PURPOSE: C-reactive protein (CRP) is a marker of chronic systemic inflammation frequently used in cardiovascular disease risk assessment. The purpose of this meta-analysis was to provide a quantitative estimate of the magnitude of change in CRP following participation in physical exercise interventions. METHODS: All studies included in the meta-analysis were peer reviewed and published in English. Human participants were assigned to a non-exercise comparison group or exercise training group, with the intervention lasting > 2 weeks. CRP levels were measured at baseline, during and/or after completion of the exercise training programme. Random-effects models were used to aggregate a mean effect size (ES), 95% CIs and potential moderators. RESULTS: 83 randomised and non-randomised controlled trials met the inclusion criteria and resulted in 143 effects (n = 3,769). The mean ES of 0.26 (95% CI 0.18 to 0.34, p < 0.001) indicated a decrease in CRP following exercise training. A decrease in body mass index (BMI beta = 1.20, SE 0.25, p < 0.0001) and %fat (beta = 0.76, SE 0.21, p = 0.0002) were associated with a decrease in CRP, independently accounting for 11.1% and 6.6% of the variation in response, respectively. Exercise training led to a greater reduction in CRP when accompanied by a decrease in BMI (ES 0.38, 95% CI 0.26 to 0.50); however, a significant improvement in CRP occurred in the absence of weight loss (ES 0.19, 95% CI 0.10 to 0.28; both p < 0.001). CONCLUSIONS: These results suggest that engaging in exercise training is associated with a decrease in CRP levels regardless of the age or sex of the individual; however, greater improvements in CRP level occur with a decrease in BMI or %fat.
Reproduced with permission from the BMJ Publishing Group.

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