Moderate physical activity improves inflammatory markers (IL-6 and TNF Alpha) and diabetic profile in prediabetic population

  • Zubia Shah Khyber Medical University, Peshawar
  • Dr Abdul Waheed Mughal Sarhad University of science and Technology, Peshawar
  • Sherbaz Khan Khyber Medical University, Peshawar
  • Saman Tauqir Khyber Medical University, Peshawar
  • Inayat Shah Khyber Medical University Peshawar
Keywords: Prediabetes, IL-6, TNF-α, inflammatory cytokine, moderate intensity, aerobic exercise


Purpose: Prediabetes is a health condition that precedes type 2 diabetes. Globally prevalence of prediabetes is on the rise and approximately 37% of local population are suffering from it. Apart from many other factors, inflammatory markers especially IL-6 and TNF-α play a significant part in development of prediabetes to diabetes. How exercise affects the inflammatory cytokines is elucidated and not completely understood.

Methods: A non commercial experimental trail including a total of 48 participants, (36 males and 12 females) with mean age 30.7 ± 7.80 years was carried out after ethical approval and written informed consent. Demographic data, Body plethysmography, exercise parameters, diabetic and inflammatory markers were determined at pre- and post-interventional stage. The exact intensity of exercise capable of eliciting the required heart rate was determined and each participant was asked to perform moderate intensity exercise (45 minutes including warm up and cool down) for 5 days a week for 12 weeks.

Results: Twelve weeks of moderate intensity aerobic exercise at (55% to 65% of PMHR) had significant positive effects on body composition including BMI (<0.001), weight (<0.001), diabetic parameters (FBS (0.02), HbA1c (0.001)) and inflammatory parameters (IL-6 (0.018), and TNF-α (0.02)). The effects were identical for males and females with mild differences.

Conclusion:Moderate intensity exercise significantly decreases the levels of circulating inflammatory cytokines. Moderate intensity aerobic exercise is easy to incorporate in lifestyle of prediabetic population and can be used as one of the effective strategies for prevention of development of diabetes.

Author Biography

Dr Abdul Waheed Mughal, Sarhad University of science and Technology, Peshawar

DEean Social Sciences


Aamir, A. H., Ul-Haq, Z., Mahar, S. A., Qureshi, F. M., Ahmad, I., Jawa, A., … Heald, A. H. (2019). Diabetes Prevalence Survey of Pakistan (DPS-PAK): prevalence of type 2 diabetes mellitus and prediabetes using HbA1c: a population-based survey from Pakistan. BMJ open, 9(2), e025300.

Andonian, B. J., Bartlett, D. B., Huebner, J. L., Willis, L., Hoselton, A., Kraus, V. B., … Huffman, K. M. (2018). Effect of high-intensity interval training on muscle remodeling in rheumatoid arthritis compared to prediabetes. Arthritis Research & Therapy, 20(283), 1-9.

Bweir, S., Al-Jarrah, M., Almalty, A.-M., Maayah, M., Smirnova, I. V., Novikova, L. & Stehno-Bittel, L. (2009). Resistance exercise training lowers HbA1c more than aerobic training in adults with type 2 diabetes. Diabetology & Metabolic Syndrome, 1(27).

Earnest, C. P. (2008). Exercise interval training: an improved stimulus for improving the physiology of pre-diabetes. Medical Hypotheses, 71(5), 752-761.

Gleeson, M. (2000). Interleukins and exercise. The Journal of Physiology, 529(1), 1-1.

Golbidi, S., Badran, M. & Laher, I. (2011). Antioxidant and anti-inflammatory effects of exercise in diabetic patients. Experimental Diabetes Research, 2012.

Grundy, S. M. (2012). Pre-diabetes, metabolic syndrome, and cardiovascular risk. Journal of the American College of Cardiology, 59(7), 635-643.

Hopps, E., Canino, B. & Caimi, G. (2011). Effects of exercise on inflammation markers in type 2 diabetic subjects. Acta Diabetologica, 48, 183-189.

Hordern, M. D., Dunstan, D. W., Prins, J. B., Baker, M. K., Singh, M. A. F. & Coombes, J. S. (2012). Exercise prescription for patients with type 2 diabetes and pre-diabetes: a position statement from Exercise and Sport Science Australia. Journal of Science and Medicine in Sport, 15(1), 25-31.

Keller, C., Keller, P., Giralt, M., Hidalgo, J. & Pederson, B. K. (2004). Exercise normalises overexpression of TNF-α in knockout mice. Biochemical and Biophysical Research Communications, 321(1), 179-182.

Lucas, R., Parikh, S. J., Sridhar, S., Guo, D.-H., Bhagatwala, J., Dong, Y., … Zhu, H. (2013). Cytokine profiling of young overweight and obese female African American adults with prediabetes. Cytokine, 64(1), 310-315.

Malin, S. K., Gerber, R., Chipkin, S. R. & Braun, B. (2012). Independent and combined effects of exercise training and metformin on insulin sensitivity in individuals with prediabetes. Diabetes Care, 35(1), 131-136.

Najafipour, F., Mobasseri, M., Yavari, A., Nadrian, H., Aliasgarzadeh, A., Abbasi, N. M., … Sadra, V. (2017). Effect of regular exercise training on changes in HbA1c, BMI and VO2max among patients with type 2 diabetes mellitus: an 8-year trial. BMJ Open Diabetes Research and Care, 5(1).

Olson, T. P., Dengel, D., Leon, A. & Schimtz, K. (2007). Changes in inflammatory biomarkers following one-year of moderate resistance training in overweight women. International Journal of Obesity, 31, 996-1003.

Pederson, B. K. (2017). Anti-inflammatory effects of exercise: role in diabetes and cardiovascular disease. European Journal of Clinical Investigation, 47(8), 600-611.

Pederson, B. K. & Fischer, C. P. (2007). Beneficial health effects of exercise–the role of IL-6 as a myokine. Trends in Pharmacological Sciences, 28(4), 152-156.

Peterson, A. M. W. & Pedersen, B. K. (2005). The anti-inflammatory effect of exercise. Journal of Applied Physiology, 98(4), 1154-1162.

Starkie, R., Ostrowski, S. R., Jauffred, S., Febbraio, M. & Pedersen, B. K. (2003). Exercise and IL‐6 infusion inhibit endotoxin‐induced TNF‐α production in humans. The FASEB Journal, 17(8), 1-10.

Straczkowski, M., Kowalska, I., Dzienis-Straczkowska, S., Stepien, A., Skibinska, E., Szelachowska, M. & Kinalska, I. (2001). Changes in tumor necrosis factor-alpha system and insulin sensitivity during an exercise training program in obese women with normal and impaired glucose tolerance. European Journal of Endocrinology, 145(3), 273-280.

Tabák, A. G., Herder, C., Rathmann, W., Brunner, E. J. & Kivimakli, M. (2012). Prediabetes: a high-risk state for diabetes development. The Lancet, 379(9833), 2279-2290.

How to Cite
Shah, Z., Mughal, A. W., Khan, S., Tauqir, S., & Shah, I. (2021). Moderate physical activity improves inflammatory markers (IL-6 and TNF Alpha) and diabetic profile in prediabetic population. Annales Kinesiologiae, 11(2), 131-144.