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August 06, 2020
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Aerobic exercise may improve histologic endpoints in MAFLD

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An aerobic exercise program may help improve histologic endpoints in patients with metabolic dysfunction associated fatty liver disease, according to study results.

Philip O’Gorman, PhD, of Trinity Centre of Health Sciences at St. James’s Hospital in Ireland, and colleagues wrote that lifestyle interventions are some of the most important treatment methods for MAFLD, but the specific impact of exercise is not well studied.

“Exercise is known to be beneficial for the treatment and prevention of many chronic inflammatory diseases such as cancer, type 2 diabetes, arthritis and cardiovascular disease,” they wrote. “However, the independent role of exercise in the treatment of MAFLD remains unclear.”

Researchers assessed the effects of a 12-week aerobic exercise intervention on histologic and cardiometabolic endpoints in a study comprising 24 patients with biopsy-confirm MAFLD. They assessed liver histology, cardiorespiratory fitness (using estimated VO2max), physical activity, anthropometry and biochemical markers at baseline, completion of the intervention, and at 12 and 52 weeks after completion. They assigned 16 patients to an exercise group and 8 to control group.

In the exercise group, 58% of patients experienced a reduction in fibrosis (P = .034) and 67% experienced a reduction in hepatocyte ballooning by one stage (P = .02).

Patients in the exercise group also increased their estimated VO2max by 17% compared with the control group (P = .027). Patients with fibrosis and ballooning improvement increased their estimated VO2max by 25% (P = .02) and 26% (P = .007), respectively.

Although investigators observed reductions in body mass, waist circumference and fat mass, no patients achieved between 7% and 10% in weight loss.

“The significant histological improvements may relate to improvements in cardiorespiratory fitness, adding to the emerging body of evidence indicating the role for cardiorespiratory fitness as a clinical marker of disease progression/regression in MAFLD patients,” O’Gorman and colleagues wrote. “This pilot study paves the way for larger randomized controlled trials to investigate the effects of aerobic exercise on histological features of MAFLD, with a particular focus on determining strategies to transition exercise into the community setting in order to promote lifelong adherence to exercise therapy.”