no report pooled effect estimates. |
| «Kodama S, Tanaka S, Saito K, ym. Effect of aerobic...»7 | Risk of bias from restricted search and insufficient quality-based analyses |
Results
| Reference | Lipid | Number of studies and number of patients (I/C) | Duration and frequency of training | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|---|
| Level of evidence: moderate The quality of evidence is downgraded due to study limitations, inconsistency, imprecision. I=intervention; C=comparison; CI=confidence interval; TC=total cholesterol; SMD= standardized mean difference; VMD=weighted mean difference; *p-value<0.05/significant |
||||||
| Aerobic training | ||||||
| «Chen Z, Zhou R, Liu X, ym. Effects of Aerobic Exer...»1 | TC | 26 355/357 |
3 sessions/week, moderate + vigorous intensity | N/A | N/A | SMD −0.24 (−0.39 to −0.08)* |
| «Chen Z, Zhou R, Liu X, ym. Effects of Aerobic Exer...»1 | TC | 12 184/183 |
3 sessions/week, moderate intensity | N/A | N/A | SMD −0.23 (−0.43 to −0.02)* |
| «Chen Z, Zhou R, Liu X, ym. Effects of Aerobic Exer...»1 | TC | 12 142/147 |
3 sessions/week, vigorous intensity | N/A | N/A | SMD −0.35(−0.64 to −0.07)* |
| Resistance training | ||||||
| «Kelley GA, Kelley KS. Impact of progressive resist...»2 | TC | 30 | 2–3 sessions/week, intensity 50–87% of 1RM, number of exercises 3–16, sets 1–5, progressive intensity | N/A | N/A | −5.5 mg/dL (−9.4 to −1.6)* |
| Aerobic and resistance training | ||||||
| «Lin X, Zhang X, Guo J, ym. Effects of Exercise Tra...»3 | TC | 68 1754/ 1604 |
N/A | N/A | WMD 1.16 mg/dL (-9.28 to 11.99) | |
| «Masmoum MD, Khan S, Usmani WA, ym. The Effectivene...»4 | TC | 12 8533/19532 |
N/A | N/A | −0.10 mg/dL (−1.33 to 1.14) | |
| Reference | Lipid | Number of studies and number of patients (I/C) | Duration and frequency of training | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|---|
| Level of evidence: moderate The quality of evidence is downgraded due to study limitations, inconsistency, imprecision. LDL=low-density lipoprotein; I=intervention; C=comparison; CI=confidence interval; ACSM= American College of Sports Medicine; MD=mean difference; SMD=standardized mean difference; VMD=weighted mean difference; *p-value<0.05/significant |
||||||
| Aerobic training | ||||||
| «Chen Z, Zhou R, Liu X, ym. Effects of Aerobic Exer...»1 | LDL | 22 292/298 |
3 sessions/week | N/A | N/A | SMD −0.42 (−0.65 to −0.18)* |
| «Chen Z, Zhou R, Liu X, ym. Effects of Aerobic Exer...»1 | LDL | 9 137/140 |
3 sessions/week, moderate intensity | N/A | N/A | SMD −0.49 (−0.76 to −0.23)* |
| «Chen Z, Zhou R, Liu X, ym. Effects of Aerobic Exer...»1 | LDL | 11 126/131 |
3 sessions/week, vigorous intensity | N/A | SMD -0.54 (−0.89 to −0.19)* | |
| Resistance training | ||||||
| «Kelley GA, Kelley KS. Impact of progressive resist...»2 | LDL | 23 | 2–3 sessions/week, intensity 50–87% of 1RM, number of exercises 3–16, sets 1–5, progressive intensity | N/A | N/A | −6.1 mg/dL (−11.2 to −1.0)* |
| «de Oude KI, Elbers RG, Gerger H, ym. The effect of...»5 | LDL | 11 137/137 |
2–4 sessions/week (ACSM requirement at minimum), low intensity | N/A | N/A | MD −0.10 mmol/L (−0.16 to −0.04) |
| «de Oude KI, Elbers RG, Gerger H, ym. The effect of...»5 | LDL | 4 81/75 |
2–4 sessions/week (ACSM requirement at minimum), progressive intensity | N/A | N/A | MD −0.16 mmol/L (−0.19 to −0.13) |
| Aerobic and resistance training | ||||||
