Joanna Słomko1, Marta Zalewska2, Wojciech Niemiro3,4, Sławomir Kujawski1, Maciej Słupski5, Beata Januszko-Giergielewicz5, Monika Zawadka-Kunikowska1, Julia Newton6, Lynette Hodges7, Jacek Kubica8, Paweł Zalewski1. 1. Department of Hygiene, Epidemiology, Ergonomy and Postgraduate Education, Ludwik Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland. 2. Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, 02-091 Warsaw, Poland. 3. Faculty of Mathematics, Informatics and Mechanics University of Warsaw, 02-097 Warsaw, Poland. 4. Faculty of Mathematics and Computer Science Nicolaus Copernicus University, 87-100 Torun, Poland. 5. Department of Hepatobiliary and General Surgery, Faculty of Medicine Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 85-094 Bydgoszcz, Poland. 6. Population Health Sciences Institute, The Medical School, Newcastle University, Newcastle-upon-Tyne NE2 4AX, UK. 7. School of Sport, Exercise and Nutrition, Massey University, Palmerston North 4442, New Zealand. 8. Department of Cardiology and Internal Medicine, Nicolaus Copernicus University Collegium Medicum, 85-094 Bydgoszcz, Poland.
Abstract
BACKGROUND: This meta-analysis evaluates the overall effect of the non-pharmacological intervention, aerobic exercise, upon serum liver enzymes levels, glucose metabolism and anthropometric measures amongst patients with metabolic associated fatty liver disease (MAFLD). It also examines whether the effects on these outcomes are moderated by the aerobic training protocol when considered according to the American College of Sports Medicine (ACSM) recommended FITT (frequency, intensity, time, type) principles. Approach and Results: Fifteen randomized control trials were included in the meta-analysis. Compared with usual care, continuous and interval training showed significant efficacy in alanine aminotransferase (ALT) level improvement (MD = -2.4, 95% CI: -4.34 to -0.46 p = 0.015, I2 = 9.1%). Interventions based on all types of aerobic exercise protocols showed significant improvement of intrahepatic triglycerides (MD = -4.0557, 95% CI: -5.3711 to -2.7403, p < 0.0001, I2 = 0%) and BMI (MD = -0.9774, 95% CI: -1.4086 to -0.5462, p < 0.0001, I2 = 0). Meta-regression analysis demonstrated a significant correlation between total intervention time and ALT level (for all aerobic protocols: 6.0056, se = 2.6896, z = 2.2329, p = 0.02; as well as for continuous and interval aerobic protocols: 5.5069, se = 2.7315, z = 2.016, p = 0.04). CONCLUSIONS: All types of aerobic exercise protocols are effective at improving intrahepatic triglycerides and lead to a reduction in body mass index. In addition, continuous and interval aerobic exercise may be more effective at improving ALT ≤12 weeks intervention time benefits the management of MAFLD.
BACKGROUND: This meta-analysis evaluates the overall effect of the non-pharmacological intervention, aerobic exercise, upon serum liver enzymes levels, glucose metabolism and anthropometric measures amongst patients with metabolic associated fatty liver disease (MAFLD). It also examines whether the effects on these outcomes are moderated by the aerobic training protocol when considered according to the American College of Sports Medicine (ACSM) recommended FITT (frequency, intensity, time, type) principles. Approach and Results: Fifteen randomized control trials were included in the meta-analysis. Compared with usual care, continuous and interval training showed significant efficacy in alanine aminotransferase (ALT) level improvement (MD = -2.4, 95% CI: -4.34 to -0.46 p = 0.015, I2 = 9.1%). Interventions based on all types of aerobic exercise protocols showed significant improvement of intrahepatic triglycerides (MD = -4.0557, 95% CI: -5.3711 to -2.7403, p < 0.0001, I2 = 0%) and BMI (MD = -0.9774, 95% CI: -1.4086 to -0.5462, p < 0.0001, I2 = 0). Meta-regression analysis demonstrated a significant correlation between total intervention time and ALT level (for all aerobic protocols: 6.0056, se = 2.6896, z = 2.2329, p = 0.02; as well as for continuous and interval aerobic protocols: 5.5069, se = 2.7315, z = 2.016, p = 0.04). CONCLUSIONS: All types of aerobic exercise protocols are effective at improving intrahepatic triglycerides and lead to a reduction in body mass index. In addition, continuous and interval aerobic exercise may be more effective at improving ALT ≤12 weeks intervention time benefits the management of MAFLD.
Authors: Francesco Giallauria; Teresa Strisciuglio; Gianluigi Cuomo; Anna Di Lorenzo; Andrea D'Angelo; Mario Volpicelli; Raffaele Izzo; Maria Virginia Manzi; Emanuele Barbato; Carmine Morisco Journal: High Blood Press Cardiovasc Prev Date: 2021-11-01