This randomized controlled trial investigated the effects of a 12-week structured lifestyle intervention-including supervised aerobic exercise and a calorie-restricted diet-on inflammatory cytokines and oxidative stress biomarkers in overweight adults with type 2 diabetes mellitus (T2DM) and moderate chronic kidney disease (CKD stages 3-4). A total of 60 sedentary participants aged 36-58 years were randomly assigned to either the intervention group or the control group. The primary outcomes included changes in TNF-α, IL-6, and sCRP levels. Secondary outcomes assessed oxidative stress markers (MDA, CD) and antioxidant enzymes (GSH, SOD, GPx).
Diabetic CKD is characterized by chronic low-grade inflammation and heightened oxidative stress, both of which contribute significantly to cardiovascular morbidity and kidney function decline. This study evaluated whether a 12-week structured lifestyle intervention could improve systemic inflammatory and oxidative profiles in overweight adults with T2DM and CKD stages 3-4. Participants in the intervention group underwent supervised aerobic exercise (5 sessions/week) and received individualized dietary counseling with a 1,200 kcal/day Mediterranean-style diet. The control group received standard nephrology care without lifestyle modification. Outcomes were measured pre- and post-intervention and included pro-inflammatory markers (TNF-α, IL-6, sCRP), lipid peroxidation markers (MDA, CD), and antioxidant defenses (GSH, SOD, GPx). The intervention group demonstrated statistically significant improvements in all biomarker categories compared to controls. The study supports the integration of structured lifestyle interventions into standard care for diabetic CKD patients to improve redox balance and reduce inflammatory burden.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
60
Participants received a 12-week supervised aerobic exercise program (5 sessions per week at 70% of age-predicted maximum heart rate) and dietary counseling with a calorie-restricted Mediterranean-style diet of 1,200 kcal/day. The intervention was culturally adapted, including modifications for Ramadan.
Manshyet El-Bakry Hospital
Cairo, Egypt
TNF-α (pg/mL)
Change in tumor necrosis factor-alpha
Time frame: Baseline and Week 12
sCRP (mg/L)
Change in serum C-reactive protein levels
Time frame: Baseline and Week 12
IL-6 (pg/mL)
Change in interleukin-6 levels
Time frame: Baseline and Week 12
MDA (mmol/L)
Malondialdehyde levels (oxidative stress marker)
Time frame: Baseline and Week 12
CD (mmol/L)
Conjugated dienes levels
Time frame: Baseline and Week 12
GSH (mmol/gHb)
Reduced glutathione level
Time frame: Baseline and Week 12
GPx (units/gHb)
Glutathione peroxidase enzyme activity
Time frame: Baseline and Week 12
SOD (units/mL)
Superoxide dismutase activity
Time frame: Baseline and Week 12
BMI (kg/m²)
Body mass index
Time frame: Baseline and Week 12
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