Abstract
Nonalcoholic fatty liver disease is likely to be associated with increased circulating branched-chain amino acids. We investigated the relationship between changes in branched-chain amino acids levels in the serum and improvement in liver fat content caused by exercise intervention in individuals with nonalcoholic fatty liver disease. The exploratory study included 208 central obesity and nonalcoholic fatty liver disease individuals from an exercise intervention randomized clinical trial for nonalcoholic fatty liver disease. The participants were randomly assigned to control, moderate, and vigorous-moderate exercise groups for 12 months. Changes in total branched-chain amino acids, leucine, isoleucine, and valine levels from baseline to 6 months were calculated. Liver fat content was determined by proton magnetic resonance spectroscopy. Reductions in circulating levels of total branched-chain amino acids, leucine, and valine levels from baseline to 6 months were significantly associated with the improvement of liver fat content at 6 months and 12 months (p < 0.01 for all) after adjustments for age, sex, total energy intake, protein intake, intervention groups, HOMA-IR, BMI, liver fat content, total branched-chain amino acids, leucine, and valine at baseline, respectively. These associations were still significant after further adjustments for changes in HOMA-IR and BMI from baseline to 6 months (p < 0.05 for all). Our findings indicated that reductions in circulating branched-chain amino acids levels were associated with an improvement in liver fat content by exercise intervention among patients with nonalcoholic fatty liver disease, which was independent of changes in BMI or HOMA-IR.
Highlights
Nonalcoholic fatty liver disease (NAFLD) has rapidly become a global pandemic d isease[1], which is related to obesity, type 2 diabetes, and cardiovascular d isease[2,3,4]
We did not find significant interactions between intervention groups and changes in serum total BCAAs, isoleucine, leucine, and valine levels on change in liver fatcontent (Table 8). In this long-term exercise intervention trial, we found that reductions in circulating levels of total BCAAs, isoleucine, leucine, and valine from baseline to 6 months were associated with an improvement of liver fat content at 6 months and 12 months, independent of changes in Body mass index (BMI) and Homeostatic model assessment of insulin resistance (HOMA-IR)
To the best of our knowledge, the present study is the first to investigate the association between changes in BCAAs levels and improvement in liver fat content in response to exercise interventions in NAFLD
Summary
Nonalcoholic fatty liver disease (NAFLD) has rapidly become a global pandemic d isease[1], which is related to obesity, type 2 diabetes, and cardiovascular d isease[2,3,4]. Accumulating evidence has demonstrated the increased circulating levels of branched-chain amino acids (total BCAAs, leucine, isoleucine, and valine) in NAFLD and nonalcoholic steatohepatitis (NASH)[5,6,7]. The levels of BCAAs have been shown to be associated with the lipid droplets heterogeneity of hepatocytes around zone 3 in patients with NAFLD/NASH. To the best of our knowledge, there is still a lack of comprehensive study analyzing the association between change in BCAAs levels and improvement in liver fat content caused by exercise interventions in NAFLD population. In the present study, we determined the changes in BCAAs levels and further analyzed its association with improvement in liver fat content among NAFLD from the effects of Moderate and Vigorous Exercise on Nonalcoholic Fatty Liver Disease, a1-year randomized trial[11]
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