Zhu YUPING, Lei TIANBI, Zhang GUODONG
Turkish Journal of Kinesiology - 2026;12(4):373-384
To systematically evaluate the effects of exercise interventions on plasma fibrinogen levels in patients with type 2 diabetes and to provide evidence to support the use of exercise prescription in the management of diabetes-related thrombotic risk. PubMed, Web of Science, Scopus, and Embase were systematically searched for randomized controlled trials investigating the effects of exercise or lifestyle interventions incorporating an exercise component on plasma fibrinogen levels. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool. Effect sizes were expressed as Cohen's d with 95% confidence intervals and pooled using a random-effects model. Subgroup analyses were conducted According to intervention type and intervention duration. Publication bias and the robustness of the findings were examined using Egger's regression test and sensitivity analyses involving the exclusion of individual studies. Eight randomized controlled trials involving 2,371 participants were included. The pooled analysis indicated that exercise interventions were associated with improvements plasma fibrinogen levels (Cohen's d=0.38, 95% CI: 0.09 to 0.67, I² = 75.2%). Subgroup analysis by intervention type showed a larger beneficial effect for exercise-only interventions, whereas the effect of combined exercise and dietary interventions was smaller; the between-subgroup difference was statistically significant (P<0.001). When studies were stratified by intervention duration, short-term interventions (<=16 weeks) demonstrated a comparatively larger positive effect, whereas the effect of longer-term interventions (>16 weeks) was close to the null. These findings suggest that shorter-term structured exercise programs may be associated with larger observed effect estimates. Exercise interventions may improve plasma fibrinogen levels in patients with type 2 diabetes, with exercise-only and shorter-duration interventions showing comparatively larger effects. However, given the limited number of included studies, substantial between-study heterogeneity, and variation in intervention protocols, these findings should be confirmed in further high-quality, large-scale randomized controlled trials.
