Iranian Journal of Diabetes and Lipid Disorders

The Effect of Exercise Training on Chemerin, Vaspin, and Body Composition in Type 2 Diabetics: A Systematic Review and Meta-Analysis

Omid Zafarmand

Background: Exercise training represents an effective approach that contributes substantially to lowering chemerin and vaspin levels, enhancing body composition, and preventing complications related to overweight and obesity. In this context, the present study sought to examine the effects of exercise training on chemerin, vaspin, and body composition in individuals with type 2 diabetes.
Methods: A systematic review and meta-analysis was conducted to evaluate the effects of exercise interventions on various outcomes in patients with type 2 diabetes. A comprehensive search for English and Persian articles published up to )January 4, 2025( was performed across the following databases: PubMed, Web of Science, Scopus, Google Scholar, IranDoc, Magiran, Noormags, and SID (Scientific Information Database). Fifteen studies, including 19 exercise interventions and 440 participants with type 2 diabetes, were included. Data were analyzed using a random-effects model, and the mean differences with 95% confidence intervals (CI) were calculated. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated through visual inspection of funnel plots and Egger’s test.
Results: A total of 15 studies (with 19 exercise interventions) involving 440 participants with type 2 diabetes were included in the meta-analysis. The results indicated that exercise interventions led to non-significant changes in c-Merlin [SMD= −0.967, 95% CI: −2.453 to 0.518, P= 0.202], body mass index (BMI) [SMD= −0.228, 95% CI: −0.470 to 0.013, P= 0.064], waist-to-hip ratio (WHR) [SMD= −0.038, 95% CI: −0.773 to 0.007, P= 0.054], and body fat percentage [SMD= 0.080, 95% CI: −0.524 to 0.685, P= 0.795] compared with the control group in individuals with type 2 diabetes.
Conclusion: The results of the present study demonstrated that exercise training significantly reduces vaspin levels in patients with type 2 diabetes, while it has no significant effect on chemerin, body composition, or body composition indices (including body mass index, body fat percentage, and waist-to-hip ratio). It appears that physical exercise may play an effective role in improving the metabolic status of patients with type 2 diabetes through the modulation of vaspin levels.

Research Trends of Iranian Scholars on the Effects of Exercise and Ginger Supplementation on Insulin Resistance: A Bibliometric Analysis

Shahin Riyahi malayeri

Background: Insulin resistance plays a fundamental role in disorders such as obesity, diabetes, cardiovascular diseases, and metabolic syndrome. Regular physical activity and the use of medicinal plants are important strategies for its reduction and management. Ginger has attracted research attention due to its phytochemical compounds that influence insulin signaling pathways. Despite numerous studies, a bibliometric analysis examining the effects of exercise and ginger supplementation on insulin resistance has not yet been conducted. Therefore, the present study aimed to analyze the trends in Iranian research in this field.
Methods: In a bibliometric review, the keywords “training,” “ginger supplementation,” and “insulin resistance” were searched in the Magiran database. According to the entry criteria, 13 eligible articles were selected and data extracted from them, including writing pattern, collaboration, prolific authors and institutions, selected journals and study trends, and common keywords were extracted from the database of recipients and analyzed using VOSviewer software.
Results: The results indicated that 36 authors had an average of 3.23 ± 0.89 cooperation in writing articles. Fifty-four percent of the articles were published by public university faculty and 46% by independent universities. The most frequent keywords included "ginger", "insulin resistance", "obesity", "diabetes mellitus", "irisin" and "lipid peroxidation".
Conclusion: The results of this bibliometric study showed that exercise with ginger supplement reduced insulin resistance. In particular, 84% of the articles showed the positive effect of combined exercises (resistance and aerobic exercises) along with ginger supplements on the reduction of insulin resistance. Compared to other types of exercise, these exercises have had the greatest effect on improving the glycemic profile and body composition. In addition, high intensity interval training (HIIT) has also shown positive effects on reducing insulin resistance, but is not as effective as combined training. Also, due to the relationship between insulin resistance and various diseases, it is felt to conduct more studies on diverse statistical populations and people suffering from various diseases.

Association Between Triglyceride-glucose Related Indices and Bone Health: A Review Study

Mahnaz Pejman Sani

Osteoporosis is a metabolic bone disorder characterized by reduced bone mineral density and an increased risk of fractures. It has significant health impacts and is associated with socioeconomic consequences. Triglyceride-glucose indices [TyG, TyG-body mass index (BMI), TyG-waist circumference (WC), and TyG-waist to height ratio (WHTR)] are recognized as surrogate and cost-effective markers for assessing insulin resistance and can be effective in evaluating bone health and predicting the risk of osteoporosis and fractures. However, according to existing evidence, the relationship between these indices and bone health can be influenced by various factors such as gender, age, obesity, and metabolic disorders. There is also evidence of a nonlinear association between these indices and bone density, where their positive effect diminishes or reverses after reaching a certain threshold. These indices can serve as alternative and affordable markers for assessing bone health and early identification of individuals at risk of osteoporosis and bone fractures. Nonetheless, further longitudinal research is needed to confirm these findings across different populations and to determine the underlying mechanisms. The aim of this review study was to examine the existing evidence regarding the relationship between triglyceride-glucose indices and bone health.

