The effect of exercise on blood concentrations of angiogenesis markers in older adults: a systematic review and meta-analysis

BACKGROUND: Physical exercise has positive impacts on health and can improve angiogenesis, which is impaired during aging, but the underlying mechanisms of benefit are unclear. This meta-analysis and systematic review investigated the effects of exercise on several peripheral angiogenesis markers in older adults to better understand the relationship between exercise and angiogenesis. METHODS: MEDLINE, Embase, and Cochrane CENTRAL were searched for original, peer-reviewed reports of peripheral concentrations of angiogenesis markers before and after exercise interventions in older adults (> 50 years). The risk of bias was assessed with standardized criteria. Standardized mean differences (SMD) with 95% confidence intervals (CIs) were calculated from random-effects models. Publication bias was assessed with Egger’s test, funnel plots, and trim-and-fill. A priori subgroup analyses and meta-regressions were performed to investigate heterogeneity where possible. RESULTS: Of the 44 articles included in the review, 38 were included in meta-analyses for five proteins. Vascular endothelial growth factor (VEGF) was found to be higher after exercise (SMD[95%CI] = 0.18[0.03, 0.34], p = 0.02), and e-selectin (CD62E) was found to be lower after exercise (SMD[95%CI]= −0.72[−1.42, −0.03], p = 0.04). Endostatin (SMD[95%CI] = 0.28[−0.56, 1.11], p = 0.5), fibroblast growth factor 2 (SMD[95%CI] = 0.03[−0.18, 0.23], p = 0.8), and matrix metallopeptidase-9 (SMD[95%CI] = −0.26[−0.97, 0.45], p = 0.5) levels did not change after exercise. CONCLUSIONS: Of the five angiogenesis blood markers evaluated in this meta-analysis, only VEGF and CD62E changed with exercise. Although more studies are needed, changes in angiogenesis markers may explain the beneficial effects of exercise on angiogenesis and health in older adults.