Association between Physical Activity and Non-Alcoholic Fatty Liver Disease in Adults with Metabolic Syndrome: The FLIPAN Study.

Catalina M Mascaró,Josep A Tur,Lucía Ugarriza,Cristina Gómez,Pere-Antoni Borràs,Cristina Bouzas,Sofia Montemayor,Miguel Casares,José Alfredo Martínez

doi:10.3390/nu14051063

Abstract

Background: A lifestyle with regular PA (physical activity) and Mediterranean diet has benefits on NAFLD (non-alcoholic fatty liver disease) and MetS (metabolic syndrome). Objectives: To assess the association between physical activity and NAFLD in adults with MetS. Design: Cross-sectional study in 155 participants (40–60 years old) from Balearic Islands and Navarra (Spain) with diagnosis of NAFLD and MetS, and BMI (body mass index) between 27 and 40 Kg/m2. Methods: PA level was categorized into two groups according to weekly METs (metabolic equivalents of tasks). PA was assessed using a validated Minnesota questionnaire and accelerometers. MetS parameters were assessed by blood collection analysis and NAFLD by abdominal MRI (magnetic resonance imaging). Results: Participants with high PA showed more energy expenditure and expended more calories than ingested (−143.9 Kcal/day; p < 0.001). PA was a risk factor for AST (aspartate aminotransferase) (adjusted OR: 7.26; 95% CI: 1.79–29.40) and a protective factor for ALT (alanine aminotransferase) (adjusted OR: 0.24; 95% CI: 0.12–0.48), GGT (gamma-glutamyl transferase) (adjusted OR: 0.52; 95% CI: 0.29–0.94) and IFC-NMR (intrahepatic fat content by nuclear magnetic resonance) (adjusted OR: 0.26; 95% CI: 0.12–0.56) when sociodemographic confounders were considered. Conclusions: NAFLD patients with high PA showed more positive relationship on MetS parameters and liver profile (ALT, GGT, IFC-NMR) than subjects with low PA, but not for AST. Difference between calories ingested and expended influenced this relationship.

Highlights

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease, with an overall prevalence higher than 25% [1]
The current study involves 155 participants aged 40–60 years, with NAFLD diagnosed by magnetic resonance imaging (MRI; Signa Explorer 1.5T, General Electric Healthcare, Chicago, IL, USA), with body mass index (BMI) 27–40 kg/m2, and meeting at least three metabolic syndrome (MetS) criteria as described by the International Diabetes Federation (IDF) [12]
The difference between ingested and expended calories was negative in the high physical activity (PA) group (−143.9 Kcal/day), confirming higher calorie expenditure than calorie intake

Summary

Introduction

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease, with an overall prevalence higher than 25% [1]. It is characterized by steatosis in 5% or more of the hepatocytes, without being caused by excessive alcohol consumption and/or druginduced steatosis [2] It can be influenced by different risk factors, including age, metabolic syndrome (MetS), insulin resistance, sociodemographic characteristics, diet, and physical activity (PA) [2,3]. The Mediterranean lifestyle includes the practice of regular PA In this way, it has been pointed out that an association between physical activity and risk of nonalcoholic fatty liver disease [8,9], and people with NAFLD showed low levels of PA [6]. A lifestyle with regular PA (physical activity) and Mediterranean diet has benefits on NAFLD (non-alcoholic fatty liver disease) and MetS (metabolic syndrome).

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