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Resistance, aerobic training similarly reduced hepatic fat content in diabetic NAFLD patients

Sedentary patients with nonalcoholic fatty liver disease and type 2 diabetes experienced similar reductions in hepatic fat content after completing resistance or aerobic exercise programs in a recent study.

In a subanalysis of the RAED2 study, researchers randomly assigned 30 sedentary patients with type 2 diabetes and nonalcoholic fatty liver disease (NAFLD) to undergo aerobic (AER; n=13) or resistance training (RES; n=17) three times a week for 4 months. Researchers measured the impact on body composition, hepatic fat content, insulin sensitivity and abdominal adipose tissue. The cohort was white, aged 40 to 70 years and had a BMI range of 24 kg/m2 to 36 kg/m2.

Both groups experienced significant reductions in hepatic fat content, with a mean relative reduction of 32.8% in the AER group and 25.9% in the RES group (P<.001 for both). Hepatic steatosis, defined as hepatic fat content above 5.56%, was resolved in 23.1% of AER patients and 23.5% of the RES group.

Similar improvements to total body fat mass, BMI, visceral and superficial adipose tissue, sagittal abdominal diameter and hemoglobin A1c occurred in each group (P<.001), as well as to triglycerides (P=.036) and insulin sensitivity (P=.025). Multivariate analysis indicated that baseline hepatic fat content at baseline and changes to deep subcutaneous adipose tissue were positively predictive of a reduction in hepatic fat content following intervention, while change to superficial adipose tissue was negatively predictive (R2 model=0.63; P=.001).

“The results of this … trial demonstrate for the first time that 4 months of resistance training or aerobic training are equally effective in reducing hepatic fat content in sedentary type 2 diabetic patients with NAFLD,” the researchers concluded. “Our data indicate that exercise alone can provide benefit for the management of NAFLD in patients with type 2 diabetes. However, the long-term impact of exercise training … will depend on long-term maintenance and sustainability of exercise; this now needs to be investigated in longer randomized controlled trials.”

Disclosure: See the study for a full list of relevant financial disclosures.