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Document Type

Abstract

Publication Date

12-1-2024

Abstract

Background/Purpose: Nonalcoholic fatty liver disease (NAFLD) is a prevalent chronic liver condition globally, often linked to sedentary behaviors and central obesity. It is characterized by the activation of multiple signaling cascades leading to inflammation, which plays a critical role in the occurrence and progression of NAFLD liver damage. With the absence of targeted pharmacological treatments, lifestyle and dietary adjustments remain primary interventions for many patients. However, the optimal exercise intensity for managing NAFLD remains unclear, with conflicting evidence on its effectiveness in modulating inflammation. This study aimed to clarify the impact of different exercise types and intensities on liver function and inflammation in NAFLD patients.

Methods: Using keywords such as “exercise,” “NAFLD,” and “inflammation,” we searched related studies published in the PubMed, Embase, Cochrane Library, and Web of Science databases. Inclusion criteria were randomized controlled trials (RCTs) with an exercise intervention lasting over four weeks, involving NAFLD or NASH patients (≥18 years) diagnosed through clinical, laboratory, and biopsy data, with a focus on liver enzymes and inflammatory markers as outcomes.

Results: Twelve RCTs encompassing 543 NAFLD patients were included. Exercise interventions ranged from 12 weeks to 8.6 months, with frequencies of 2 to 5 times weekly and durations of 30 to 90 minutes per session. Overall, the results of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels following aerobic and resistance training were significantly affected (all P < 0.05). However, high-intensity interval training and combined aerobic-resistance exercise showed negligible effects on ALT and AST levels (all P > 0.05). Regarding the effect of exercise on inflammatory factors, exercise training reduced IL-6 levels in six trials (P < 0.05). However, no specific exercise type was found to reduce IL-6 levels. Exercise training had no significant effect on reducing TNF-α levels, and no specific exercise reduced TNF-α levels across five trials.

Conclusion/Discussion: Exercise, particularly aerobic and resistance training, positively affected liver function in NAFLD patients by reducing liver enzymes and IL-6 levels. Despite these promising findings, the analysis faces limitations, including the heterogeneity of IL-6 and TNF-α outcomes and insufficient RCTs for high-intensity interval training subgroups. Further research is essential to explore the specific connections between exercise, inflammation, and NAFLD progression.

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