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Alcohol abstinence may be necessary to induce changes in liver lipids

After 12 weeks of exercise without weight change or reduction of alcohol, patients with obesity who consume alcohol increased lean body mass, reduced fat mass and reduced cytokeratin-18, but no effect on liver lipid was seen, according to results of a recently published study.

“Despite the multiplicative effects of alcohol and obesity, lifestyle studies in [nonalcoholic fatty liver disease] have focused on people who, by definition, do not consume alcohol,” the researchers wrote. “[This study examined] the effects of exercise on liver lipid, metabolism and liver function in overweight/obese sedentary adults consuming alcohol.”

The study comprised 27 patients with BMI over 25 kg/m²; the men consumed 144 g to 366 g per week of alcohol and the women consumed 88 g to 224 g per week, all considered less than the criteria for alcoholism. Mean patient age was 54 years and the average BMI was 31 kg/m².

Patients were considered to have sedentary lifestyles, defined as less than 60 minutes of moderate to vigorous activity per week and were assigned to either the exercise group (n = 14) or the standard care group (n = 13). Treatment for the exercise group consisted of three sessions of exercise per week on non-consecutive days for 12 weeks. The program consisted of aerobic and circuit of resistance exercise.

The patients completed all 36 sessions. During the study, there was no change in BMI, weight or hepatic triglyceride content with exercise.

At the end of the 12 weeks, the exercise group had a mean increase in lean body mass of 1.9 kg (P < .01), a mean reduction in fat mass of 2.1 kg (P < .01), a reduction of 23 cm² in subcutaneous fat (P < .01) and a reduction of circulating levels of CK-18 (P = .04).

While there was a positive correlation between hepatic triglyceride content and alcohol consumption at baseline (r = 0.6; P < .01), this was not present at the end of the study. The researchers found negative correlations between changes in fat mass and lean body mass (r = –0.74; P < .01), lean body mass and subcutaneous fat (r = –0.45; P = .02) and subcutaneous and visceral fat (r = –0.38; P = .05). Positive correlations included fat mass and subcutaneous fat (r = 0.4; P < .05), fat mass and visceral fat (r = 0.64; P < .01) and CK-18 with alanine aminotransferase (r = 0.63; P < .01).

There were no significant changes in the exercise group to liver enzymes, triglycerides, albumin, ferritin, platelets or glucose control.

“Alcohol induced liver damage may take longer than 12 weeks to resolve, and only with abstinence,” the researchers concluded. “These data suggest that the optimal clinical value of exercise for people consuming alcohol appears likely to be an adjunct to weight loss and alcohol reduction which warrants further study.” – by Talitha Bennett

Disclosures: The researchers report no relevant financial disclosures.