Journals / Turkish Journal of Kinesiology / 2026 / Volume: 12 Issue: 4

Effects of exercise interventions on plasma fibrinogen levels in patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials

Yuping Zhu(Institute of Sport Science, College of Physical Education, Southwest University, Chongqing, China.)0009-0002-9995-7234
Tianbi Lei(Department of Physical Education, Sichuan Province Science City Chunlei School, Mianyang, China.)0009-0007-7425-0888
Guodong Zhang(Institute of Sport Science, College of Physical Education, Southwest University, Chongqing, China.)0000-0003-4090-9123
Pages
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Publication Date
2026-08-29
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

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.

📌 3 Key Takeaways

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Objective & Hypothesis: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.
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Key Findings & Data:Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool.
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Conclusion & Impact: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.
🔬Design:Lab & Field Experiment
📍Scope:Comprehensive Sample
⚙️Variables:Coagulation function · exercise intervention · type 2 diabetes mellitus

Abstract

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 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.

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Cite This Article

Zhu, Y., Lei, T., Zhang, G. (2026). Effects of exercise interventions on plasma fibrinogen levels in patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. Turkish Journal of Kinesiology, Volume: 12 Issue: 4. https://doi.org/10.31459/turkjkin.1969873

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References (29)

  1. Belalcazar, L. M., Ballantyne, C. M., Lang, W., Haffner, S. M., Rushing, J., Schwenke, D. C., Pi-Sunyer, F. X., Tracy, R. P., & Group, T. L. A. A. (2011). Metabolic factors, adipose tissue, and plasminogen activator inhibitor-1 levels in type 2 diabetes. Arterioscler Thromb Vasc Biol, 31(7), 1689-1695. doi: 10.1161/atvbaha.111.224386
  2. Bryk-Wiązania, A. H., & Undas, A. (2021). Hypofibrinolysis in type 2 diabetes and its clinical implications: from mechanisms to pharmacological modulation. Cardiovasc Diabetol, 20(1), 191. doi: 10.1186/s12933-021-01372-w
  3. Chen, X., Sun, X., Wang, C., & He, H. (2020). Effects of exercise on inflammatory cytokines in patients with type 2 diabetes: a meta-analysis of randomized controlled trials. Oxid Med Cell Longev, 2020, 6660557. doi: 10.1155/2020/6660557
  4. Danesh, J., Lewington, S., Thompson, S. G., Lowe, G. D. O., Collins, R., Kostis, J. B., Wilson, A. C., Folsom, A. R., Wu, K., Benderly, M., Goldbourt, U., Willeit, J., Kiechl, S., Yarnell, J. W. G., Sweetnam, P. M., Elwood, P. C., Cushman, M., Psaty, B. M., Tracy, R. P., … & Wood, A. (2005). Plasma fibrinogen level and the risk of major cardiovascular diseases and nonvascular mortality: an individual participant meta-analysis. JAMA, 294(14), 1799-1809. doi: 10.1001/jama.294.14.1799
  5. Di Francescomarino, S., Sciartilli, A., Di Valerio, V., Di Baldassarre, A., & Gallina, S. (2009). The effect of physical exercise on endothelial function. Sports Med, 39(10), 797-812. doi: 10.2165/11317750-000000000-00000
  6. Dunn, E. J., Ariëns, R. A. S., & Grant, P. J. (2005). The influence of type 2 diabetes on fibrin structure and function. Diabetologia, 48(6), 1198-1206. doi: 10.1007/s00125-005-1742-2
  7. Dunn, E. J., & Grant, P. J. (2005). Type 2 diabetes: an atherothrombotic syndrome. Curr Mol Med, 5(3), 323-332. doi: 10.2174/1566524053766059
  8. El-Sayed, M. S., El-Sayed Ali, Z., & Ahmadizad, S. (2004). Exercise and training effects on blood haemostasis in health and disease: an update. Sports Med, 34(3), 181-200. doi: 10.2165/00007256-200434030-00004
  9. Eslami, R., Heidary, D., Mehdipour, A., & Heidari, S. (2021). The effects of acute exercise and exercise training onplasma fibrinogen levels in healthy individuals:a meta-analysis. J Iran Blood Transfus, 18 (2), 127-141.
  10. Federation, I. D. (2025). IDF Diabetes Atlas (11th ed.). Brussels, Belgium: International Diabetes Federation.
  11. Fernández-Rodríguez, R., Monedero-Carrasco, S., Bizzozero-Peroni, B., Garrido-Miguel, M., Mesas, A. E., & Martínez-Vizcaíno, V. (2023). Effectiveness of resistance exercise on inflammatory biomarkers in patients with type 2 diabetes mellitus: a systematic review with meta-analysis. Diabetes Metab J, 47(1), 118-134. doi: 10.4093/dmj.2022.0007
  12. Gao, J., Pan, X., Li, G., Chatterjee, E., & Xiao, J. (2022). Physical exercise protects against endothelial dysfunction in cardiovascular and metabolic diseases. J Cardiovasc Transl Res, 15(3), 604-620. doi: 10.1007/s12265-021-10171-3
