Effects of exercise on glycolipid metabolism in adolescents with overweight and obesity: a systematic review and meta-analysis of 26 randomized controlled trials

Objective The aim of this meta-analysis was to investigate the effect of exercise intervention on glycolipid metabolism in overweight and obese adolescents. Methods A systematic review and meta-analysis of randomized trials were conducted. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered (ID: CRD42024623686). Electronic searches were performed using the following databases: Web of Science, PubMed, Scopus, Cochrane and Embase. Randomized controlled trials of exercise interventions were included. Data on fasting blood glucose (FBG), fasting insulin (FINS), total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) before and after exercise interventions were extracted for overweight and obese adolescents. Risk of bias was assessed using the Cochrane risk of bias tool. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) tool was used to evaluate the quality of the evidence. Standardized mean differences (SMDs) were calculated to compare differences between exercise and conventional control groups. Subgroup analyses were performed to assess whether effects differed by exercise type, intervention duration, supervision, and intervention frequency. Results A total of 984 participants (576 in experimental groups and 408 in control groups) were included across 26 studies. The analysis revealed that exercise interventions significantly improved key metabolic parameters: FBG (SMD: -0.42 95% CI [-0.73 to -0.12]), FINS (SMD: -0.81 95% CI [-1.13 to -0.49]), TC (SMD: -0.18 95% CI [-0.34 to -0.01]), TG (SMD: -0.46 95% CI [-0.56 to -0.25]), LDL-C (SMD: -0.28 95% CI [-0.44 to -0.12]), and HDL-C (SMD: 0.26 95% CI [0.11-0.40]). Subgroup analysis indicated that exercise type, supervision and intervention frequency influenced the effectiveness. Conclusion The analysis suggests that exercise interventions improve glycolipid metabolism in adolescents with overweight and obesity. Continuous endurance training demonstrated greater efficacy in improving blood glucose parameters, whereas hybrid-type exercise showed advantages in improving lipid metabolism. Engaging in three supervised training sessions weekly may be the optimal approach to enhance glycolipid metabolism in obese adolescents. These findings provide evidence for clinicians and healthcare professionals (e.g., exercise physiologists, physical therapists) to guide exercise prescriptions for obese adolescents, thereby preventing worsening metabolic imbalances.