Excess fat in the liver—often a consequence of inactivity and central obesity—triggers inflammatory pathways, driving the progression of nonalcoholic fatty liver disease (NAFLD).
In NAFLD patients, aerobic and resistance training can improve liver function by decreasing liver enzymes and inflammation, while high-intensity interval training and combined exercise modalities show limited effects.
Excess fat in the liver—often a consequence of inactivity and central obesity—triggers inflammatory pathways, driving the progression of nonalcoholic fatty liver disease (NAFLD). With no specific medications available, lifestyle and dietary changes serve as the frontline approach. However, the ideal exercise intensity for lessening liver inflammation remains debated. Hence, this study sought to evaluate how different exercise types and intensities influence liver function and inflammation in NAFLD-affected people.
A systematic search was carried out across PubMed, Embase, Cochrane Library, and Web of Science. Eligible studies encompassed randomized controlled trials (RCTs) with exercise interventions lasting over 4 weeks in NAFLD or nonalcoholic steatohepatitis (NASH) patients (age ≥18 years), diagnosed through clinical, laboratory, or biopsy data. The primary outcomes measured were liver enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST]) and inflammatory markers (interleukin-6 [IL-6], tumor necrosis factor-alpha [TNF-α]).
In this meta-analysis, 12 RCTs with 543 patients were included. Exercise interventions lasted 12 weeks to 8.6 months, with sessions ranging from 30 to 90 minutes, 2–5 times per week. Aerobic and resistance training markedly reduced ALT and AST levels, while high-intensity interval training (HIIT) and combined aerobic-resistance exercises exhibited no prominent effects on liver enzymes.
Exercise also reduced IL-6 levels, though no specific exercise modality was the most beneficial. Across 5 trials, no specific exercise regimen markedly lowered TNF-α levels, suggesting a limited impact of exercise training on this inflammatory marker.
Aerobic and resistance training positively impacted liver function in NAFLD patients by lowering ALT, AST, and IL-6 levels. However, variations in IL-6 and TNF-α outcomes, along with a lack of RCTs on HIIT, limited the analysis. Unraveling the precise link between exercise, inflammation, and NAFLD progression remains a key area for upcoming investigations.
International Journal of Physical Activity and Health
A170: Effects of Exercise on Liver Function and Inflammatory Markers in NAFLD Patients: A Meta-Analysis
Wang S et al.
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