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Exercise improves liver parameters in NAFLD

Exercise-based lifestyle interventions improved blood levels of alanine and asparate aminotransferases in patients with nonalcoholic fatty liver disease, suggesting they are effective and beneficial for this patient population, according to results of a meta-analysis.

Lorenzo A. Orci, MD, PhD, of the Geneva University Hospitals and faculty of medicine, University of Geneva, Switzerland, and colleagues evaluated clinical data from randomized trials examining exercise-based lifestyle interventions found in the PUBMED-MEDLINE, EMBASE, and the Cochrane Central registries through October 2015. The researchers examined various trial endpoints such as intrahepatic lipid content and blood levels of alanine aminotransferase and aspartate aminotransferase to determine if exercise-based lifestyle interventions had any impact on liver-specific endpoints in populations with NAFLD and other metabolic disorders (eg, obesity or type 2 diabetes).

“Evidence surrounding the effectiveness of exercise with respect to liver fat content, independent of diet, remains insufficient, particularly with respect to children and adolescents, where data is scarce,” Orci and colleagues wrote. “By improving quality of life and reducing mortality in a dose-dependent manner, physical activity is generally regarded as a health enhancing process. Our objective, therefore, was to evaluate the literature addressing the effectiveness of physical activity on liver-specific endpoints in both adults and young people.”

Twenty-eight trials were analyzed and results showed physical activity, independent from any change in diet, was associated with a significant reduction in intrahepatic lipid content (95% CI, –0.90 to –0.48). In addition, physical activity was also associated with reduced ALT (95% CI, 5.57 to –1.04) and ASP (95% CI, –8.68 to –1.02).

Meta-regression analysis further indicated individuals with increasing BMI were progressively more likely to benefit from exercise intervention for intrahepatic lipid content improvement (P = .037). Study duration (P = .542), number of exercise sessions per week (P = .233) and duration of each session (P = .517) did not significantly impact this effect, according to the study.

The researchers concluded: “By revealing a significant attenuation of liver fat content with a moderate-to-large effect size, this meta-analysis of randomized controlled trials provides strong evidence for the recommendation of physical activity as an effective intervention in the treatment of [NAFLD]. Physical activity is also associated with an improvement in blood levels of aminotransferases and is particularly beneficial in patients presenting with severe obesity at baseline.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.