title: Exercise Reduces Liver Lipids and Visceral Adiposity in Patients With Nonalcoholic Steatohepatitis in a Randomized Controlled Trial.
abstract: Pharmacologic treatments for nonalcoholic steatohepatitis (NASH) are limited. Lifestyle interventions are believed to be effective in reducing features of NASH, although the effect of regular exercise, independent of dietary change, is unclear. We performed a randomized controlled trial to study the effect of exercise on hepatic triglyceride content (HTGC) and biomarkers of fibrosis in patients with NASH.
  
  
  
  Twenty-four patients (mean age, 52 ± 14 y; body mass index, 33 ± 6 kg/m2) with sedentary lifestyles (<60 min/wk of moderate-vigorous activity) and biopsy-proven NASH were assigned randomly to groups that exercised (n = 12) or continued standard care (controls, n = 12) for 12 weeks while maintaining their weight. The exercise (cycling and resistance training) was supervised at an accredited sports center and supervised by a certified exercise specialist and recorded 3 times per week on nonconsecutive days. We measured HTGC, body composition, circulating markers of inflammation, fibrosis, and glucose tolerance at baseline and at 12 weeks.
  
  
  
  Compared with baseline, exercise significantly reduced HTGC (reduction of 16% ± 24% vs an increase of 9% ± 15% for controls; P < .05), visceral fat (reduction of 22 ± 33 cm2vs an increase of 14 ± 48 cm2for controls; P < .05), plasma triglycerides (reduction of 0.5 ± 1.0 mmol/L vs an increase of 0.3 ± 0.4 mmol/L for controls; P < .05), and γ-glutamyltransferase (reduction of 10 ± 28 U/L-1vs a reduction of 17 ± 38 U/L-1for controls; P < .05). There were no effects of exercise on liver enzyme levels, metabolic parameters, circulatory markers of inflammation (levels of interleukin 6, tumor necrosis factor-α, or C-reactive protein) and fibrosis.
  
  
  
  In a randomized controlled trial, 12 weeks of exercise significantly reduced HTGC, visceral fat, and plasma triglyceride levels in patients with NASH, but did not affect circulating markers of inflammation or fibrosis. Exercise without weight loss therefore affects some but not all factors associated with NASH. Clinical care teams should consider exercise as part of a management strategy of NASH, but weight management strategies should be included. Larger and longer-term studies are required to determine the effects of exercise in patients with NASH. ISRCTN registry.com: ISRCTN16070927.
authors: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors: David
authors: D
authors: Houghton
authors: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors: Christian
authors: C
authors: Thoma
authors: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors: Kate
authors: K
authors: Hallsworth
authors: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors: Sophie
authors: S
authors: Cassidy
authors: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; Liver Unit, Newcastle Upon Tyne Hospitals NHS Trust, Freeman Hospital, Newcastle Upon Tyne, United Kingdom.
authors: Timothy
authors: T
authors: Hardy
authors: Faculty of Health Sciences, The University of Adelaide, Adelaide, SA, Australia.
authors: Alastair D
authors: AD
authors: Burt
authors: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; Liver Unit, Newcastle Upon Tyne Hospitals NHS Trust, Freeman Hospital, Newcastle Upon Tyne, United Kingdom.
authors: Dina
authors: D
authors: Tiniakos
authors: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors: Kieren G
authors: KG
authors: Hollingsworth
authors: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom.
authors: Roy
authors: R
authors: Taylor
authors: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; Liver Unit, Newcastle Upon Tyne Hospitals NHS Trust, Freeman Hospital, Newcastle Upon Tyne, United Kingdom.
authors: Christopher P
authors: CP
authors: Day
authors: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; Liver Unit, Newcastle Upon Tyne Hospitals NHS Trust, Freeman Hospital, Newcastle Upon Tyne, United Kingdom.
authors: Stuart
authors: S
authors: McPherson
authors: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom; Liver Unit, Newcastle Upon Tyne Hospitals NHS Trust, Freeman Hospital, Newcastle Upon Tyne, United Kingdom.
authors: Quentin M
authors: QM
authors: Anstee
authors: Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom. Electronic address: michael.trenell@ncl.ac.uk.
authors: Michael I
authors: MI
authors: Trenell
mesh_terms: D050154:Adiposity; D000368:Aged; D015444:Exercise; D005260:Female; D006801:Humans; D008055:Lipids / Q000032:analysis*; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
chemical_list: D008055:Lipids; D014280:Triglycerides
keywords: Body Composition; Inflammation; NAFLD; Therapy