title: Long-term effects of aerobic plus resistance training on the adipokines and neuropeptides in nonalcoholic fatty liver disease obese adolescents.
abstract: OBJECTIVE
  To compare the effects of aerobic training (AT) with aerobic plus resistance training (AT+RT) in nonalcoholic fatty liver disease (NAFLD) obese adolescents.
  
  
  METHODS
  Long-term interdisciplinary weight-loss therapy (1 year of clinical, nutritional, psychological, and exercise-related intervention).
  
  
  METHODS
  Fifty-eight postpubertal obese adolescents were randomized to AT or AT+RT according to NAFLD diagnosis. Adipokine and neuropeptide concentrations were measured by enzyme-linked immunosorbent assay, visceral fat by ultrasound, and body composition by plethysmography.
  
  
  RESULTS
  The NAFLD group that followed the AT+RT protocol presented lower insulin, homeostasis model assessment-insulin resistance (HOMA-IR), and alanine transaminase (ALT) values after intervention compared with AT. It was verified that there was a higher magnitude of change in the subcutaneous fat, glycemia, total cholesterol (TC), low-density lipoprotein-cholesterol, ALT, and adiponectin in response to AT+RT than in the control group (AT). All patients who underwent the AT+RT exhibited significantly higher adiponectin, leptin, and Δadiponectin and lower melanin-concentrating hormone (MCH) concentrations after therapy compared with the AT group. In the simple linear regression analysis, changes in glycemia, insulin, and HOMA-IR were independent predictors of significant improvement in adiponectin concentration. Indeed, ΔAST (aspartate transaminase) and ΔGGT (γ-glutamyl transpeptidase) were independent predictors of ΔALT, while Δfat mass and ΔAgRP (agouti-related protein) were independent predictors of ΔMCH. Although the number of patients was limited, we showed for the first time the positive effects of AT+RT protocol in a long-term interdisciplinary therapy to improve inflammatory biomarkers and to reduce orexigenic neuropeptide concentrations in NAFLD obese adolescents.
  
  
  CONCLUSIONS
  The long-term interdisciplinary therapy with AT+RT protocol was more effective in significantly improving noninvasive biomarkers of NAFLD that are associated with the highest risk of disease progression in the pediatric population.
authors.affiliation: Post Graduate Program of Nutrition, Federal University of São Paulo, Paulista Medicine School, UNIFESP-EPM, São Paulo, Brazil.
authors.forename: Aline
authors.initials: A
authors.lastname: de Piano
authors.forename: Marco T
authors.initials: MT
authors.lastname: de Mello
authors.forename: Priscila de L
authors.initials: Pde L
authors.lastname: Sanches
authors.forename: Patrícia L
authors.initials: PL
authors.lastname: da Silva
authors.forename: Raquel M S
authors.initials: RM
authors.lastname: Campos
authors.forename: June
authors.initials: J
authors.lastname: Carnier
authors.forename: Flavia
authors.initials: F
authors.lastname: Corgosinho
authors.forename: Denis
authors.initials: D
authors.lastname: Foschini
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Masquio
authors.forename: Lian
authors.initials: L
authors.lastname: Tock
authors.forename: Lila M
authors.initials: LM
authors.lastname: Oyama
authors.forename: Claudia Maria da Penha Oller
authors.initials: CM
authors.lastname: do Nascimento
authors.forename: Sérgio
authors.initials: S
authors.lastname: Tufik
authors.forename: Ana R
authors.initials: AR
authors.lastname: Dâmaso
mesh_terms: D054392:Adipokines / Q000097:blood*; D052242:Adiponectin / Q000097:blood; D050154:Adiposity; D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D001938:Brazil; D004797:Enzyme-Linked Immunosorbent Assay; D015444:Exercise; D005234:Fatty Liver / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D007028:Hypothalamic Hormones / Q000097:blood; D018836:Inflammation Mediators / Q000097:blood; D007328:Insulin / Q000097:blood; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging / Q000503:physiopathology; D020738:Leptin / Q000097:blood; D016014:Linear Models; D008055:Lipids / Q000097:blood; D008297:Male; D008543:Melanins / Q000097:blood; D009479:Neuropeptides / Q000097:blood*; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D010907:Pituitary Hormones / Q000097:blood; D010991:Plethysmography; D055070:Resistance Training; D013997:Time Factors; D016896:Treatment Outcome; D014463:Ultrasonography; D015431:Weight Loss; D055815:Young Adult
chemical_list: C499918:ADIPOQ protein, human; D054392:Adipokines; D052242:Adiponectin; D015415:Biomarkers; D001786:Blood Glucose; D007028:Hypothalamic Hormones; D018836:Inflammation Mediators; D007328:Insulin; D020738:Leptin; D008055:Lipids; D008543:Melanins; D009479:Neuropeptides; D010907:Pituitary Hormones; C019463:melanin-concentrating hormone