title: Short-term aerobic exercise training improves gut peptide regulation in nonalcoholic fatty liver disease.
abstract: Obesity-related nonalcoholic fatty liver disease (NAFLD) is now the most common chronic liver disease. Exercise and diet are uniformly prescribed treatments for NAFLD; however, there are limited empirical data on the effects of exercise training on metabolic function in these patients. The purpose of this study was to investigate the fasting and glucose-stimulated adaptation of gut peptides to short-term aerobic exercise training in patients with NAFLD. Twenty-two obese subjects, 16 with NAFLD [body mass index (BMI), 33.2 ± 1.1 (SE) kg/m(2)] and 6 obese controls (BMI, 31.3 ± 1.2 kg/m(2)), were enrolled in a supervised aerobic exercise program (60 min/day, 85% of their heart rate maximum, for 7 days). Fasting and glucose-stimulated glucagon-like peptide-1 (GLP-17-36) and peptide tyrosine tyrosine (PYYTotal) concentrations in plasma were assessed before and after the exercise program. Initially, the NAFLD group had higher fasting PYY (NAFLD = 117 ± 18.6, control = 47.2 ± 6.4 pg/ml, P < 0.05) and GLP-1 (NAFLD = 12.4 ± 2.2, control = 6.2 ± 0.2 pg/ml, P < 0.05) and did not significantly increase GLP-1 or PYY in response to glucose ingestion. After the exercise program, fasting GLP-1 was reduced in the NAFLD group (10.7 ± 2.0 pg/ml, P < 0.05). Furthermore, exercise training led to significant increase in the acute (0-30 min) PYY and GLP-1 responses to glucose in the NAFLD group, while the total area under the glucose-stimulated GLP-1 response curve was reduced in both NAFLD and controls (P < 0.05). In summary, 7 days of vigorous aerobic exercise normalized the dynamic PYY and GLP-1 responses to nutrient stimulation and reduced the GLP-1 response in NAFLD, suggesting that exercise positively modulates gut hormone regulation in obese adults with NAFLD.
authors.affiliation: Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio;
authors.forename: Emily L
authors.initials: EL
authors.lastname: Kullman
authors.affiliation: Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio;
authors.forename: Karen R
authors.initials: KR
authors.lastname: Kelly
authors.affiliation: Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio;
authors.forename: Jacob M
authors.initials: JM
authors.lastname: Haus
authors.affiliation: Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio;
authors.forename: Ciaran E
authors.initials: CE
authors.lastname: Fealy
authors.affiliation: Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio;
authors.forename: Amanda R
authors.initials: AR
authors.lastname: Scelsi
authors.affiliation: Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio;
authors.forename: Mangesh R
authors.initials: MR
authors.lastname: Pagadala
authors.affiliation: Department of Radiology and Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio; and.
authors.forename: Chris A
authors.initials: CA
authors.lastname: Flask
authors.affiliation: Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio;
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: McCullough
authors.affiliation: Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio; Department of Gastroenterology and Hepatology, Digestive Disease Institute, Cleveland Clinic, Cleveland, Ohio; Metabolic Translational Research Center, Endocrinology & Metabolism Institute, Cleveland Clinic, Cleveland, Ohio kirwanj@ccf.org.
authors.forename: John P
authors.initials: JP
authors.lastname: Kirwan
mesh_terms: D001786:Blood Glucose / Q000378:metabolism / Q000502:physiology; D015444:Exercise / Q000502:physiology*; D005215:Fasting / Q000378:metabolism / Q000502:physiology; D005260:Female; D041981:Gastrointestinal Tract / Q000378:metabolism*; D052216:Glucagon-Like Peptide 1 / Q000378:metabolism; D005947:Glucose / Q000378:metabolism; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000378:metabolism* / Q000503:physiopathology*; D009765:Obesity / Q000378:metabolism / Q000503:physiopathology; D019894:Peptide YY / Q000378:metabolism*
chemical_list: D001786:Blood Glucose; D019894:Peptide YY; D052216:Glucagon-Like Peptide 1; D005947:Glucose
keywords: fatty liver disease; insulin resistance; nonalcoholic steatohepatitis; obesity; physical activity