Comparative effects of combined aerobic exercise-based interventions on metabolic, cardiovascular, and inflammatory markers in adult men: a systematic review and meta-analysis

Objective: The objective of this meta-analysis was to systematically assess and quantitatively synthesize the effects of aerobic exercise-based combined interventions on metabolic, cardiovascular, and inflammation-related outcomes in adult men. Methods: For this systematic review and meta-analysis of randomized controlled trials, systematic searches were conducted in PubMed, Embase, Web of Science, and the Cochrane Library from inception to December 20, 2025. Eligible studies compared aerobic exercise-based combined interventions (aerobic exercise delivered concurrently with at least one additional component, such as resistance training, nutritional supplementation, or adjunctive therapies) with control conditions. A random-effects model was applied for quantitative synthesis. Risk of bias was assessed using the Risk of Bias 2.0 tool. All statistical analyses were performed using Stata 15. Results: Fourteen randomized controlled trials involving 369 adult men were included. Pooled analyses suggested that aerobic exercise-based combined interventions were associated with reductions in BMI (WMD = -1.53, 95% CI -2.38 to -0.67) and changes in lipid parameters, including higher HDL (WMD = 2.37, 95% CI 0.72 to 4.02) and lower LDL (WMD = -9.25, 95% CI -15.16 to -3.34) and TC (WMD = -19.15, 95% CI -36.46 to -1.85). However, substantial between-study heterogeneity was observed across most outcomes (I² ranging from 76% to 99%). No statistically significant pooled effects were found for TG, SBP, DBP, or IL-6. Subgroup analyses showed variability in effect estimates across intervention types and populations, although several subgroup findings were based on single studies and should be interpreted cautiously. Conclusions: Aerobic exercise-based combined interventions may be associated with favorable changes in BMI and selected lipid parameters in adult men. However, the evidence is limited by substantial heterogeneity, small sample sizes, and reliance on combined intervention designs, which precludes clear attribution of effects to specific components. Further well-designed trials are needed to clarify the consistency and clinical relevance of these findings. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261299383, identifier CRD420261299383.