Introduction: Flow-dependent vasodilation (FMD) is a well-known marker for predicting cardiovascular disease, indicating impaired endothelial function. Although evidence suggests that lifestyle modification, including a low-calorie diet, is associated with improvements in FMD levels,there is much uncertainty regarding the response of this biomarker to exercise. Therefore, the aim of the present study was to investigate the effect of aerobic exercise on FMD in  adults with metabolic disorders
Methods: This study was a systematic review and meta-analysis conducted in accordance with the Cochrane and PRISMA guidelines. A comprehensive literature search was systematically performed across PubMed, Scopus, Web of Science, Google Scholar, Magiran, Noor Mags, and SID databases
up to April 9, 2025, for articles published in English or Persian. Eligible studies were randomized controlled trials that examined the effects of aerobic exercise on flow-mediated dilation (FMD) in adults with metabolic disorders and reported pre- and post-intervention means and standard deviations,
along with a control group. Ultimately, 8 studies (comprising 9 aerobic exercise interventions) with a total of 319 participants met the inclusion criteria and were incorporated into the meta-analysis. Data were analyzed using the weighted mean difference (WMD) with corresponding 95% confidence
intervals (CIs), applying a random-effects model implemented in CMA version 2 software 
Results: The results indicated that aerobic exercise led to a significant increase in FMD among adults with metabolic disorders [WMD = 2.52; 95% CI: 1.407–3.637; P< 0.001] compared to the control group
Conclusions: The results of the present meta-analysis showed that aerobic exercise is associated with increased FMD in adults with metabolic disorders. Therefore, it is suggested that aerobic exercise, including brisk walking and cycling, should be included in the lifestyle of adults at least three times a week in order to prevent and even treat metabolic disorders