Subscribe to RSS
DOI: 10.1055/a-1742-4257
Efficacy of aerobic and resistance exercises in improving visceral adipose in patients with non-alcoholic fatty liver: a meta-analysis of randomized controlled trials
Die Wirksamkeit von aerobem Bewegungs- und Widerstandstraining zur Verbesserung der viszeralen Adipositas bei Patienten mit nichtalkoholischer Fettleber: Eine Meta-Analyse randomisierter, kontrollierter Studien Supported by: The National Science and Technology Major Project of China 2017ZX10202203-007;2017ZX10202203-008Abstract
Background Non-alcoholic fatty liver disease (NAFLD) is a common chronic disease that can cause liver deterioration if insufficiently diagnosed and untreated. The verification of whether exercise interventions improve liver enzymes and lipid and glucose parameters is scant.
Aim We conducted this systematic review and meta-analysis to examine the efficacy of aerobic and resistance exercise interventions in patients with NAFLD.
Methods We searched the related studies in the PubMed, Embase, Cochrane Library, and Web of Science databases. We screened 1129 articles published before September 1, 2021, based on the inclusion and exclusion standards, after which 17 articles with a total of 1168 participants were finally included. The indices of liver enzymes and lipid and glucose metabolism were gathered and examined by Stata SE.
Results The outcomes suggested that aerobic and resistance exercise can markedly improve the parameters of liver enzymes, blood lipids, and glucose, and especially visceral adipose tissue (weighted mean different [WMD] = −8.3 at 95% CI [−11.59 to −5.00], p < 0.0001), in patients with NAFLD.
Conclusion This study demonstrated that aerobic and resistance exercises positively affect NAFLD treatment. To further quantify the effects on patients with NAFLD, a more specific and uniform exercise program should be proposed.
Zusammenfassung
Hintergrund Die nicht-alkoholische Fettlebererkrankung (NAFLD) ist eine häufige chronische Erkrankung, die bei unzureichender Diagnose und unzureichender Behandlung zu einer Verschlechterung der Leberwerte führen kann. Es gibt nur wenige Studien, die belegen, dass Sport die Leberenzymwerte sowie die Lipid- und Glukoseparameter verbessert.
Ziel In dieser systematischen Übersichtsarbeit und Meta-Analyse wurde die Wirksamkeit von aerobem Bewegungs- und Widerstandstraining bei Patienten mit NAFLD untersucht.
Methoden Wir recherchierten in den Datenbanken PubMed, Embase, Cochrane Library und Web of Science die entsprechenden Studien. Anhand der Ein- und Ausschlusskriterien wurden insgesamt 1129 Artikel, die vor dem 1. September 2021 veröffentlicht worden waren, gescreent und schlussendlich 17 Artikel mit insgesamt 1168 Teilnehmern eingeschlossen. Die Werte der Leberenzyme sowie des Lipid- und Glukosestoffwechsels wurden erfasst und mit Stata SE untersucht.
Ergebnisse Die Ergebnisse legen nahe, dass aerobes Bewegungs- und Widerstandstraining bei Patienten mit NAFLD die Werte der Leberenzyme, der Blutfette und des Blutzuckers und insbesondere des viszeralen Fettgewebes deutlich verbessern können (WMD=–8,3 bei 95% CI [–11,59 bis –5,00], p<0,0001).
Schlussfolgerung Diese Studie hat gezeigt, dass aerobes Bewegungs- und Widerstandstraining eine positive Rolle bei der Behandlung von NAFLD spielen. Um die Auswirkungen auf Patienten mit NAFLD besser quantitativ beurteilen zu können, sollte ein spezifischeres und einheitlicheres Trainingsprogramm angeboten werden.
