Effects of lifestyle interventions on clinical characteristics of patients with non-alcoholic fatty liver disease: A meta-analysis

Katsagoni, Christina N.; Georgoulis, Michael; Papatheodoridis, George V.; Panagiotakos, Demosthenes B.; Kontogianni, Meropi D.

doi:10.1016/j.metabol.2016.12.006

Cited by 221 publications

(202 citation statements)

References 60 publications

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“…The current study explored the benefit of a short, individualised exercise intervention in patients with histologically confirmed NAFLD. Albeit the availability of many exercises programs, which promote lifestyle changes, is proven, a major challenge is the motivation of the mostly asymptomatic patients with NAFLD . Also, most programs require supervision of qualified teams, which are cost intensive and are only rarely found in hepatological practices .…”

Section: Discussionmentioning

confidence: 99%

“…Albeit the availability of many exercises programs, which promote lifestyle changes, is proven, a major challenge is the motivation of the mostly asymptomatic patients with NAFLD. 27,28 Also, most programs require supervision of qualified teams, which are cost intensive and are only rarely found in hepatological practices. 29 Therefore, we chose a web-based intervention program as a novel tool to overcome the disconnect of liver and sports medicine specialists and allow a resource saving participation with involvement of patients and physicians.…”

Section: Discussionmentioning

confidence: 99%

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Improvement of non‐invasive markers of NAFLD from an individualised, web‐based exercise program

Huber

Pfirrmann

Gebhardt

et al. 2019

Aliment Pharmacol Ther

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Summary Background Lifestyle modifications remain the cornerstone of treatment in non‐alcoholic fatty liver disease (NAFLD). However, they requently fail related to the inability of patients to implement lasting changes. Aims To evaluate the effects of a short, web‐based, individualised exercise program on non‐invasive markers of hepatic steatosis, inflammation and fibrosis. Methods Patients with histologically confirmed NAFLD underwent an 8‐week, web‐based, individualised exercise program that contained bidirectional feedback. Results Forty‐four patients entered the study and 41 completed the assigned training goal (93.2%). In the completer population, 8 weeks of individualised exercise increased the VO2peak by 12.2% compared to baseline (P < .001). ALT and AST decreased by 14.3% (P = .002) and 18.2% (P < .001) and remained at this level until follow‐up 12 weeks after the intervention. Markers of inflammation including hsCRP, ferritin, and M30 decreased. In parallel, gut microbiota exhibited increased metagenomic richness (P < .05) and at the taxonomic levels Bacteroidetes and Euryarchaeota increased whereas Actinobacteria phylum decreased. Surrogate scores of steatosis and fibrosis including the fatty liver index (FLI), FiB‐4, APRI and transient elastography showed significant reductions. In parallel, a marker of procollagen‐3 turnover (PRO‐C3) decreased while C4M2, reflecting type IV collagen, degradation increased suggesting beneficial hepatic fibrosis remodelling from exercise. Also, an enhancement in health‐related quality of life was reported. Conclusion The current study underlines the plausibility and potential of an 8 week individualised web‐based exercise program in NAFLD. Clinical trial number: NCT02526732

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Improvement of non‐invasive markers of NAFLD from an individualised, web‐based exercise program

Huber

Pfirrmann

Gebhardt

et al. 2019

Aliment Pharmacol Ther

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“…Previous reviews report that exercise training significantly reduces IHTG with a moderate to large pooled effect size (13,15,17). The restriction of the current meta-analysis to a single technique ( 1 H-MRS) allowed us to report this pooled effect as the absolute mean difference, and our findings suggest that exercise training for between 1 and 24 weeks (mode 12 weeks) elicits an absolute reduction in IHTG of approximately 2.2 to 4.7% (mean~3.5%), re-enforcing the meaningful therapeutic role of exercise for individuals with NAFLD.…”

Section: Discussionmentioning

confidence: 99%

The effect of exercise training on intrahepatic triglyceride and hepatic insulin sensitivity: a systematic review and meta‐analysis

et al. 2018

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This systematic review and meta-analysis determined the impact of structured exercise training, and the influence of associated weight loss, on intrahepatic triglyceride (IHTG) in individuals with non-alcoholic fatty liver disease (NAFLD). It also examined its effect on hepatic insulin sensitivity in individuals with or at increased risk of NAFLD. Analyses were restricted to studies using magnetic resonance spectroscopy or liver biopsy for the measurement of IHTG and isotope-labelled glucose tracer for assessment of hepatic insulin sensitivity. Pooling data from 17 studies (373 exercising participants), exercise training for one to 24 weeks (mode: 12 weeks) elicits an absolute reduction in IHTG of 3.31% (95% CI: -4.41 to -2.22%). Exercise reduces IHTG independent of significant weight change (-2.16 [-2.87 to -1.44]%), but benefits are substantially greater when weight loss occurs (-4.87 [-6.64 to -3.11]%). Furthermore, meta-regression identified a positive association between percentage weight loss and absolute reduction in IHTG (β = 0.99 [0.62 to 1.36], P < 0.001). Pooling of six studies (94 participants) suggests that exercise training also improves basal hepatic insulin sensitivity (mean change in hepatic insulin sensitivity index: 0.13 [0.05 to 0.21] mg m min per μU mL ), but available evidence is limited, and the impact of exercise on insulin-stimulated hepatic insulin sensitivity remains unclear.

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“…Few exhaustive reviews and meta-analyses have more precisely addressed the benefits of physical activity in NAFLD 61,[80][81][82][83][84] (Table 2). Magkos 80 reviewed the extreme variability of results linking physical exercise and liver fat accumulation (ie, intrahepatic triglycerides).…”

Section: Nonalcoholic Fatty Liver Disease (Nafld)mentioning

confidence: 99%

Exercising the hepatobiliary‐gut axis. The impact of physical activity performance

Molina-Molina

Baccetto

Wang

et al. 2018

Eur J Clin Investigation

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Effects of lifestyle interventions on clinical characteristics of patients with non-alcoholic fatty liver disease: A meta-analysis

Cited by 221 publications

References 60 publications

Improvement of non‐invasive markers of NAFLD from an individualised, web‐based exercise program

Improvement of non‐invasive markers of NAFLD from an individualised, web‐based exercise program

The effect of exercise training on intrahepatic triglyceride and hepatic insulin sensitivity: a systematic review and meta‐analysis

Exercising the hepatobiliary‐gut axis. The impact of physical activity performance

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