Table 4: Summary of selected clinical trials in which TNF-α level has been measured as a clinical outcome before and after exercise.

NumberSubjectsExercise intensityMeasured parametersResults

17467 healthy, premenopausal women and 40 age matched normal weight womenWalk for at least 1 h three times a week plus a diet contained 1300 Kcal/d and behavioral counselingEchocardiography plus circulating levels of TNF-α, IL-6, IL-8, and CRPAfter one year, there was a significant reduction in inflammatory markers and improvement in cardiac function
17523 overweight and obese adults are randomized into vit D + exercise and exercise groupAll participants did 12-week (3 d/wk) progressive resistance exercise at 70–80% of one repetition maximumStimulated TNF-α, circulating CRP, TNF-α, IL-6, and ALT Both groups had a significant reduction in nonstimulated TNF-α production after 12 weeks
17682 subjects with type II diabetes and metabolic syndrome are randomized to following groups:
20 T2D (sedentary control, A)
20 T2D (low intensity aerobic exercise, B)
20 T2D (high intensity aerobic exercise, C)
22 T2D (aerobic and resistance exercise, D)
Twice a week supervised sessions of 60 min of aerobic exercise at 70–80% VO2 max for group C patients and 40 min aerobic exercise at 70–80% VO2 max + 20 min resistance exercise at 80% of 1 repetition maximum for Group D subjects. group B received counseling to perform low intensity physical activities. These protocols continued for 12 monthsHbA1c, FBS, TG, TC, HDL, hs-CRP, IL-1β, IL-4, IL-6, IL-10, TNF-α, IFN-γ, leptin, resistin, and adiponectin VO2 max(i) Significant decrease of hs-CRP in groups C and D
(ii) Leptin, resistin, and IL-6 decreased in groups C & D, while adiponectin increased
(iii) IL-1β, TNF-α, and IFN-γ decreased in group D, whereas anti-inflammatory IL-4 & 10 levels declined
17731 inactive subjects with metabolic syndrome are divided to
(i) High-intensity aerobic interval training (AIT),
(ii) strength training (ST),
(iii) control group
Exercise training was carried out three times per week for 12 weeksSerum insulin, hs-CRP, IL-18, IL-6, and TNF-αSerum IL-18 was reduced after AIT
TNF-α level was lower in AIT group compared to ST and controls
No changes in serum IL-6, insulin, or hs-CRP within or between the groups
17820 obese individuals (BMI, 32) with at least one other component of the metabolic syndrome are randomized to exercise group and diet group after 8 weeks of control periodExercise consisted of 8 weeks of moderate cycling exercise (30 min, 3 times/wk)Fasting glucose and insulin levels
Muscle biopsy for analysis of skeletal muscle TNF-α and GLUT4
Both interventions reduced plasma insulin levels
Only diet reduced muscle TNF-α but exercise did not change TNF-α protein expression
17947 obese diabetic patients randomly assigned to aerobic (AT, ) or aerobic plus resistance (ART, ) exercise protocols AT program was 15 min row ergometer plus 15 min bicycle ergometer at 70% of HR max for 5 d/wk
ART program was AT program plus 15 min resistance training at 40–50% of HR max
Blood glucose, insulin, and lipid profile
Leptin, adiponectin, resistin, TNF-α, MCP-1, and MMP-2
Adiponectin level increased 54% after AT while decreased by 13% after ART
MMP-2, TNF-α, and MCP-1 levels decreased in AT while increased in ART group
18023 obese postmenopausal women underwent resistance exercise training or social interaction intervention3 sets, 10 exercises, 3 × per week, 8–12 repetition maximumIL-6, leptin, CRP, TNF-α, adiponectin, mRNA expression of TLR4, and MC1R.TNF-α, CRP, and leptin reduced in exercise group without any change in body composition

ALT: alanine aminotransferase; BMI: body mass index; CRP: C reactive protein; FBS: fasting blood sugar; GLUT4: glucose transporter 4; HDL: high density lipoprotein; IFN-γ: interferon-gamma; MCP-1: monocyte chemoattractant protein-1; MC1R: melanocortin 1 receptor; MMP-2: matrix metalloproteinase-2; TG: triglyceride; TC: total cholesterol; TLR4: toll-like receptor 4.