| «Lin X, Zhang X, Guo J, ym. Effects of Exercise Tra...»3 | LDL | 59 1681/1525 |
N/A | N/A | WMD 3.87 mg/dL (-8.12 to 0.39) | |
| Reference | Lipid | Number of studies and number of patients (I/C) | Duration and frequency of training | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|---|
| Level of evidence: moderate The quality of evidence is downgraded due to study limitations, inconsistency. HDL=high-density lipoprotein; I=intervention; C=comparison; CI=confidence interval; SMD= standardized mean difference; MD=mean difference; VMD=weighted mean difference;*p-value<0.05/significant |
||||||
| Aerobic training | ||||||
| «Chen Z, Zhou R, Liu X, ym. Effects of Aerobic Exer...»1 | HDL | 26 355/357 |
3 sessions/week, moderate + vigorous intensity | N/A | N/A | SMD 0.33 (0.11 to 0.55)* |
| «Chen Z, Zhou R, Liu X, ym. Effects of Aerobic Exer...»1 | HDL | 12 184/183 |
3 sessions/week, moderate intensity | N/A | N/A | SMD 0.36 (0.03 to 0.68)* |
| «Chen Z, Zhou R, Liu X, ym. Effects of Aerobic Exer...»1 | HDL | 12 142/147 |
3 sessions/week, vigorous intensity | N/A | N/A | SMD 0.25 (−0.10 to 0.59) |
| «Liang L, Peng F, Wang L, ym. Effects of exercise o...»6 | HDL | 21 780/ 593 |
1-6 sessions/week | N/A | N/A | SMD 0.27 (0.07 to 0.48)* |
| «Kodama S, Tanaka S, Saito K, ym. Effect of aerobic...»7 | HDL | 25 total 1404 |
3.7 sessions/week, session duration 40.5 minutes, intensity ~65% VO2max | N/A | N/A | MD 2.53 mg/dL (1.36 to 3.70)* |
| Resistance training | ||||||
| «Kelley GA, Kelley KS. Impact of progressive resist...»2 |
HDL | 28 | 2–3 sessions/week, intensity 50–87% of 1RM, number of exercises 3–16, sets 1–5, progressive intensity | N/A | N/A | 0.7 mg/dL (−1.2 to 2.6) |
| Aerobic and resistance training | ||||||
| «Lin X, Zhang X, Guo J, ym. Effects of Exercise Tra...»3 | HDL | 74 1976/1800 |
N/A | N/A | WMD 2.32 mg/dL (1.16 to 3.87)* | |
| All exercise forms | ||||||
| «Liang L, Peng F, Wang L, ym. Effects of exercise o...»6 | HDL | 42 1327/ 1315 |
1-6 session/week | N/A | N/A | SMD 0.22 (0.09 to 0.35)* |
| Reference | Lipid | Number of studies and number of patients (I/C) | Duration and frequency of training | Absolute number of events (%) I | Absolute number of events (%) C | Relative effect (95% CI) |
|---|---|---|---|---|---|---|
| Level of evidence: moderate The quality of evidence is downgraded due to study limitations, imprecision. TG=triglyceride; I=intervention; C=comparison; CI=confidence interval; SMD=standardized mean difference; VMD=weighted mean difference; *p-value<0.05/significant |
||||||
| Aerobic training | ||||||
| «Chen Z, Zhou R, Liu X, ym. Effects of Aerobic Exer...»1 | TG | 27 380/374 |
3 sessions/week, moderate + vigorous intensity | N/A | N/A | SMD −0.54 (−0.75 to −0.33)* |
| «Chen Z, Zhou R, Liu X, ym. Effects of Aerobic Exer...»1 | TG | 12 188/183 |
3 sessions/week, moderate intensity | N/A | N/A | SMD −0.48 (−0.69 to −0.27) * |
| «Chen Z, Zhou R, Liu X, ym. Effects of Aerobic Exer...»1 | TG | 13 163/164 |
3 sessions/week, vigorous-Intensity | N/A | N/A | SMD −0.66(−1.06 to −0.25)* |
| Resistance training | ||||||
| «Liang L, Peng F, Wang L, ym. Effects of exercise o...»6 | TG | 26 | 2–3 sessions/week, intensity 50–87% of 1RM, number of exercises 3–16, sets 1–5, progressive intensity | −8.1 mg/dL (−14.5 to −1.8)* | ||
| Aerobic and resistance training | ||||||
| «Lin X, Zhang X, Guo J, ym. Effects of Exercise Tra...»3 | TG | 66 1851/1703 |
N/A | N/A | WMD -5.31 mg/dL (-10.63 to -0.89)* | |