چکیده مقاله
Background: Type ۲ diabetes mellitus T۲DM is a progressive metabolic disorder characterized by insulin resistance, chronic hyperglycemia, and elevated systemic oxidative stress The NRF۲/ARE nuclear factor erythroid ۲‑related factor ۲ / antioxidant response element pathway serves as a master regulator of cellular antioxidant defense, governing the expression of phase‑II detoxifying and antioxidant enzymes, including glutathione‑S‑transferase and glutathione peroxidase The reduced‑to‑oxidized glutathione ratio GSH/GSSG is a sensitive and reliable indicator of intracellular redox balance Middle‑aged women are particularly vulnerable to T۲DM complications due to hormonal shifts and age‑related muscle loss sarcopenia , which exacerbate oxidative damage Both resistance training RT and aerobic training AT have been individually suggested to modulate NRF۲ signaling; however, a direct comparative synthesis in this specific population is lacking This systematic review aims to compare the effects of RT versus AT on serum NRF۲ protein concentration and the GSH/GSSG ratio in middle‑aged women with T۲DM Methods: This systematic review was conducted following PRISMA guidelines A comprehensive literature search was performed in PubMed, Scopus, Web of Science, Google Scholar, and SID up to January ۲۰۲۵ using Persian and English keywords, including resistance training, aerobic training, type ۲ diabetes, middle‑aged women, NRF۲, GSH/GSSG ratio, and oxidative stress Original clinical trials and quasi‑experimental studies that evaluated the effect of either RT or AT or directly compared both on the target variables were included Study quality was assessed using the PEDro scale Results: Out of ۴۵۲ initial records, ۱۸ studies met inclusion criteria ۹ RT, ۷ AT, and ۲ head‑to‑head comparative trials Both RT ۶۰‑۸۰% of ۱RM, ۳ sessions/week and AT ۵۰‑۷۵% of maximum heart rate, ۳‑۵ sessions/week for ۸‑۱۲ weeks significantly increased serum NRF۲ levels and improved the GSH/GSSG ratio P < ۰ ۰۵ However, indirect comparisons suggested that RT was more effective in reducing systemic inflammation lowering IL‑۶ and TNF‑α and increasing muscle mass, while AT showed a greater impact on enhancing insulin sensitivity and reducing reactive oxygen species ROS production derived from chronic hyperglycemia Mechanistically, both modalities activated PI۳K/Akt and MAPK/ERK pathways in response to mechanical RT or metabolic AT stress, leading to increased NRF۲ phosphorylation, nuclear translocation, and subsequent upregulation of NRF۲‑dependent antioxidant enzymes The two comparative studies indicated a potential superiority of combined RT AT training over either modality alone, though this finding requires further confirmation Conclusion: Both resistance and aerobic training are effective non‑pharmacological strategies for enhancing NRF۲‑mediated antioxidant defense and improving redox balance GSH/GSSG ratio in middle‑aged women with T۲DM The choice between them should be individualized based on patient goals glycemic control vs muscle preservation Preliminary evidence suggests that combined training may offer additive benefits Future head‑to‑head randomized controlled trials with dose‑response designs are warranted to establish precise exercise prescriptions for this high‑risk population
کلیدواژهها
نویسندگان
Hanieh PanahYab
Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
Reza Farzizadeh
Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
شیوه ارجاع
PanahYab، Hanieh و Farzizadeh، Reza،1405،Comparative Efficacy of Resistance versus Aerobic Training on NRF۲/ARE Axis Modulation and Redox Status Markers in Middle Aged Women with Type ۲ Diabetes: A Systematic Review،هفتمین همایش بین المللی تربیت بدنی ،سلامت و علوم ورزشی،همدان
ارائهشده در
مجموعه مقالات هفتمین همایش بین المللی تربیت بدنی ،سلامت و علوم ورزشی3 مرداد 1405 · همدان