Regular aerobic exercise reduces hepatic steatosis and fibrosis in MAFLD: Study

Metabolic (dysfunction) associated fatty liver disease (MAFLD) is now the most common cause of chronic liver disease worldwide with a global estimated prevalence of 25%1 ; this is linked to the increasing global incidence of type 2 diabetes mellitus (T2DM) and obesity.

Researchers undertook the study to assess the effects of a 12-week aerobic exercise intervention on histological and cardiometabolic endpoints in MAFLD. Exercise is known to be beneficial for the treatment and prevention of many chronic inflammatory diseases such as cancer, T2DM, arthritis and CVD.10-12 However, the independent role of exercise in the treatment of MAFLD remains unclear.

The primary objective of this study was to determine the independent effects of exercise alone, specifically 12 weeks of moderate-to-vigorous intensity aerobic exercise, without prescribed dietary modifications, on histological endpoints of MAFLD. Secondary objectives included: determining the impact of the exercise intervention on cardiorespiratory fitness, physical activity levels and measures of cardiometabolic health including body composition, vascular health, glucose and lipid metabolism and circulating inflammatory markers. The final objective was to determine the sustainability of the exercise intervention at 12 weeks and 52 weeks post-exercise intervention completion.

Patients with biopsy-confirmed MAFLD participated in a 12-week aerobic exercise intervention were included in the study. Liver histology, cardiorespiratory fitness (estimated V̇ O2max), physical activity, anthropometry and biochemical markers were assessed at baseline, intervention completion, and 12 and 52 weeks after intervention completion.

On analysis, the following facts emerged.

• Twenty-four patients completed the exercise intervention (exercise group n = 16, control group n = 8).
• In the exercise group, 12 weeks of aerobic exercise reduced fibrosis and hepatocyte ballooning by one stage in 58% (P = 0.034) and 67% (P = 0.020) of patients, with no changes in steatosis (P = 1.000), lobular inflammation (P = 0.739) or NAFLD activity score (P = 0.172).
• Estimated V̇ O2max increased by 17% compared to the control group (P = 0.027) but this level of improvement was not maintained at 12 or 52 weeks after the intervention.
• Patients with fibrosis and ballooning improvement increased estimated V̇ O2max by 25% (P = 0.020) and 26% (P = 0.010), respectively.
• Anthropometric reductions including body mass (P = 0.038), waist circumference (P = 0.015) and fat mass (P = 0.007) were also observed, but no patient achieved 7%-10% weight loss.

"This pilot study paves the way for larger randomised 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."wrote the team.

Primary source: Alimentary Pharmacology & Therapeutics

For full article follow the link: doi:10.1111/apt.15989