title: Regular exercise is associated with a reduction in the risk of NAFLD and decreased liver enzymes in individuals with NAFLD independent of obesity in Korean adults.
abstract: BACKGROUND
  We evaluated the association of regular physical exercise with the presence of non-alcoholic fatty liver disease (NAFLD) and liver enzymes in relation to obesity and insulin resistance.
  
  
  RESULTS
  A cross-sectional analysis was conducted in 72,359 healthy Korean adults without diabetes who participated in a comprehensive health check-up. Subjects who have been exercising regularly (more than 3 times per week, at least for 30 minutes each time and for consecutive 3 month) were categorized into exercise group. All subjects were categorized into deciles based on their body mass index (BMI) and we estimated the odds ratios (ORs) for having NAFLD according to exercise regularity in each decile. The diagnosis of NAFLD was based on ultrasonography findings. Individuals with NAFLD (n = 19,921) were analyzed separately to evaluate ORs for having elevated liver enzymes based on regularity of exercise. The risk for NAFLD was significantly reduced in exercise group with age- and sex-adjusted ORs of 0.53-0.72 for all BMI deciles except at BMI categories of <19.6 and 20.7-21.6 kg/m(2). While no difference was seen in BMI between subjects in exercise and non-exercise group across the BMI deciles, the values of body fat percentage and metabolic risk factors differed. Among NAFLD patients, subjects in exercise group had a lower risk for having elevated liver enzymes with multivariable adjusted OR of 0.85 (95% CI 0.74-0.99, for AST) and 0.74 (95% CI 0.67-0.81, for ALT) than did subjects in non-exercise group.
  
  
  CONCLUSIONS
  Regular exercise was associated with a reduced risk for having NAFLD and decreased liver enzymes in patients with NAFLD, and this relationship was also independent of obesity.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Cheol
authors.initials: JC
authors.lastname: Bae
authors.forename: Sunghwan
authors.initials: S
authors.lastname: Suh
authors.forename: Se Eun
authors.initials: SE
authors.lastname: Park
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Rhee
authors.forename: Cheol Young
authors.initials: CY
authors.lastname: Park
authors.forename: Ki Won
authors.initials: KW
authors.lastname: Oh
authors.forename: Sung Woo
authors.initials: SW
authors.lastname: Park
authors.forename: Sun Woo
authors.initials: SW
authors.lastname: Kim
authors.forename: Kyu Yeon
authors.initials: KY
authors.lastname: Hur
authors.forename: Jae Hyeon
authors.initials: JH
authors.lastname: Kim
authors.forename: Myung-Shik
authors.initials: MS
authors.lastname: Lee
authors.forename: Moon Kyu
authors.initials: MK
authors.lastname: Lee
authors.forename: Kwang-Won
authors.initials: KW
authors.lastname: Kim
authors.forename: Won-Young
authors.initials: WY
authors.lastname: Lee
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology*; D005234:Fatty Liver / Q000097:blood / Q000201:enzymology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008099:Liver / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease; D009765:Obesity / Q000097:blood / Q000201:enzymology* / Q000503:physiopathology*
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase