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Peer-reviewedCC BY 4.0International Journal of Molecular Sciences

Exercise Modalities, Training Dose, and Circulating Myostatin and Follistatin in Adults: A Systematic Review and Multilevel Meta-Analysis

  • Chuyuan Qiao1
  • Chuwei Yang1
  • Sitong Guo2
  • Shenglei Yang1
  • Yan Wang1
  1. 1School of Sports Medicine and Rehabilitation, Beijing Sport University, Beijing 100084, China
  2. 2National Institute of Biological Sciences, Beijing 102206, China
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Abstract

Exercise-associated changes in circulating myostatin (MSTN) and follistatin (FST) across training modalities remain uncertain. Seven bibliographic databases were searched for controlled exercise interventions lasting at least four weeks in adults (PROSPERO CRD420261492548). Multilevel random-effects models used study-clustered CR2 inference. Renewed retrieval enabled assessment of 203 of 220 reports. The review included 79 reports from 78 study families; 39 studies contributed primary effects. Exercise was associated with lower MSTN (57 effects; 33 studies; Hedges’ g = 1.25, 95% CI 0.68–1.82) and higher FST (42 effects; 23 studies; g = 1.58, 95% CI 0.92–2.23). Heterogeneity remained high and reference-model prediction intervals crossed zero. Excluding extreme effects attenuated the pooled magnitudes. Graph-exclusion and leave-one-study-out analyses retained positive average-effect intervals. Exploratory modality and dose analyses did not establish superiority or an optimal prescription. GRADE certainty was low for both outcomes. Exercise may alter circulating MSTN and FST, but assay differences, retrieval restrictions and heterogeneous protocols limit interpretation. These findings do not establish a confirmed intracellular mechanism or validated clinical surrogate endpoint.

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Cite

BibTeXRIS
BibTeX
@article{qiao2026exercise,
  title = {{Exercise Modalities, Training Dose, and Circulating Myostatin and Follistatin in Adults: A Systematic Review and Multilevel Meta-Analysis}},
  author = {Chuyuan Qiao and Chuwei Yang and Sitong Guo and Shenglei Yang and Yan Wang},
  journal = {International Journal of Molecular Sciences},
  year = {2026},
  month = oct,
  doi = {10.3390/ijms27219657},
  url = {https://www.mdpi.com/1422-0067/27/21/9657},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Exercise Modalities, Training Dose, and Circulating Myostatin and Follistatin in Adults: A Systematic Review and Multilevel Meta-Analysis
AU  - Chuyuan Qiao
AU  - Chuwei Yang
AU  - Sitong Guo
AU  - Shenglei Yang
AU  - Yan Wang
PY  - 2026
DA  - 2026/10/28
JO  - International Journal of Molecular Sciences
DO  - 10.3390/ijms27219657
UR  - https://www.mdpi.com/1422-0067/27/21/9657
AB  - Exercise-associated changes in circulating myostatin (MSTN) and follistatin (FST) across training modalities remain uncertain. Seven bibliographic databases were searched for controlled exercise interventions lasting at least four weeks in adults (PROSPERO CRD420261492548). Multilevel random-effects models used study-clustered CR2 inference. Renewed retrieval enabled assessment of 203 of 220 reports. The review included 79 reports from 78 study families; 39 studies contributed primary effects. Exercise was associated with lower MSTN (57 effects; 33 studies; Hedges’ g = 1.25, 95% CI 0.68–1.82) and higher FST (42 effects; 23 studies; g = 1.58, 95% CI 0.92–2.23). Heterogeneity remained high and reference-model prediction intervals crossed zero. Excluding extreme effects attenuated the pooled magnitudes. Graph-exclusion and leave-one-study-out analyses retained positive average-effect intervals. Exploratory modality and dose analyses did not establish superiority or an optimal prescription. GRADE certainty was low for both outcomes. Exercise may alter circulating MSTN and FST, but assay differences, retrieval restrictions and heterogeneous protocols limit interpretation. These findings do not establish a confirmed intracellular mechanism or validated clinical surrogate endpoint.
SN  - 1422-0067
ER  -