{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T14:10:41Z","timestamp":1785507041073,"version":"3.56.0"},"reference-count":61,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To examine how baseline insulin resistance (IR) modulates exercise-induced changes in systemic immune-inflammation index (SII) and metabolic parameters in type 2 diabetes mellitus (T2DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty-five T2DM patients stratified by fasting C-peptide tertiles into low- (Group 1), moderate- (Group 2), and high-IR groups (Group 3) completed a 4-week moderate-intensity combined aerobic-resistance exercise program. Changes in SII (neutrophils \u00d7 platelets\/lymphocytes), anthropometrics, and glucolipid markers were assessed, with ANCOVA and hierarchical regression modeling intergroup differences and predictors (Clinical Trial Registration ID: ChiCTR2200066710).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant reductions in weight, BMI, and body fat% occurred in Group 1\/Group 2 (all\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;0.05) but not Group 3. SII decreased in Group 1 (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;0.05) yet increased in Group 3 due to neutrophil elevation (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;0.05). Fasting glucose and HbA1c improved across all groups (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;0.05), with Group 3\u2019s glycemic benefits independent of weight loss or anti-inflammatory effects. Baseline C-peptide independently predicted increases in \u0394SII across all adjusted models (\u03b2=19.85\u201321.94,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt;0.01), whereas covariates including age, diabetes duration, and BMI showed no significant effects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Severe baseline IR attenuates exercise-mediated SII improvement and body composition optimization, whereas glycemic benefits remain IR-independent, necessitating IR-stratified exercise prescriptions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>Chinese Clinical Trial Registry, identifier ChiCTR2200066710.<\/jats:p>\n                  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