CLINICAL TRIAL article
Front. Endocrinol.
Sec. Clinical Diabetes
This article is part of the Research TopicInsights into the Molecular and Cellular Mechanisms of Insulin ResistanceView all articles
Postexercise Immune-Inflammatory Improvement in Type 2 Diabetes Is Associated with Baseline Insulin Resistance
Provisionally accepted
- 1Yangpu Hospital, Tongji University, Yangpu, China
- 2Tongji Hospital Affiliated to Tongji University, Shanghai, China
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Purpose: To examine how baseline insulin resistance (IR) modulates exercise-induced changes in systemic immune-inflammation index (SII) and metabolic parameters in type 2 diabetes mellitus (T2DM). Methods: Fifty-five T2DM patients stratified by fasting C-peptide tertiles into low- (Group 1), moderate- (Group 2), and high-IR groups (Group 3) completed a 4-week moderate-intensity combined aerobic-resistance exercise program. Changes in SII (neutrophils × platelets / lymphocytes), anthropometrics, and glucolipid markers were assessed, with ANCOVA and hierarchical regression modeling intergroup differences and predictors (Clinical Trial Registration ID: ChiCTR2200066710). Results: Significant reductions in weight, BMI, and body fat% occurred in Group 1/ Group 2 (all p<0.05) but not Group 3. SII decreased in Group 1 (p<0.05) yet increased in Group 3 due to neutrophil elevation (p<0.05). Fasting glucose and HbA1c improved across all groups (p<0.05), with Group 3's glycemic benefits independent of weight loss or anti-inflammatory effects. Baseline C-peptide independently predicted increases in ΔSII across all adjusted models (β=19.85–21.94, p<0.01), whereas covariates including age, diabetes duration, and BMI showed no significant effects. Conclusion: Severe baseline IR attenuates exercise-mediated SII improvement and body composition optimization, whereas glycemic benefits remain IR-independent, necessitating IR-stratified exercise prescriptions.
Keywords: Systemic Immune-inflammation Index1, Type 2 diabetes mellitus2, insulin resistance3, Exercise intervention4, heterogeneous response5
Received: 19 Aug 2025; Accepted: 29 Oct 2025.
Copyright: © 2025 Cheng, Guo, Zhang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wei Cheng, chengwei780411@sohu.com
Keqin Zhang, keqzhang2007@126.com
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