Comparative efficacy of exercise and nutritional interventions on serum IGF-1 levels in older adults with frailty and/or sarcopenia: A systematic review and network meta-analysis.
Rui Chu, Mingming Li, Yeshou Xie et al.
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In 30 seconds
This systematic review and frequentist random-effects network meta-analysis compared exercise, nutritional supplementation, and combined interventions for serum IGF-1 in older adults with sarcopenia and/or frailty. It included 19 randomized controlled trials. Compared with control, combined training improved IGF-1 (SMD = 0.53, 95% CI: 0.07-0.99), as did resistance training (SMD = 0.47, 95% CI: 0.11-0.84). Resistance training plus nutrition ranked highest, but its estimated effect versus control was not statistically significant; overall certainty was low to very low.
Key findings
- Combined training improved IGF-1 versus control (SMD = 0.53, 95% CI: 0.07-0.99).
- Resistance training improved IGF-1 versus control (SMD = 0.47, 95% CI: 0.11-0.84).
- Resistance training plus nutrition ranked highest by SUCRA (87.6%), but its effect versus control was non-significant (SMD = 0.89, 95% CI: -0.02-1.80).
- GRADE certainty was low to very low, mainly because of risk of bias and imprecision.
Why it matters
IGF-1 is an outcome used to compare biological responses to interventions in older adults with frailty or sarcopenia. The analysis suggests that exercise approaches, particularly combined or resistance training, may improve this measure versus control, while the highest-ranked combined nutrition and exercise approach did not show a statistically significant effect. Low certainty means these rankings should not be treated as proof of comparative superiority.
What to keep in mind
Evidence certainty was low to very low, mainly due to risk of bias and imprecision; the analysis does not establish superiority of the highest-ranked intervention.