Schlüsselwörter Nicht-alkoholische Fettlebererkrankung, aerobes Bewegungstraining, Widerstandstraining, randomisierte kontrollierte Studie, Meta-Analyse
Schlüsselwörter
Nichtalkoholische Fettlebererkrankung - aerobes Bewegungstraining - Widerstandstraining - randomisierte kontrollierte Studie - Meta-AnalyseKeywords
non-alcoholic fatty liver disease - aerobic exercise - resistance training - randomized controlled trial - meta-analysisPublication History
Received: 09 June 2021
Accepted after revision: 14 January 2022
Article published online:
30 May 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
-
References
- 1 Younossi Z, Anstee QM, Marietti M. et al. Global burden of NAFLD and NASH: trends, predictions, risk factors and prevention. Nat Rev Gastroenterol Hepatol 2018; 15: 11-20 DOI: 10.1038/nrgastro.2017.109. (PMID: 28930295)
- 2 Cotter TG, Rinella M. Nonalcoholic fatty liver disease 2020: the state of the disease. Gastroenterology 2020; 158: 1851-1864 DOI: 10.1053/j.gastro.2020.01.052. (PMID: 32061595)
- 3 Targher G, Byrne CD, Tilg H. NAFLD and increased risk of cardiovascular disease: clinical associations, pathophysiological mechanisms and pharmacological implications. Gut 2020; 69: 1691-1705 DOI: 10.1136/gutjnl-2020-320622. (PMID: 32321858)
- 4 Neuschwander-Tetri BA. Therapeutic landscape for NAFLD in 2020. Gastroenterology 2020; 158: 1984-1998.e3 DOI: 10.1053/j.gastro.2020.01.051. (PMID: 32061596)
- 5 Parry SA, Hodson L. Managing NAFLD in type 2 diabetes: the effect of lifestyle interventions, a narrative review. Adv Ther 2020; 37: 1381-1406 DOI: 10.1007/s12325-020-01281-6. (PMID: 32146704)
- 6 Farzanegi P, Dana A, Ebrahimpoor Z. et al. Mechanisms of beneficial effects of exercise training on non-alcoholic fatty liver disease (NAFLD): roles of oxidative stress and inflammation. Eur J Sport Sci 2019; 19: 994-1003 DOI: 10.1080/17461391.2019.1571114. (PMID: 30732555)
- 7 Chalasani N, Younossi Z, Lavine JE. et al. The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology 2018; 67: 328-357 DOI: 10.1002/hep.29367. (PMID: 28714183)
- 8 Golabi P, Locklear CT, Austin P. et al. Effectiveness of exercise in hepatic fat mobilization in non-alcoholic fatty liver disease: systematic review. World J Gastroenterol 2016; 22: 6318-6327 DOI: 10.3748/wjg.v22.i27.6318. (PMID: 27468220)
- 9 Katsagoni CN, Georgoulis M, Papatheodoridis GV. et al. Effects of lifestyle interventions on clinical characteristics of patients with non-alcoholic fatty liver disease: a meta-analysis. Metabolism 2017; 68: 119-132 DOI: 10.1016/j.metabol.2016.12.006. (PMID: 28183444)
- 10 Orci LA, Gariani K, Oldani G. et al. Exercise-based interventions for nonalcoholic fatty liver disease: a meta-analysis and meta-regression. Clin Gastroenterol Hepatol 2016; 14: 1398-1411 DOI: 10.1016/j.cgh.2016.04.036. (PMID: 27155553)
- 11 Sargeant JA, Gray LJ, Bodicoat DH. et al. The effect of exercise training on intrahepatic triglyceride and hepatic insulin sensitivity: a systematic review and meta-analysis. Obes Rev 2018; 19: 1446-1459 DOI: 10.1111/obr.12719. (PMID: 30092609)
- 12 Wang S-T, Zheng J, Peng H-W. et al. Physical activity intervention for non-diabetic patients with non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials. BMC Gastroenterol 2020; 20: 66 DOI: 10.1186/s12876-020-01204-3. (PMID: 32164541)
