Abstract / Summary
Obesity and type 2 diabetes mellitus (T2DM) are strongly associated with insulin resistance and chronic inflammation. Retinol-Binding Protein 4 (RBP4), an adipokine secreted by the liver and adipose tissue, has been implicated in metabolic dysfunction, with elevated circulating levels linked to impaired glucose homeostasis. Exercise is known to improve insulin sensitivity; however, its effects on RBP4 remain unclear. This systematic review aimed to synthesize the available evidence on the impact of exercise interventions on circulating RBP4 concentrations and to evaluate differences by exercise modality and population characteristics. The review followed PRISMA guidelines. A systematic search of PubMed, Web of Science, and Google Scholar (2005-2025) was conducted. Inclusion criteria were human studies ?18 years evaluating structured aerobic, resistance, or combined training with pre- and post-intervention RBP4 measurement. Non-exercise interventions and animal studies were excluded. Data extraction and quality appraisal were independently performed using Joanna Briggs Institute checklists. Out of 1,422 records screened, 16 studies met the eligibility criteria, including randomized controlled trials, quasi-experimental studies, and pre-post designs. Participants included healthy individuals, obese subjects, and patients with T2DM or metabolic syndrome. The exercise interventions varied from a single session to structured aerobic or combined aerobic-resistance programs lasting up to 12 weeks. Results showed context-dependent effects with conflicting results between different studies. Aerobic and combined aerobic-resistance exercise were associated with significant reductions in circulating RBP4 levels among obese and T2DM groups, whereas results in healthy individuals remained inconsistent. In contrast, single-session and endurance training interventions did not produce significant effects. Exercise training demonstrates potential to lower circulating RBP4, particularly in metabolically compromised populations. However, inconsistent results highlight the need for larger, standardized trials to clarify exercise modality-specific effects.
Primary Source
Physiological research
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