ReviewJournal of sport and health science2026
Optimal exercise strategies to improve HDL-C in metabolic syndrome: A systematic review with pairwise, network, and dose-response meta-analysis.
Review in Journal of sport and health science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
backgroundReduced high-density lipoprotein cholesterol (HDL-C) is a hallmark metabolic abnormality in metabolic syndrome (MetS). Exercise is widely recommended to improve HDL-C, but the optimal modality and dose remain uncertain.
methodsThis systematic review and network meta-analysis (NMA) followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Cochrane guidelines and was prospectively registered in PROSPERO (CRD420251049084). Five databases were searched through November 17, 2025. The NMA compared continuous aerobic exercise (CAE), high-intensity interval training (HIIT), resistance training (RT), combined aerobic-resistance exercise (CAREX), and mind-body exercise (MBE). Dose-response NMA (DR-NMA) using restricted cubic splines modeled multidimensional exercise doses derived from metabolic equivalent of task (MET)-min/week, % maximal oxygen uptake (VO₂
resultsFifty-six randomized controlled trials comprising 3788 individuals with MetS were included. HIIT ranked as the most effective modality for raising HDL-C, with the highest surface under the cumulative ranking curve value (SUCRA = 86%), producing an increase of 0.08 mmol/L when performed at 750-1500 MET-min/week and 80%-90% VO₂
conclusionExercise effectively improves HDL-C in individuals with MetS, with HIIT and CAREX offering the greatest benefits. Clear optimal dose ranges were identified across physiological load indicators, underscoring the need for individualized, dose-precise exercise prescriptions to optimize HDL-C improvement.
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