- 13 Higgins JP, Altman DG, Gotzsche PC. et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. BMJ (Clinical research ed) 2011; 343: d5928 DOI: 10.1136/bmj.d5928. (PMID: 22008217)
- 14 Cheng SL, Ge J, Zhao C. et al. Effect of aerobic exercise and diet on liver fat in pre-diabetic patients with non-alcoholic-fatty-liver-disease: a randomized controlled trial. Sci Rep 2017; 7: 15952 DOI: 10.1038/s41598-017-16159-x. (PMID: 29162875)
- 15 Jia GY, Han T, Gao L. et al. Effect of aerobic exercise and resistance exercise in improving non-alcoholic fatty liver disease: a randomized controlled trial. Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chin J Hepatol 2018; 26: 34-41 DOI: 10.3760/cma.j.issn.1007-3418.2018.01.009. (PMID: 29804360)
- 16 Zhang HJ, He J, Pan LL. et al. Effects of moderate and vigorous exercise on nonalcoholic fatty liver disease: a randomized clinical trial. JAMA Intern Med 2016; 176: 1074-1082 DOI: 10.1001/jamainternmed.2016.3202. (PMID: 27379904)
- 17 Cuthbertson DJ, Shojaee-Moradie F, Sprung VS. et al. Dissociation between exercise-induced reduction in liver fat and changes in hepatic and peripheral glucose homoeostasis in obese patients with non-alcoholic fatty liver disease. Clin Sci (Lond. ) 2016; 130: 93-104 DOI: 10.1042/CS20150447. (PMID: 26424731)
- 18 Hallsworth K, Thoma C, Hollingsworth KG. et al. Modified high-intensity interval training reduces liver fat and improves cardiac function in non-alcoholic fatty liver disease: a randomized controlled trial. Clinical Sci (Lond. ) 2015; 129: 1097-1105 DOI: 10.1042/CS20150308. (PMID: 26265792)
- 19 Houghton D, Thoma C, Hallsworth K. et al. Exercise reduces liver lipids and visceral adiposity in patients with nonalcoholic steatohepatitis in a randomized controlled trial. Clin Gastroenterol Hepatol 2017; 15: 96-102.e103
- 20 Pugh CJA, Cuthbertson DJ, Sprung VS. et al. Exercise training improves cutaneous microvascular function in nonalcoholic fatty liver disease. Am J Physiol Endocrinol Metab 2013; 305: E50-E58 DOI: 10.1152/ajpendo.00055.2013. (PMID: 23651847)
- 21 Pugh CJ, Spring VS, Kemp GJ. et al. Exercise training reverses endothelial dysfunction in nonalcoholic fatty liver disease. Am J Physiol Heart Circ Physiol 2014; 307: H1298-H1306 DOI: 10.1152/ajpheart.00306.2014. (PMID: 25193471)
- 22 Shojaee-Moradie F, Cuthbertson DJ, Barrett M. et al. Exercise Training reduces liver fat and increases rates of VLDL clearance but not VLDL production in NAFLD. J Clin Endocrinol Metab 2016; 101: 4219-4228 DOI: 10.1210/jc.2016-2353. (PMID: 27583475)
- 23 Abdelbasset WK, Tantawy SA, Kamel DM. et al. Effects of high-intensity interval and moderate-intensity continuous aerobic exercise on diabetic obese patients with nonalcoholic fatty liver disease: a comparative randomized controlled trial. Medicine (Baltimore) 2020; 99: e19471 DOI: 10.1097/MD.0000000000019471. (PMID: 32150108)
- 24 Abdelbasset WK, Tantawy SA, Kamel DM. et al. A randomized controlled trial on the effectiveness of 8-week high-intensity interval exercise on intrahepatic triglycerides, visceral lipids, and health-related quality of life in diabetic obese patients with nonalcoholic fatty liver disease. Medicine (Baltimore) 2019; 98: e14918 DOI: 10.1097/MD.0000000000014918. (PMID: 30896648)
