Yvonne Huber1, Daniel Pfirrmann2, Ines Gebhardt1, Christian Labenz1, Nadine Gehrke1, Beate K Straub3, Christian Ruckes4, Heike Bantel5, Eugenio Belda6, Karine Clément7, Diana J Leeming8, Morten A Karsdal8, Peter R Galle1, Perikles Simon2, Jörn M Schattenberg1. 1. Department of Internal Medicine I, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany. 2. Department of Sports Medicine, Rehabilitation and Prevention, Johannes Gutenberg-University Mainz, Mainz, Germany. 3. Institute of Pathology, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany. 4. Interdisciplinary Centre for Clinical Trials (IZKS), University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany. 5. Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany. 6. Integromics team, Institute of cardiometabolism and Nutrition, Paris, France. 7. Nutrition Department, Pitié-Salpêtrière Hospital, Assistance Publique Hôpitaux de Paris, Sorbonne Université, INSERM, NutriOmics Research Team, Paris, France. 8. Nordic Bioscience Biomarkers and Research A/S, Herlev, Denmark.
Abstract
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.
RCT Entities:
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.
Authors: Wolf Peter Hofmann; Peter Buggisch; Lisa Schubert; Nektarios Dikopoulos; Jeannette Schwenzer; Marion Muche; Gisela Felten; Renate Heyne; Patrick Ingiliz; Anna Schmidt; Kerstin Stein; Heiner Wedemeyer; Thomas Berg; Johannes Wiegand; Frank Lammert; Stefan Zeuzem; Jörn M Schattenberg Journal: JHEP Rep Date: 2020-08-04
Authors: Yasser Fouad; Melissa Palmer; Minjun Chen; Arie Regev; Rajarshi Banerjee; Rob Myers; Robert Riccio; Richard Torstenson; Ramy Younes; Puneet S Arora; Henrik Landgren; Morten A Karsdal; Martin Blake; David A Shapiro; Hans-Juergen Gruss; Muhammad Y Sheikh; Dina Attia; Steven Bollipo; Alastair D Smith; Bradley Freilich; Robert G Gish; Detlef Schuppan Journal: J Clin Transl Hepatol Date: 2021-10-22
Authors: Christian Labenz; Jürgen H Prochaska; Yvonne Huber; Michael Nagel; Beate K Straub; Philipp Wild; Peter R Galle; Jörn M Schattenberg Journal: Hepatol Commun Date: 2019-09-30