The Effect of Combined Exercises and Grape Seed Extract on Some Factors of Oxidative Stress and Antioxidant in Postmenopausal Women with Type 2 Diabetes: A Randomized Controlled Trial

Saeid Shamlou kazemi

Background: Moderate and intense aerobic exercise increases the production of free radicals, and on the other hand, the use of antioxidant supplements such as grape seed extract (GSE) has been suggested as one of the ways to deal with oxidative stress. Based on this, the aim of this study was to determine the interventions effect of combined exercise and consumption of GSE on some factors of oxidative and antioxidant stress in postmenopausal women with type 2 diabetes.
Methods: The current study was conducted as a clinical trial on the 80 women with type 2 diabetes, who were randomly divided into four groups (20 people): control, exercise, GSE supplement, exercise + GSE supplement. The combined exercise protocol consisted of aerobic (20 minutes of treadmill running at an intensity of 60–70% of reserve heart rate) and strength training (at an intensity of 70% of one repetition maximum), which was performed for eight weeks (five days/week). GSE supplement was taken in the form of 200 mg capsules daily (morning and noon). Samples (five cc) were taken before and after eight weeks of interventions. In order to determine the acceptance or rejection of the null hypothesis of intragroup and intergroup changes, was used the two-way AVOVA, and then Tukey's post hoc test to determine different groups by SPSS version 25 (P≤ 0.05).
Results: The values of total antioxidant capacity (TAC) and serum glutathione reduction (GSH) in the GSE and exercise + GSE groups increased significantly compared to the control and exercise groups (P= 0.001). Serum malondialdehyde (MDA) levels in the GSE group showed a significant decrease compared to the control and exercise groups (P= 0.001).
Conclusion: It seems that the intervention of grape seed extract is more effective in reducing oxidative stress than combined exercise. The consumption of this extract alone, as well as with combined exercise, has a significant effect on increasing the total antioxidant capacity and reducing GSH (glutathione).

Comparison of the Effects of High-Intensity Interval Games and High-Intensity Interval Training on Body Composition, Aerobic Power and Lipid Profile in Overweight and Obese Girls Aged 10 To 12 Years

Mohammadreza Esmaelzadeh Toloee

Background: This study aimed to compare the effects of high-intensity interval games and high intensity interval training on body composition indicators, aerobic capacity and lipid profiles of obese and overweight girls aged 10 to 12 years.
Methods: In this semi-experimental research, 30 girls (average height 149.26 ± 5.32 m, weight 67.41 ± 7.65 kg, and body mass index 30.14 ± 2.3 kg/m2) with overweight and obesity participated and were randomly divided into the groups of high intensity interval training (10), high intensity interval game (10) and the control (10). Training programs for eight weeks(3d/w), (90-85% of maximum heart rate) and 3-minute recovery (65-75% of maximum heart rate) with 4 times Repetition was done, which was done in the form of running in high intensity interval training and in the form of playing in high intensity interval game. Blood samples were taken to measure the serum levels of lipid profiles (48 hours before and after the intervention period).
Results: The two training groups compared to the control group, increased aerobic capacity and High-density lipoprotein (HDL) and body fat percentage, Triglyceride (TG), Total Cholesterol (TC) and Low-density lipoprotein (LDL) (P< 0.010) showed a significant decrease and between the two training groups in TG, LDL and HDL (P< 0.01) was a significant difference, with a greater increase in HDL and a greater decrease in TG and LDL was accompanied in the high intensity game group.
Conclusion: High intensity interval games can be suggested as a more suitable solution to improve the lipid profile of obese and overweight girls.

The Effect of Aerobic Exercise Timing, Specifically Contrasting the Light Phase with the Dark Phase, on the Protein Expression Levels of the Inflammatory Marker C3 and Interleukin 1 Beta (IL-1β) in Older Adults’ Women Diagnosed with Type 2 Diabetes Mellitus

Azra Mohammadpanah Ardakan

Background: Inflammatory protein C3 and IL-1β are significantly involved in the pathophysiology of type 2 diabetes (T2D) and Alzheimer's disease. Moreover, examining the importance of aerobic exercise timing (light vs. dark phase) can provide a better understanding of how exercise timing affects inflammatory markers associated with neurological diseases in older adult women with T2D. Therefore, this study aimed to investigate the effect of aerobic exercise timing on C3 and IL-1β levels in older adults’ women with T2D.
Methods: In this semi-experimental study, 45 women with T2D with an average age of 60 ± 5.07 years were divided into training groups (light and dark phase) and control (15 people in each group). Aerobic exercise was performed for 12 weeks at a moderate intensity (60-70% of heart rate reserve). Protein levels (C3 and IL-1β) were measured before and after the intervention using the ELISA method. Data were analyzed using SPSS27 software and ANOVA with a significance level of 0.05.
Results: Complement C3 was significantly lower in the dark phase exercise group compared to the control group (P= 0.0083). Additionally, the results showed that dark phase aerobic exercise significantly decreased C3 (P= 0.0028) and IL-1β (P= 0.0045) levels compared to baseline.
Conclusion: Aerobic exercise performed during the dark phase effectively reduced inflammatory protein levels of C3 and IL-1β in older adult women with T2D, suggesting it could be considered as a crucial strategy in managing this disease.

