BACKGROUND AND OBJECTIVES: People with metabolic syndrome (MetS) may benefit from regular exercise. Here, we investigated the effects of aerobic, resistance, and combined (aerobic plus resistance) exercise on insulin resistance and muscle function in people with MetS. DATA SEARCHES: Medline via PubMed, Cochrane-CENTR, SPORTDiscus, and Embase. STUDY CHOICE: The efficacy of exercise training in reducing at least one of the following outcomes was evaluated: HOMA, fasting glucose, and fasting insulin in adults with MetS. Two independent reviewers extracted data and evaluated the quality of the studies included. The results of the exercise training group and control group were compared based on random effects. RESULTS: Seven of the 1671 articles retrieved were included in the review. In the studies, the irisin-1 levels increased in both aerobic and resistance exercise groups, and the nesfatin-1 level increased in all groups. Compared with the control, three groups showed positive changes in anthropometric indices, lipid profile, and insulin resistance. Both aerobic interval training (AIT) and strength training (ST) reduced the total body fat, fat mass, and waist circumference of participants. AIT increased the VO2max by 11%, and ST increased the maximum leg strength by 45%. The Ln HOMA-IR, carnosine, or musclin levels did not differ between the high-intensity interval training (HIIT) and moderate-intensity continuous training groups. HIIT plus resistance training reduced the body weight, body mass index, waist circumference, and fasting glycaemia of participants. Meanwhile, HIIT plus HIIT improved the triglyceride levels and mean blood pressure. Both therapies caused a non-significant decrease in the musclin levels. Exercise training also reduced insulin resistance and improved cell function. Our findings show that combined training exhibits greater efficacy in controlling MetS parameters than the other forms of physical activity studied. This modality can be applied widely to prevent MetS and improve MetS parameters in affected individuals.

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