title: Significance of exercise in nonalcoholic fatty liver disease in men: a community-based large cross-sectional study.
abstract: BACKGROUND
  Nonalcoholic fatty liver disease (NAFLD) is a risk factor for diabetes and cardiovascular disease that could progress to nonalcoholic steatohepatitis, cirrhosis, and liver failure. We aimed to assess the relationship between NAFLD and lifestyle habits.
  
  
  METHODS
  Using a community-based, cross-sectional design, the records of 11,094 Japanese subjects who had undergone at least 1 annual health checkup were reviewed.
  
  
  RESULTS
  Of the 6,370 subjects who qualified for enrolment, 1,346 met the diagnostic criteria for NAFLD. The prevalence rate (PR) of NAFLD increased significantly to 36.6, 41.5, and 41.1 % with no snacking, snacking less than once/day, and snacking ≥2 times/day, respectively, in men (P = 0.0495) and to 10.8, 11.7, and 15.3 %, respectively, in women (P = 0.002). In men, the NAFLD PR decreased significantly to 48.8, 36.9, and 29.9 % with no exercise, exercise consciousness, and periodical exercise, respectively (P < 0.001). In women, the NAFLD PR decreased significantly to 19.3, 13.5, 11, and 8 % with sleep durations of ≤4, 5-6, 7-8, and ≥9 h, respectively (P = 0.003). Periodical exercise was identified as an independent factor associated with NAFLD in men (odds ratio 0.707, 95 % confidence interval 0.546-0.914; P = 0.008).
  
  
  CONCLUSIONS
  Performing regular exercise was associated with a reduced risk for NAFLD in men. Men with a high risk for NAFLD can be identified using questionnaires on exercise in an outpatient setting. Disease progression and further complications may be prevented by educating high-risk NAFLD patients about the importance of exercise.
authors.affiliation: Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
authors.forename: Teruki
authors.initials: T
authors.lastname: Miyake
authors.forename: Teru
authors.initials: T
authors.lastname: Kumagi
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirooka
authors.forename: Shinya
authors.initials: S
authors.lastname: Furukawa
authors.forename: Keitarou
authors.initials: K
authors.lastname: Kawasaki
authors.forename: Mitsuhito
authors.initials: M
authors.lastname: Koizumi
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Todo
authors.forename: Shin
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nunoi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tokumoto
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Masanori
authors.initials: M
authors.lastname: Abe
authors.forename: Kohichiro
authors.initials: K
authors.lastname: Kitai
authors.forename: Bunzo
authors.initials: B
authors.lastname: Matsuura
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hiasa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008019:Life Style; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D012890:Sleep; D055815:Young Adult
references.citation: J Gastroenterol. 2012 Jun;47(6):696-703
references.pmid: 22331365
references.citation: Biomed Environ Sci. 2012 Aug;25(4):383-91
references.pmid: 23026517
references.citation: J Gastroenterol Hepatol. 2013 Dec;28 Suppl 4:71-8
references.pmid: 24251708
references.citation: N Engl J Med. 2002 Apr 18;346(16):1221-31
references.pmid: 11961152
references.citation: Hepatology. 2004 Dec;40(6):1387-95
references.pmid: 15565570
references.citation: PLoS One. 2012;7(10):e46819
references.pmid: 23110056
references.citation: Hepatology. 2007 Aug;46(2):582-9
references.pmid: 17661414
references.citation: Hepatology. 2008 Dec;48(6):1791-8
references.pmid: 18972405
references.citation: J Hepatol. 2005 Sep;43(3):508-14
references.pmid: 16006003
references.citation: Hepatology. 2003 Apr;37(4):917-23
references.pmid: 12668987
references.citation: Intern Med. 2009;48(10):739-46
references.pmid: 19443967
references.citation: Gynecol Endocrinol. 2014 May;30(5):325-9
references.pmid: 24460502
references.citation: Diabetol Metab Syndr. 2013 May 27;5(1):26
references.pmid: 23711224
references.citation: J Hepatol. 2013 Aug;59(2):351-7
references.pmid: 23578884
references.citation: J Gastroenterol. 2003;38(10):954-61
references.pmid: 14614602
references.citation: Public Health Nutr. 2001 Apr;4(2B):499-515
references.pmid: 11683545
references.citation: J Gastroenterol. 2013 Apr;48(4):550-1
references.pmid: 23361473
references.citation: Nat Genet. 2008 Dec;40(12):1461-5
references.pmid: 18820647
references.citation: Curr Opin Pharmacol. 2012 Jun;12(3):363-71
references.pmid: 22398320
references.citation: J Hepatol. 2007 Nov;47(5):711-7
references.pmid: 17850914
references.citation: Ann Intern Med. 2000 Jan 18;132(2):112-7
references.pmid: 10644271
references.citation: Nutr Rev. 2004 Jul;62(7 Pt 2):S82-97
references.pmid: 15387473
references.citation: Am J Clin Nutr. 1982 Nov;36(5):936-42
references.pmid: 7137077
references.citation: J Clin Gastroenterol. 2007 Jul;41(6):624-9
references.pmid: 17577120
references.citation: J Gastroenterol. 2013 Mar;48(3):413-22
references.pmid: 22933183
references.citation: Hepatology. 2013 Oct;58(4):1287-95
references.pmid: 23504926
references.citation: J Hepatol. 2002 Jul;37(1):154-60
references.pmid: 12076877
references.citation: Eur J Gastroenterol Hepatol. 2003 May;15(5):539-43
references.pmid: 12702913