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) ⊕ ⊕ ⊕     ⃝ Moderatea 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) ⊕⊕⊕     ⃝ Moderatea HbA1c (%) 20 RCT serious serious not serious not serious 494 508 MD 0.09 lower (95% CI 0.27 lower to 0.09 higher) ⊕⊕     ⃝     ⃝ Lowab 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 lowabd 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 lowacd 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 lowac 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) ⊕⊕⊕     ⃝ Moderatea 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) ⊕⊕⊕     ⃝ Moderatea 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) ⊕⊕⊕     ⃝ Moderatea 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) ⊕⊕⊕     ⃝ Moderatea 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) ⊕⊕⊕     ⃝ Moderatea 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) ⊕⊕     ⃝     ⃝ Lowad 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) ⊕⊕     ⃝     ⃝ Lowab 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,