  13. Hämäläinen, H., Rönnemaa, T., Virtanen, A., Lindström, J., Eriksson, J. G., Valle, T. T., Ilanne-Parikka, P., Keinänen-Kiukaanniemi, S., Rastas, M., Aunola, S., Uusitupa, M., Tuomilehto, J., & Group, O. B. O. T. (2005). Improved fibrinolysis by an intensive lifestyle intervention in subjects with impaired glucose tolerance. The Finnish diabetes prevention study. Diabetologia, 48(11), 2248-2253. doi: 10.1007/s00125-005-1938-5
  14. Hayashino, Y., Jackson, J. L., Hirata, T., Fukumori, N., Nakamura, F., Fukuhara, S., Tsujii, S., & Ishii, H. (2014). Effects of exercise on C-reactive protein, inflammatory cytokine and adipokine in patients with type 2 diabetes: a meta-analysis of randomized controlled trials. Metabolism, 63(3), 431-440. doi: 10.1016/j.metabol.2013.08.018
  15. Hejazi, K., & Wong, A. (2023). Effects of exercise training on inflammatory and cardiometabolic health markers in overweight and obese adults: a systematic review and meta-analysis of randomized controlled trials. J Sports Med Phys Fitness, 63(2), 345-359. doi: 10.23736/S0022-4707.22.14103-4
  16. Kadoglou, N. P. E., Fotiadis, G., Athanasiadou, Z., Vitta, I., Lampropoulos, S., & Vrabas, I. S. (2012). The effects of resistance training on ApoB/ApoA-I ratio, Lp(a) and inflammatory markers in patients with type 2 diabetes. Endocrine, 42(3), 561-569. doi: 10.1007/s12020-012-9650-y
  17. Kadoglou, N. P. E., Vrabas, I. S., Sailer, N., Kapelouzou, A., Fotiadis, G., Noussios, G., Karayannacos, P. E., & Angelopoulou, N. (2010). Exercise ameliorates serum MMP-9 and TIMP-2 levels in patients with type 2 diabetes. Diabetes Metab, 36(2), 144-151. doi: 10.1016/j.diabet.2009.11.004
  18. Kamath, S., & Lip, G. Y. H. (2003). Fibrinogen: biochemistry, epidemiology and determinants. QJM, 96(10), 711-729. doi: 10.1093/qjmed/hcg129
  19. Kanaley, J. A., Colberg, S. R., Corcoran, M. H., Malin, S. K., Rodriguez, N. R., Crespo, C. J., Kirwan, J. P., & Zierath, J. R. (2022). Exercise/physical activity in individuals with type 2 diabetes: a consensus statement from the American College of Sports Medicine. Med Sci Sports Exerc, 54(2), 353-368. doi: 10.1249/MSS.0000000000002800
  20. Kearney, K., Tomlinson, D., Smith, K., & Ajjan, R. (2017). Hypofibrinolysis in diabetes: a therapeutic target for the reduction of cardiovascular risk. Cardiovasc Diabetol, 16(1), 34. doi: 10.1186/s12933-017-0515-9
  21. Kirk, A., Mutrie, N., MacIntyre, P., & Fisher, M. (2004). Effects of a 12-month physical activity counselling intervention on glycaemic control and on the status of cardiovascular risk factors in people with Type 2 diabetes. Diabetologia, 47(5), 821-832. doi: 10.1007/s00125-004-1396-5
  22. Li, X., Weber, N. C., Cohn, D. M., Hollmann, M. W., DeVries, J. H., Hermanides, J., & Preckel, B. (2021). Effects of hyperglycemia and diabetes mellitus on coagulation and hemostasis. J Clin Med, 10(11) doi: 10.3390/jcm10112419
  23. Liang, M., Pan, Y., Zhong, T., Zeng, Y., & Cheng, A. S. K. (2021). Effects of aerobic, resistance, and combined exercise on metabolic syndrome parameters and cardiovascular risk factors: a systematic review and network meta-analysis. Rev Cardiovasc Med, 22(4), 1523-1533. doi: 10.31083/j.rcm2204156
  24. Lin, X., Zhang, X., Guo, J., Roberts, C. K., McKenzie, S., Wu, W., Liu, S., & Song, Y. (2015). Effects of exercise training on cardiorespiratory fitness and biomarkers of cardiometabolic health: a systematic review and meta-analysis of randomized controlled trials. J Am Heart Assoc, 4(7) doi: 10.1161/JAHA.115.002014
  25. MacIntyre, P., Fisher, M., Kirk, A., & Mutrie, N. (2004). Effects of a 12-month physical activity counselling intervention on glycaemic control and on the status of cardiovascular risk factors in people with Type 2 diabetes. Diabetologia, 47(5), 821-832. doi: 10.1007/s00125-004-1396-5
  26. Mori, T., Puddey, I., Beilin, L., Burke, V., Morton, A., Stanton, K., & Dunstan, D. (1999). A randomised, controlled study of the effects of aerobic exercise and dietary fish on coagulation and fibrinolytic factors in type 2 diabetics. Thromb Haemost, 81(03), 367-372. doi: 10.1055/s-0037-1614479
  27. Rajabi, A., Akbar Nezhad Gharehlo, A., Madadizadeh, E., Basereh, A., Khoramipoor, K., Pirani, H., Khoramipour, K., Moser, O., & Khoramipour, K. (2024). The effect of 12 weeks of aerobic exercise training with or without saffron supplementation on diabetes‐specific markers and inflammation in women with type 2 diabetes: A randomized double‐blind placebo‐controlled trial. Eur J Sport Sci, 24(7), 899-906. doi: 10.1002/ejsc.12125
  28. Rezaeimanesh, D. (2020). The effects of high-intensity interval training on fibrinolytic factors, D-dimer, and fibrinogen in men with type 2 diabetes. Arch Pharma Pract, 11(S1), 154-160.
  29. Wolberg, A. S. (2016). Primed to understand fibrinogen in cardiovascular disease. Arterioscler Thromb Vasc Biol, 36(1), 4-6. doi: 10.1161/ATVBAHA.115.306754