Exercise-based interventions and circulating irisin concentrations in older adults: A systematic review and meta-analysis

Abstract

Ageing is accompanied by progressive metabolic dysfunction and alterations in skeletal-muscle endocrine activity. Irisin, a contraction-induced myokine, has been implicated in energy metabolism and metabolic homeostasis; however, the effect of exercise on circulating irisin levels in older adults remains uncertain. The aim of this systematic review and meta-analysis was to evaluate the association between exercise-based interventions and circulating irisin levels in older adults. PubMed, Scopus, and Embase were systematically searched for eligible studies published up to March 20, 2026. Prospective studies assessing post-intervention irisin levels among older adults receiving exercise-based interventions and control participants were included. Pooled mean differences (MDs) were calculated using a random-effects model. Eight prospective cohort studies comprising 299 participants, including 152 participants in intervention groups and 147 controls, were included. Exercise modalities included strength, resistance, aquarobic, periodized, and Nordic walking training, with intervention durations ranging from three to six months. Exercise-based interventions were associated with higher circulating irisin levels than control conditions (MD: 1.40; 95% confidence interval (CI): 0.17–2.62; p=0.026). Significant between-study heterogeneity was observed (p for heterogeneity <0.001), whereas Egger’s test did not indicate statistically significant publication bias (p=0.160). In conclusion, exercise-based interventions may increase circulating irisin levels in older adults. Nevertheless, the substantial heterogeneity, relatively small pooled sample, and predominance of nonrandomized studies warrant cautious interpretation.