- 25 Sullivan S, Kirk EP, Mittendorfer B. et al. Randomized trial of exercise effect on intrahepatic triglyceride content and lipid kinetics in nonalcoholic fatty liver disease. Hepatology 2012; 55: 1738-1745 DOI: 10.1002/hep.25548. (PMID: 22213436)
- 26 Eckard C, Cole R, Lockwood J. et al. Prospective histopathologic evaluation of lifestyle modification in nonalcoholic fatty liver disease: a randomized trial. Therap Adv Gastroenterol 2013; 6: 249-259 DOI: 10.1177/1756283X13484078. (PMID: 23814606)
- 27 Franco I, Bianco A, Mirizzi A. et al. Physical activity and low glycemic index Mediterranean diet: main and modification effects on NAFLD score. Results from a randomized clinical trial. Nutrients 2020; 13: 66 DOI: 10.3390/nu13010066. (PMID: 33379253)
- 28 Shamsoddini A, Sobhani V, Ghamar Chehreh ME. et al. Effect of aerobic and resistance exercise training on liver enzymes and hepatic fat in Iranian men with nonalcoholic fatty liver disease. Hepat Mon 2015; 15: e31434 DOI: 10.5812/hepatmon.31434. (PMID: 26587039)
- 29 Hoseini Z, Behpour N, Hoseini R. Co-treatment with vitamin D supplementation and aerobic training in elderly women with Vit D deficiency and NAFLD: a single-blind controlled trial. Hepat Mon 2020; 20: e96437
- 30 Zelber-Sagi S, Buch A, Webb M. et al. The effect of resistance training on non-alcoholic fatty liver disease (NAFLD) a randomized clinical trial. J Hepatol 2012; 56: S526-S527
- 31 Araújo AR, Rosso N, Bedogni G. et al. Global epidemiology of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis: what we need in the future. Liver Int 2018; 38 (Suppl. 01) 47-51 DOI: 10.1111/liv.13643. (PMID: 29427488)
- 32 Lonardo A, Nascimbeni F, Maurantonio M. et al. Nonalcoholic fatty liver disease: Evolving paradigms. World J Gastroenterol 2017; 23: 6571-6592 DOI: 10.3748/wjg.v23.i36.6571. (PMID: 29085206)
- 33 Martin M, Krystof S, Jiri R. et al. Modulation of energy intake and expenditure due to habitual physical exercise. Curr Pharm Des 2016; 22: 3681-3699 DOI: 10.2174/1381612822666160419144200. (PMID: 27090792)
- 34 Myers J. Cardiology patient pages. Exercise and cardiovascular health. Circulation 2003; 107: e2-e5 DOI: 10.1161/01.cir.0000048890.59383.8d. (PMID: 12515760)
- 35 Woods JA, Wilund KR, Martin SA. et al. Exercise, inflammation and aging. Aging Dis 2012; 3: 130-140 (PMID: 22500274)
- 36 Hunter GR, Weinsier RL, Bamman MM. et al. A role for high intensity exercise on energy balance and weight control. Int J Obes Relat Metab Disord 1998; 22: 489-493 DOI: 10.1038/sj.ijo.0800629. (PMID: 9665667)
- 37 Sattelmair J, Pertman J, Ding EL. et al. Dose response between physical activity and risk of coronary heart disease: a meta-analysis. Circulation 2011; 124: 789-795 DOI: 10.1161/CIRCULATIONAHA.110.010710. (PMID: 21810663)
- 38 Swain DP, Franklin BA. Comparison of cardioprotective benefits of vigorous versus moderate intensity aerobic exercise. Am J Cardiol 2006; 97: 141-147 DOI: 10.1016/j.amjcard.2005.07.130. (PMID: 16377300)
- 39 Kelley GA, Kelley KS. Efficacy of aerobic exercise on coronary heart disease risk factors. Prev Cardioly 2008; 11: 71-75 DOI: 10.1111/j.1751-7141.2008.08037.x. (PMID: 18401233)
- 40 Chatzinikolaou A, Fatouros I, Petridou A. et al. Adipose tissue lipolysis is upregulated in lean and obese men during acute resistance exercise. Diabetes Care 2008; 31: 1397-1399 DOI: 10.2337/dc08-0072. (PMID: 18375413)