Physical Activity Patterns and Perceptions Among Iran’s Diabetic Individuals After COVID Pandemic

Morteza Tayebi

Background: Type 2 diabetes is a prevalent metabolic disorder characterized by insulin resistance and impaired glucose absorption. The COVID-19 pandemic and associated quarantines led to significant lifestyle changes, including reduced physical activity among diabetic individuals. This study investigates the patterns of physical activity and perceptions among diabetic individuals in post-COVID Iran.
Methods: An online questionnaire was created using the "Pors Online" platform and shared via social media. Among 435 participants from 35 Iranian cities, 400 responses (200 diabetics and 200 healthy individuals) were deemed complete and valid for analysis. The data were analyzed using an independent t-test, with a significance level set at P< 0.05.
Results: The results showed that the physical activity level of diabetic individuals was significantly lower than that of non-diabetic individuals P< 0.05. Additionally, their preferred types of physical activities differed; both groups showed the most interest in walking and the least interest in traditional games. The primary motivation for exercise among diabetic individuals was disease prevention, but financial barriers had the greatest impact on reducing their physical activity P< 0.05. Their main sources of information about physical activity were magazines and books.
Conclusion: Improving access to sports facilities and tailored equipment for diabetics, coupled with awareness campaigns on the benefits of exercise, is essential. Developing customized sports programs suited to the health conditions of diabetics can enhance their participation and overall well-being.

Psychometrics of Comprehensive Diabetes Self-Management Scale in Patients with Type 2 Diabetes

Masoumeh Aghamohammadi

Background: The increasing trend of diabetes patients requires lifestyle interventions to improve the self-management ability of these patients, and achieving this requires the use of valid tools in this field. This study aimed to determine the psychometric properties of the Comprehensive Diabetes Self-Management Scale (CDSMS) in patients with type 2 diabetes.
Methods: The present study was methodological research that was conducted in 2023. At the beginning of the work, the CDSMS questionnaire was translated into Persian using the standard translation-back translation method. Then, face validity, content validity, convergent validity, internal consistency, and instrument stability were determined. Data analysis was performed using descriptive statistics, Cronbach's alpha calculation, Kappa index, Pearson correlation coefficient, and intra-cluster correlation coefficient in SPSS software version 24.
Results: Based on the results, all the items of the instrument were retained. The total content validity index score of the Persian version of this questionnaire was 0.987. Also, the Kuder-Richardson and Kappa indices were 0.704 and 0.730, respectively. The level of agreement at two measurement times, two weeks apart, ranged from 0.503 to 0.990. The intra-cluster correlation index was also observed to be in the range of 0.625 to 0.952 and was significant (P < 0.001). The Cronbach's alpha coefficient of the instrument was also 0.83.
Conclusion: The results of the present study showed that the Persian version of the CDSMS questionnaire with 14 items has good validity and reliability and can be used to evaluate the self-management status of patients with type 2 diabetes in Iran.

Relationship between Stigma and Mental Well-Being Scales with Mediation of Emotional Distress and Illness Perception in Patients with Type 2 Diabetes

Keivan Kakabraee

Background: This study aimed to investigate the relationship between stigma associated with type 2 diabetes and subjective well-being measures (life satisfaction and positive/negative affect) mediated by emotional stress and illness perception in people with type 2 diabetes.
Methods: The present research was descriptive based on correlation models. The statistical population included patients with type 2 diabetes who referred to the diabetes clinic of Ayatollah Taleghani hospital in Kermanshah, 207 adults were selected using the convenient sampling method and data were collected using questionnaires Type 2 Diabetes Stigma Assessment Scale (DSAS-2) (Browne et al., 2016), life satisfaction (Diener, 1985), Positive/Negative Affect Schedule (Watson et al., 1988), Illness Perception (Broadbent et al., 2006) then analyzed with SPSS and Amos software.
Results: The results showed that there was a significant relationship between stigma, life satisfaction, and positive/negative affect (P < 0.01). Stigma was also able to predict life satisfaction indirectly and negatively through emotional distress, and negative affect indirectly and positively through emotional distress and illness perception.
Conclusion: The results indicate the need for interventions to reduce the stigma associated with type 2 diabetes and improve the mental well-being of people with this disease.