Evaluation of Homocysteine Levels and Body Composition Indices Following Aerobic Exercise in Adults With and Without Chronic Disease: A Systematic Review and Meta-Analysis

Abstract

Introduction: Homocysteine (HCY) is an important risk factor for chronic diseases and is associated with an unfavorable body composition status. Aerobic exercise can serve as a non-pharmacological intervention affecting these indicators; however, the available evidence is limited and inconsistent. The aim of this study was to conduct a systematic review and meta-analysis of the effects of aerobic exercise on HCY levels and body composition indices in adults with and without chronic disease. Materials and Methods: The databases PubMed, Web of Science, Scopus, Magiran, IranDoc, NoorMags, and SID were systematically searched up to (19 March 2025). To calculate effect sizes, the standardized mean difference (SMD) with 95% confidence intervals was analyzed using a random-effects model in CMA2 software. Statistical heterogeneity was assessed using the I² index, and publication bias was evaluated using funnel plot analysis and Egger’s test. Results: A total of 22 studies with 609 adult participants, both with and without chronic diseases, were included in the meta-analysis. The results showed that aerobic exercise interventions were associated with a significant reduction in HCY [P=0.001, SMD=-0.784 (95% CI: -1.322 to -0.246)], BMI [P=0.004, SMD=-0.379 (95% CI: -1.120 to -0.639)], WHR [P=0.002, SMD=-0.678 (95% CI: -1.111 to -0.245)] and BF [P=0.001, SMD=-0.982 (95% CI: -1.692 to -0.271)] compared to the control group in adults with and without chronic diseases. Conclusion: Aerobic training in adults, with or without chronic disease, leads to a significant reduction in HCY, BMI, WHR, and BF. These findings suggest that regular aerobic exercise can be effective in improving individuals’ metabolic profile and plays an important role in the prevention and management programs for obesity and related chronic diseases.