High-intensity circuit weight training versus aerobic training in patients with nonalcoholic fatty liver disease

Abstract

Background Nonalcoholic fatty liver disease (NAFLD) has become one of the most common causes of liver disease worldwide and has been recognized as a major health burden. To date, no evidence-based therapy has proven to be effective for NAFLD, except for exercise and dietary interventions. The unsuitability of weight-oriented aerobic training for obese people with NAFLD because of the difficulty in maintaining weight loss necessitates the development of alternative strategies such as resistance training. Objective The aim of the study was to evaluate the effect of high-intensity circuit weight training (CWT) compared with aerobic training in NAFLD patients. Materials and methods A randomized controlled trial enrolling 32 NAFLD patients of both sexes (15 men and 17 women) with ages ranging from 30 to 55 years without secondary liver disease (e.g. without hepatitis B virus, hepatitis C virus, or alcohol consumption) was conducted. Patients were randomly allocated either to CWT or to aerobic exercise training, three times weekly, for 3 months. Anthropometrics, lipid profile, liver enzymes, and liver steatosis were assessed. Steatosis was quantified with the hepatorenal-ultrasound index (HRI) representing the ratio between the brightness level of the liver and the right kidney. Results All baseline characteristics were similar for the two treatment groups with respect to demographics, anthropometrics, lipid profile, liver enzymes, and liver steatosis on imaging. HRI score was significantly reduced in the CWT group as compared with the aerobic exercise training group (−0.38 ± 0.37 vs. −0.17 ± 0.28, P = 0.017), representing an 18 versus 8.54% relative reduction from baseline in the two groups, respectively. CWT also improved body composition, most importantly waist circumference, which was positively correlated with the change in HRI ( r = 0.645 and P = 0.009). Conclusion This randomized controlled trial demonstrated a significant reduction in steatosis, as assessed by HRI, after 3 months of CWT accompanied by favorable anthropometric, lipid profile, and liver enzyme changes. CWT may serve as a complement to the treatment of NAFLD.