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Effects of Different Types of Exercise Training on Osteocalcin and Osteopontin Levels in Adults With and Without Disease: A Systematic Review and Meta-Analysis
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Fatemeh Kazeminasab    , Omid Zafarmand * , Sahar Parseh |
| , omidzafarmand2202@gmil.com |
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Abstract: (6 Views) |
Background and aim: Osteocalcin (OCN) and osteopontin (OPN) are important bone biomarkers, and the effects of exercise on these markers have shown inconsistent results across various studies. Therefore, this study aimed to investigate the effects of different types of exercise interventions on OCN and OPN levels in adults with and without diseases through a systematic review and meta-analysis.
Materials and Methods: This study was designed based on the Cochrane and PRISMA guidelines. A systematic search was conducted from inception to December 13, 2025, in the databases PubMed, Scopus, Web of Science, Google Scholar, Magiran, Noormags, Irandoc, and SID.The inclusion criteria comprised all randomized and non-randomized controlled clinical trials that investigated the effects of various exercise interventions on OCN and OPN levels in adults(≥18 years) of both sexes, with and without diseases, included at least an exercise intervention group and a control group, and provided sufficient data for effect size calculation.The exclusion criteria included non-original studies, animal studies, studies without a control group, studies with inseparable combined interventions, studies lacking sufficient statistical data, or studies that did not report OCN or OPN outcomes. The standardized mean difference(SMD) with a 95% confidence interval was used to calculate the effect size. Study heterogeneity was assessed using the I² statistic, and publication bias was evaluated through funnel plots and Egger’s test. Data analysis was performed using CMA2 software.
Results: A total of 23 studies (28 exercise interventions), including 740 adult participants with and without diseases, were included in the meta-analysis. The results showed that various types of exercise significantly increased OCN levels (SMD=0.792, 95% CI: 0.310 to 1.274, P<0.001, I²=87.448%) ompared with the control group; however, changes in OPN levels (SMD=−0.161, 95% CI: −0.816 to 0.493, P=0.629, I²=38.905%) were not statistically significant.
Conclusion: Different types of exercise increase OCN levels in adults with and without diseases; however, they do not have a significant effect on OPN levels. Nevertheless, due to the high heterogeneity among studies and the potential risk of publication bias regarding OCN, these findings should be interpreted with caution. Further high-quality clinical trials with standardized methodologies are required to confirm these results.
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| Keywords: Exercise Training, Osteocalcin, Osteopontin, Adults, Chronic Diseases. |
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Type of Study: Review |
Subject:
medicine, paraclinic
Received: 2026/02/1 | Revised: 2026/08/17 | Accepted: 2026/08/17
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