Anti-inflammatory effects of exercise: role in diabetes and cardiovascular disease

Eur J Clin Invest. 2017 Aug;47(8):600-611. doi: 10.1111/eci.12781. Epub 2017 Jul 19.


Background: Persistent inflammation is involved in the pathogenesis of chronic diseases such as type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD).

Aims: The aim of this review was to provide the reader with an update of the mechanisms whereby exercise-induced cytokines may impact cardiometabolic diseases.

Results: Evidence exists that interleukin (IL)-1β is involved in pancreatic β-cell damage, whereas TNF-α is a key molecule in peripheral insulin resistance. In addition, TNF-α appears to be involved in the pathogenesis of atherosclerosis and heart failure. A marked increase in IL-6 and IL-10 is provoked by exercise and exerts direct anti-inflammatory effects by an inhibition of TNF-α and by stimulating IL-1ra, thereby limiting IL-1β signalling. Moreover, muscle-derived IL-6 appears to have direct anti-inflammatory effects and serves as a mechanism to improve glucose tolerance. In addition, indirect anti-inflammatory effects of long-term exercise are mediated via improvements in body composition.

Conclusion: Physical activity represents a natural, strong anti-inflammatory strategy with minor side effects and should be integrated in the management of patients with cardiometabolic diseases.

Keywords: Cardiovascular disease; cytokines; diabetes; exercise; heart failure; inflammation.

Publication types

  • Review

MeSH terms

  • Abdominal Fat / metabolism
  • Adaptation, Physiological / physiology
  • C-Reactive Protein / metabolism
  • Cytokines / metabolism
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / prevention & control*
  • Exercise / physiology*
  • Exercise Therapy*
  • Heart Failure / metabolism
  • Heart Failure / prevention & control*
  • Humans
  • Inflammation / physiopathology
  • Inflammation / prevention & control
  • Insulin-Secreting Cells / physiology
  • Interleukin-1beta / metabolism
  • Interleukin-1beta / physiology
  • Interleukin-6 / physiology
  • Myocardial Ischemia / metabolism
  • Myocardial Ischemia / prevention & control*
  • Tumor Necrosis Factor-alpha / physiology
  • Yin-Yang


  • Cytokines
  • IL6 protein, human
  • Interleukin-1beta
  • Interleukin-6
  • Tumor Necrosis Factor-alpha
  • C-Reactive Protein