The effect of 12 weeks of combined aerobic-resistance training on adropin as a mediator of arterial stiffness in postmenopausal women with type 2 diabetes: a randomized controlled trial

Adropin, a protective peptide linked to metabolic regulation and vascular function, may mediate exercise-induced cardiovascular benefits in people with type 2 diabetes (T2D). However, evidence regarding its response to exercise in women with T2D is scarce. This randomized controlled trial investigated the effects of 12 weeks of combined aerobic-resistance training on adropin levels and arterial stiffness [measured via the cardio-ankle vascular index (CAVI), where lower values indicate reduced stiffness] in women with T2D while exploring the mediating role of adropin. Sedentary women aged 50–65 years with T2D were block randomized into either a supervised exercise group (EX) (3 sessions/week of 20 min aerobic exercise at 50–70% heart rate reserve) combined with nine resistance training exercises at 50–70% estimated one-repetition maximum or a usual care control group (CON). Primary outcomes included serum adropin and CAVI. All measurements were conducted at baseline and 48 h after the 12-week intervention. Thirty participants (EX: n = 15, age 60.5 ± 4.4 years, BMI 30.2 ± 1.4 kg/m²; CON: n = 15, age 60.2 ± 4.2 years, BMI 30.0 ± 1.1 kg/m²) completed the study (88% retention from 34 randomized). Compared with CON, EX showed significantly increased adropin levels (p = 0.03) and reduced CAVI (p = 0.01). Multiple mediation analysis demonstrated an association between adropin and improvements in CAVI following exercise (p < 0.001), indicating a possible mediating effect. EX resulted in a significantly greater increase in adropin and reduction in CAVI post-intervention relative to CON, suggesting reduced arterial stiffness in women with T2D. The results are clinically promising, suggesting that this intervention may help reduce cardiovascular risk in women with T2D by partially mediating vascular benefits through adropin. 1) Combined exercise resulted in a significantly greater increase in adropin levels (a hormone linked to vascular health) and reduced CAVI (a measure of arterial stiffness) relative to a control group in 30 postmenopausal women with type 2 diabetes, potentially lowering cardiovascular risk. 2) These findings suggest that regular exercise may help reduce cardiovascular risk in postmenopausal women with type 2 diabetes, providing a practical strategy to support their health.