Abstract
BackgroundNon-alcoholic fatty liver disease (NAFLD) is currently the most common cause of chronic liver disease nowadays. Changes in diet and lifestyle have led to a dramatic increase in the prevalence of NAFLD around the world. This meta-analysis is to investigate the efficacy of physical activity intervention on liver-specific endpoints in the population with NAFLD, including hepatic enzyme, serum lipid, glucose metabolism and intra-hepatic lipid.MethodsPubMed and China National Knowledge Infrastructure (CNKI) databases were searched for randomized clinical trials of physical activity intervention on NAFLD patients through April 20th, 2019. Effect sizes were reported as standardized mean difference (SMD) and 95% confidence intervals (CI). Quality of included studies was assessed according to the Cochrane risk of bias tool. Meta-analyses were conducted using random-effect or fixed-effect models depending on the significance of heterogeneity. Subgroup analyses according to types and duration of physical activity were conducted to investigate clinical variability.ResultsNine studies with a cumulative total of 951 participants met selection criteria. Physical activity was found associated with small reductions in hepatic enzyme parameters: ALT (SMD -0.17, 95% CI:-0.30 to − 0.05), AST (SMD -0.25, 95% CI: − 0.38, − 0.13) and GGT (SMD -0.22, 95% CI: − 0.36, − 0.08). Significant small improvements were also found in serum lipid parameters including TC (SMD = − 0.22, 95% CI: − 0.34, − 0.09), TG (SMD = − 0.18, 95% CI: − 0.31 to − 0.06) and LDL-C (SMD = − 0.26, 95% CI: − 0.39 to − 0.13). Significant improvement was also found in intra-hepatic lipid content (SMD = − 0.21, 95% CI: − 0.36 to − 0.06) There was no difference between physical intervention group and control group in HDL and three glucose metabolism parameters. Subgroup analysis suggested both aerobic exercise alone and resistance exercise alone can improve most liver function and longer period of exercise generally had better improvement effect.ConclusionsOur findings suggest that physical activity alone can only slightly improve hepatic enzyme levels, most serum lipid levels and intra-hepatic lipid content in non-diabetic patients with NAFLD.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is currently the most common cause of chronic liver disease nowadays
Our findings suggest that physical activity alone can only slightly improve hepatic enzyme levels, most serum lipid levels and intra-hepatic lipid content in non-diabetic patients with NAFLD
Studies were included if they fulfilled the following inclusion criteria: (1) prospective randomized controlled trials; (2) population of any age or sex or ethnic origin with NAFLD diagnosed based on the standard guidelines using noninvasive or invasive approaches; (3) intervention involving any type of physical activity with any intensity level or duration; (4) comparison with placebo or usual care without physical activity; (5) outcomes of interest were improvements in hepatic enzyme level, serum lipid level, glucose metabolism and intra-hepatic lipids content
Summary
Non-alcoholic fatty liver disease (NAFLD) is currently the most common cause of chronic liver disease nowadays. Changes in diet and lifestyle have led to a dramatic increase in the prevalence of NAFLD around the world. This meta-analysis is to investigate the efficacy of physical activity intervention on liver-specific endpoints in the population with NAFLD, including hepatic enzyme, serum lipid, glucose metabolism and intra-hepatic lipid. Dramatic changes in the lifestyle and diet of the global population are causing the prevalence of NAFLD increasing rapidly, in parallel with that of obesity and diabetes [1]. Our objective was to conduct a meta-analysis of the pooled data from published randomized controlled trails (RCTs) to evaluate the effectiveness of physical activity intervention on hepatic enzyme, serum lipid metabolism, glucose metabolism and intra-hepatic lipids content in non-diabetic patients with NAFLD [11], which will provide substantial evidence on whether physical activity intervention has a favorable effect for treating NAFLD
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