Stefano Balducci1, Patrizia Cardelli2, Luca Pugliese3, Valeria D'Errico1, Jonida Haxhi4, Elena Alessi5, Carla Iacobini6, Stefano Menini6, Lucilla Bollanti7, Francesco G Conti7, Antonio Nicolucci8, Giuseppe Pugliese9. 1. Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy; Diabetes Unit, Sant'Andrea Hospital, Rome, Italy; Metabolic Fitness Association, Monterotondo, Rome, Italy. 2. Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy; Laboratory of Clinical Chemistry, Sant'Andrea Hospital, Rome, Italy. 3. Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy; Radiology Unit, Sant'Andrea Hospital, Rome, Italy. 4. Metabolic Fitness Association, Monterotondo, Rome, Italy; Department of Human Movement and Sport Sciences, "Foro Italico" University, Rome, Italy. 5. Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy; Metabolic Fitness Association, Monterotondo, Rome, Italy. 6. Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy. 7. Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy; Diabetes Unit, Sant'Andrea Hospital, Rome, Italy. 8. Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro, Chieti, Italy. 9. Department of Clinical and Molecular Medicine, "La Sapienza" University, Rome, Italy. Electronic address: giuseppe.pugliese@uniroma1.it.
Abstract
AIMS: This study evaluated the effect of supervised exercise training on liver enzymes and two surrogate measures of non-alcoholic fatty liver disease (NAFLD) in subjects with type 2 diabetes. METHODS:Sedentary patients from 22 outpatient diabetes clinics were randomized by center, age and treatment to twice-a-week supervised aerobic and resistance training plus structured exercise counseling (exercise group, EXE; n=303) versus counseling alone (control group, CON; n=303) for 12 months. EXE participants were further randomized to low-to-moderate (n=142) or moderate-to-high (n=161) intensity training of equal energy cost. Baseline and end-of-study levels of liver enzymes, fatty liver index (FLI) and visceral adiposity index (VAI) were obtained. RESULTS:Enzyme levels did not change, whereas FLI and VAI decreased significantly in EXE, but not CON participants. Physical activity (PA) volume was an independent predictor of both FLI and VAI reductions, the extent of which increased from the 1st to the 4th quintile of PA volume and baseline to end-of-study changes in fitness parameters. Differences in the effect of LI versus HI training were negligible. CONCLUSIONS: Data from this large cohort of subjects with type 2 diabetes indicate that FLI and VAI decrease with supervised training in a volume-dependent manner.
RCT Entities:
AIMS: This study evaluated the effect of supervised exercise training on liver enzymes and two surrogate measures of non-alcoholic fatty liver disease (NAFLD) in subjects with type 2 diabetes. METHODS: Sedentary patients from 22 outpatientdiabetes clinics were randomized by center, age and treatment to twice-a-week supervised aerobic and resistance training plus structured exercise counseling (exercise group, EXE; n=303) versus counseling alone (control group, CON; n=303) for 12 months. EXE participants were further randomized to low-to-moderate (n=142) or moderate-to-high (n=161) intensity training of equal energy cost. Baseline and end-of-study levels of liver enzymes, fatty liver index (FLI) and visceral adiposity index (VAI) were obtained. RESULTS: Enzyme levels did not change, whereas FLI and VAI decreased significantly in EXE, but not CON participants. Physical activity (PA) volume was an independent predictor of both FLI and VAI reductions, the extent of which increased from the 1st to the 4th quintile of PA volume and baseline to end-of-study changes in fitness parameters. Differences in the effect of LI versus HI training were negligible. CONCLUSIONS: Data from this large cohort of subjects with type 2 diabetes indicate that FLI and VAI decrease with supervised training in a volume-dependent manner.
Authors: Timothy M Moore; Anthony Terrazas; Alexander R Strumwasser; Amanda J Lin; Xiaopeng Zhu; Akshay T S Anand; Christina Q Nguyen; Linsey Stiles; Frode Norheim; Jennifer M Lang; Simon T Hui; Lorraine P Turcotte; Zhenqi Zhou Journal: Physiol Rep Date: 2021-11