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Effect of Exercise Training on Nitric Oxide and Nitrate/Nitrite (Nox) Production: A Systematic Review and Meta-Analysis Publisher



Arefirad T1 ; Seif E2 ; Sepidarkish M3 ; Mohammadian Khonsari N4 ; Mousavifar SA5 ; Yazdani S6 ; Rahimi F6 ; Einollahi F6 ; Heshmati J7 ; Qorbani M2, 8
Authors
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Authors Affiliations
  1. 1. Department of Exercise Physiology, Science and Research Branch, Islamic Azad University, Tehran, Iran
  2. 2. Non-communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
  3. 3. Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
  4. 4. Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
  5. 5. Department of Health Education and Health Promotion, Faculty of Health, Isfahan University of Medical Sciences, Isfahan, Iran
  6. 6. Cardiovascular Research Center, Shahid Rajaei Educational & Medical Center, Alborz University of Medical Sciences, Karaj, Iran
  7. 7. Songhor Healthcare Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
  8. 8. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: Frontiers in Physiology Published:2022


Abstract

Background: Exercise and physical activity can improve circulation through various mechanisms, such as the increment of nitric oxide (NO) production, by affecting vascular endothelial nitric oxide synthase, and reducing reactive oxygen species (ROS). Although, theoretically, this mechanism is well known, studies in living subjects have made controversial findings regarding the association of NO production and its metabolites [nitrate/nitrite (NOx)] with physical activity. Hence, this systematic review and meta-analysis was designed to gather all these studies and evaluate the effects of exercise training, and physical activity duration and length on the mean change of serum/plasma NO and NOx. Method: We searched all available bibliographic electronic databases from inception through to May 2022 to include all randomized controlled trials (RCT) and quasi-experimental trials which assessed the effect of exercise and training on NO and NOx levels. Random-effects meta-analysis was used to pool the standardized mean difference (SMD) and 95% confidence interval (CI) of included RCT studies which assessed the effect of training. Stratified meta-analysis was performed according to the type of exercise (high-intensity interval training (HIIT), aerobic training (AT), the duration of exercise (≤8 and > 8 weeks), and length of exercise in each session ≥40 and 40 < minutes). Results: Overall, 15 and 10 studies were included in the systematic review and meta-analysis, respectively. According to the random-effects meta-analysis, exercise significantly increased the mean change of NO and NOx compared to control (SMD: 1.82, 95%CI: 1.14 to 2.49. In the stratified meta-analysis, the mean change of NO and NOx in the intervention group was significantly higher than in the control group in the AT (SMD: 1.36, 95%CI: 0.55–2.18), HIIT (SMD: 2.55, 95%CI: 1.14–3.96), duration of ≤8 (SMD: 2.29, 95%CI: 1.24–3.35) and > 8 weeks (SMD: 1.19, 95%CI: 0.52–1.86), length of ≥40 (SMD: 1.61, 95%CI: 1.04–2.18), and 40 < minutes in each session (SMD: 2.07, 95%CI: 0.79–3.35). Conclusion: The findings of this study indicate that, regardless of exercise duration, length, and type (AT or HIIT), exercise can significantly increase serum NO and NOx levels. Copyright © 2022 Arefirad, Seif, Sepidarkish, Mohammadian Khonsari, Mousavifar, Yazdani, Rahimi, Einollahi, Heshmati and Qorbani.
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