Equivalent Acute Anti-Inflammatory Effects of Exercise in Type 2 Diabetes Versus Healthy Adults: A Randomised...

To identify inflammatory biomarkers differentiating patients with type 2 diabetes (T2D) from healthy adults and to compare acute anti-inflammatory response to guideline-based exercise.

This was a randomised, three-period crossover trial. Twenty-one patients with T2D (47.81 ± 11.88 years) and 26 healthy adults (31.77 ± 6.66 years) completed three exercise trials separated by a ≥ 72-h washout: A (moderate-intensity aerobic, resistance and combined exercise), B (resistance exercise at low, moderate and vigorous intensities) and C (combined exercise at low, moderate and vigorous intensities). Circulating levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), tumour necrosis factor-α (TNF-α) and leukocyte count were measured at baseline (fasting), immediately after and 72 h post-exercise (fasting). Data were analysed using repeated-measures ANCOVA with age as a covariate.

Baseline hs-CRP was significantly higher in T2D than healthy adults in Trial C (p = 0.017). In most trials, hs-CRP and leukocyte counts were not acutely affected by exercise. However, in Trial B, both IL-8 and TNF-α were significantly lowered immediately post-exercise (p = 0.048, p < 0.001, respectively). A significant group × time interaction for leukocyte count was observed in Trial A (p = 0.034). IL-6 responses varied by exercise type without group differences.

This study identifies hs-CRP as a key baseline biomarker differentiating well-controlled T2D from healthy adults. Acute exercise induces transient, cytokine-specific modulation rather than a generalised anti-inflammatory effect. IL-6 dynamics may be influenced by exercise duration, fitness and temperature, informing personalised prescription.

Chinese Clinical Trial Registry (CHiCTR); ChiCTR2300076550; URL https://www.chictr.org.cn/showproj.html?proj=205156.