Modality-specific effects of structured exercise on immunometabolic biomarkers in postmenopausal obesity: a Bayesian...

Area of Science:

• Exercise physiology
• Biomarkers of inflammation
• Metabolic health in postmenopausal women

Background:

• Postmenopausal women with overweight/obesity exhibit chronic low-grade systemic inflammation (CLGSI).
• Various exercise modalities (aerobic, resistance, HIIT, combined) are proposed to mitigate inflammation.
• Comparative efficacy of different exercise types on specific inflammatory biomarkers remains unclear.

Purpose of the Study:

• To compare the efficacy of aerobic training (AT), resistance training (RT), high-intensity interval training (HIIT), and combined training (CT) on CLGSI biomarkers.
• To identify the most effective exercise modality for reducing specific inflammatory markers in this population.
• To evaluate the certainty of evidence for exercise interventions on inflammation.

Main Methods:

• Bayesian network meta-analysis (NMA) of 39 randomized controlled trials (RCTs) including 2,714 postmenopausal women.
• Systematic literature search across five databases up to November 2025.
• Standardized mean differences (SMDs) and 95% credible intervals (CrIs) for efficacy; Surface Under the Cumulative Ranking (SUCRA) for rankings; GRADE for evidence certainty.

Main Results:

• RT showed the largest reduction in C-reactive protein (CRP) (SMD = -0.97).
• Combined training (CT) most effectively reduced interleukin-6 (IL-6) (SMD = -1.58) and tumor necrosis factor-α (TNF-α) (SMD = -0.99).
• Aerobic training (AT) also reduced CRP and TNF-α; HIIT data were sparse; leptin levels were unchanged. Evidence certainty was low to very low.

Conclusions:

• Exercise modality influences specific anti-inflammatory biomarker responses in overweight/obese postmenopausal women.
• RT is optimal for CRP reduction; CT is superior for IL-6 and TNF-α.
• Low evidence certainty necessitates cautious interpretation for guiding exercise prescriptions.