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A comprehensive search was conducted in PubMed, Web of Science, and Scopus using four main keywords including \u201cexercise training,\u201d \u201cvisceral fat,\u201d \u201cdiabetes,\u201d and \u201crandomization\u201d from inception to April 2025. Thirty\u2010three randomized controlled trials or clinical trials with parallel groups were included (1740 patients), in which exercise training was compared with either nonexercise or other types of exercise training. Combined training (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095) (\u22120.63 [95% CI \u22120.95 to \u22120.30],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), high\u2010intensity interval training (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911) (\u22120.53 [95% CI \u22120.86 to \u22120.19],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), and aerobic training (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200924) (\u22120.38 [95% CI \u22120.59 to \u22120.18],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.001), but not resistance training (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098) (\u22120.25 [95% CI \u22120.54 to 0.03],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.08) were more effective for reducing VAT as compared with controls. Subgroup analyses based on age, health status, body mass index, or intervention duration confirmed that combined training, high\u2010intensity interval training, aerobic training, but not resistance training, induced advantageous alterations in VAT compared to the control group. The main findings show that the\n                      <jats:italic>P<\/jats:italic>\n                      \u2010score\u2013based ranking of interventions reported the highest probability ranking for CT (0.89), followed by HIIT (0.76), AT (0.52), and RT (0.32). These findings provide compelling evidence to support the use of exercise training as a noninvasive and cost\u2010effective nonpharmacological intervention for the reduction of VAT in patients with prediabetes and T2DM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO Registration Number<\/jats:title>\n                    <jats:p>CRD42024598045.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/obr.70031","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:19:36Z","timestamp":1759969176000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Comparative Efficacy of Exercise Type on Visceral Adipose Tissue in Patients With Prediabetes and Type 2 Diabetes Mellitus: A Systematic Review With Pairwise and Network Meta\u2010Analyses"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6465-1281","authenticated-orcid":false,"given":"Mousa","family":"Khalafi","sequence":"first","affiliation":[{"name":"Department of Sport Sciences, Faculty of Humanities University of Kashan  Kashan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8183-4986","authenticated-orcid":false,"given":"Saeid","family":"Fatolahi","sequence":"additional","affiliation":[{"name":"Department of Physical Education and Sport Sciences, Faculty of Humanities Tarbiat Modares University  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9649-8963","authenticated-orcid":false,"given":"Michael\u00a0E.","family":"Symonds","sequence":"additional","affiliation":[{"name":"Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine University of Nottingham  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