Comparative Effectiveness of Aerobic Exercise versus Resistance Training on Cardiometabolic Health in Patients with Diabesity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Table 2. Summary of findings using GRADE quality assessment.

Outcome	No of studies	Study design	Risk of bias	Inconsistency	Indirectness	Imprecision	AE	RT	Effect	Certainty
BMI (kg/m²)	15	RCT	serious	not serious	not serious	not serious	336	346	MD 0.42 lower (95% CI 0.93 lower to 0.09 higher)	⊕ ⊕ ⊕ ⃝ Moderate^a
FBG (mmol/L)	16	RCT	serious	not serious	not serious	not serious	332	342	MD 0.89 lower (95% CI 1.62 lower to 0.16 lower)	⊕⊕⊕ ⃝ Moderate^a
HbA1c (%)	20	RCT	serious	serious	not serious	not serious	494	508	MD 0.09 lower (95% CI 0.27 lower to 0.09 higher)	⊕⊕ ⃝ ⃝ Low^ab
FI (mIU/L)	6	RCT	serious	serious	not serious	serious	107	114	MD 0.35 lower (95% CI 1.67 lower to 0.98 higher)	⊕ ⃝ ⃝ ⃝ Very low^abd
HOMA-IR	3	RCT	serious	very serious	not serious	serious	45	47	MD 0.58 lower (95% CI 1.87 lower to 0.71 higher)	⊕ ⃝ ⃝ ⃝ Very low^acd
HDL-C (mg/dL)	10	RCT	serious	very serious	not serious	not serious	187	195	MD 2.35 higher (95% CI 0.06 lower to 4.76 higher)	⊕ ⃝ ⃝ ⃝ Very low^ac
LDL-C (mg/dL)	9	RCT	serious	not serious	not serious	not serious	177	186	MD 0.12 higher (95% CI 0.28 lower to 0.51 higher)	⊕⊕⊕ ⃝ Moderate^a
TG (mg/dL)	11	RCT	serious	not serious	not serious	not serious	199	207	MD 0.77 lower (95% CI 2.47 lower to 0.93 higher)	⊕⊕⊕ ⃝ Moderate^a
TC (mg/dL)	12	RCT	serious	not serious	not serious	not serious	219	227	MD 0.12 lower (95% CI -0.34 lower to 0.59 higher)	⊕⊕⊕ ⃝ Moderate^a
DBP (mmHg)	13	RCT	serious	not serious	not serious	not serious	250	259	MD 2.04 higher (95% CI 0.46 lower to 4.55 higher)	⊕⊕⊕ ⃝ Moderate^a
SBP (mmHg)	13	RCT	serious	not serious	not serious	not serious	250	259	MD 0.02 lower (95% CI 1.57 lower to 1.52 higher)	⊕⊕⊕ ⃝ Moderate^a
RHR (bpm)	3	RCT	serious	not serious	not serious	serious	76	82	MD 1.87 higher (95% CI 4.53 lower to 8.26 higher)	⊕⊕ ⃝ ⃝ Low^ad
CRF (mL/kg/min)	11	RCT	serious	serious	not serious	not serious	203	216	MD 1.78 higher (95% CI 0.38 higher to 3.18 higher)	⊕⊕ ⃝ ⃝ Low^ab

^d Downgraded one level for serious imprecision. AE: Aerobic exercise, RT: Resistance training, BMI: Body mass index, FBG: Fasting blood glucose, HbA1c: Glycated hemoglobin, FI: Fasting insulin, HOMA-IR: Homeostatic model assessment of insulin resistance, HDL-C: High-density lipoprotein cholesterol, LDL-C: Low-density lipoprotein cholesterol, TG: Triglycerides, TC: Total cholesterol, DBP: Diastolic blood pressure, SBP: Systolic blood pressure, RHR: Resting heart rate, CRF: Cardiorespiratory fitness.^c Downgraded two levels for very serious inconsistency,^b Downgraded one level for serious inconsistency,^a Downgraded one level for risk of bias,