Abstract
Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in industrialized countries. The increasing prevalence of NAFLD mirrors the outbreak of obesity in western countries, highlighting the connection between these two conditions. Nevertheless, there is currently no specific pharmacotherapy for its treatment. Accepted management begins with weight loss and exercise. Moreover, exercise can provide metabolic benefits independently of weight loss. It is known how long-term aerobic training produces improvements in hepatic triglycerides, visceral adipose tissue and free fatty acids, even if there is no weight reduction. A recent study from Boström et al. unravels a potential molecular mechanism that may explain how exercise, independently of weight loss, can potentially improve metabolic parameters through a new messenger system (irisin) linking muscle and fat tissue. Irisin has been proposed to act as a hormone on subcutaneous white fat cells increasing energy expenditure by means of a program of brown-fat-like development. Moreover, it was also shown that irisin plasma concentration was higher in people who exercise, suggesting a molecular mechanism by which exercise may improve metabolism. The present systematic review is based on the possibility that irisin might represent a hypothetical connection between NAFLD pathogenesis and disease progression.
Highlights
The benefits of a balanced diet combined with exercise have been well documented, and they constitute the basis of the non-pharmacological treatment of cardiovascular and metabolic diseases [1].In addition to improving resistance [2] and strength [3], physical exercise increases caloric expenditure, leading to a decrease in adipose tissue mass, and exerting important beneficial effects in the prevention of chronic diseases such as obesity and type 2 diabetes mellitus (T2DM) [4]
We aim to examine the current knowledge about irisin, a myokine that might represent a link between regular therapy and the clinical benefits in patients with non-alcoholic fatty liver disease (NAFLD)
These findings suggest a potential role of irisin as a neurotransmitter, suggesting that the brain can effect some modulation on adipose tissue [44,45]
Summary
The benefits of a balanced diet combined with exercise have been well documented, and they constitute the basis of the non-pharmacological treatment of cardiovascular and metabolic diseases [1]. In addition to improving resistance [2] and strength [3], physical exercise increases caloric expenditure, leading to a decrease in adipose tissue mass, and exerting important beneficial effects in the prevention of chronic diseases such as obesity and type 2 diabetes mellitus (T2DM) [4]. Being the later similar to white adipocytes, with a very low basal UCP1 expression, but able to respond, to brown adipocytes, to cAMP-dependent increase in UCP1 expression and mitochondrial activity These beige adipocytes have a specific gene expression pattern—that enables distinguishing from white and brown adipocytes—that is controlled by physical exercise, and may cause a decrease in body weight and an improvement of glucose metabolism [16,17,18]. Irisin has emerged as a potential therapeutic target in metabolic diseases including non-alcoholic fatty liver disease (NAFLD), in which insulin resistance plays a major pathogenic role
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