The acute effect of exercise on the endothelial glycocalyx in healthy adults: A systematic review and meta-analysis

BackgroundIn recent years, it has been demonstrated that when the endothelial glycocalyx, composed of proteoglycans, glycosaminoglycans and glycoproteins, is altered or modified, this property is lost, playing a fundamental role in cardiovascular pathologies. Cardiovascular risk factors can destroy the endothelial glycocalyx layer. Exercise has a positive effect on cardiovascular risk factors, but little is known about its direct effect on the integrity of the endothelial layer.MethodsThe Cochrane Library, PubMed, Web of Science and Scopus databases were searched from their inception to June 30, 2022. The DerSimonian and Laird method was used to compute pooled effect size estimates and their respective 95% confidence intervals for the acute effect of exercise (within 24 h) on the endothelial glycocalyx and its components in healthy adults.ResultsTen studies were included in the meta-analysis, with a total of 252 healthy subjects. The types of exercise included were resistance training, interval training, resistance training and maximal incremental exercise, with a duration range of 30-60 min. Glycocalyx assessment times included ranged from 0 to 90 min post-exercise. Our findings showed that endothelial glycocalyx increases after acute effect of exercise in healthy population (.56, 95% CI: .38, .74). The acute effect of exercise on endothelial glycocalyx components were .47 (95% CIs: .27, .67) for glycosaminoglycans, .67 (95% CIs: .08, 1.26) for proteoglycans and .61 (95% CIs: .35, .86) for glycoproteins.ConclusionsIn a healthy population, various types of exercise showed an acute improvement of the endothelial glycocalyx and its individual components. Endothelial glycocalyx, comprising proteoglycans, glycosaminoglycans and glycoproteins, influences vascular permeability. Currently it has been demonstrated that when the endothelial glycocalyx is altered, playing a fundamental role in cardiovascular pathologies. Our findings provide a synthesis of the evidence showing positive effects of acute exercise on the endothelial glycocalyx in a healthy population. These findings are of clinical importance, as strategies focused on improving endothelial function have recently emerged, as increasing evidence reveals the critical role of endothelial glycocalyx in cardiovascular pathologies.image