Effect of exercise and dietary modification on serum aminotransferase levels in patients with nonalcoholic steatohepatitis
Effect of exercise and dietary modification on serum aminotransferase levels in patients with nonalcoholic steatohepatitis
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DOI：
10.1111/j.1440-1746.2005.04233.x
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发表时间：
2006-01-01
影响因子：
4.1
通讯作者：
Choudhuri, G
中科院分区：
文献类型：
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作者：
Baba, CS;Alexander, G;Choudhuri, G
背景：非酒精性脂肪性肝炎（NASH）通常与超重和胰岛素抵抗有关。有氧运动可以降低胰岛素抵抗。我们研究了有规律的有氧运动对NASH.Methods患者血清转氨酶水平的影响：94例NASH患者中有65例（平均年龄38.7 ± 9.5岁; 46例[78%]男性）参与了这项研究。建议每名患者每天进行30分钟的常规有氧运动，每周至少5天训练心率达到他/她最大心率的60-70%。此外，那些身体质量指数（BMI）高的人被建议适度限制能量饮食。每月随访患者的BMI、腰臀比（WHR）、腰围（WC）、谷草转氨酶（AST）和谷丙转氨酶（ALT），随访时间至少3个月。58例（98.3%）患者存在中心性肥胖（男性WHR ≥ 0.90 cm，女性WHR ≥ 0.85 cm），12例（20.3%）患者存在代谢综合征。在44例定期遵守运动计划的患者中，20例（45%; P < 0.05）血清ALT恢复正常，平均AST和ALT值分别从70.5和104.0降至41.5（P < 0.001）和63.2（P < 0.001）。超重患者平均体重减轻3.1 kg（范围0-13 kg），BMI（28.7 vs 27.5; P < 0.001）和WC（99.4 cm vs 96.1 cm; P = 0.001）下降。15名未能遵守运动计划的患者中，任何一名的血清ALT均未恢复正常;他们的术前和术后AST（分别为82.8和81.2）和ALT（分别为98.0和96.1）水平，BMI（分别为27.5和27.6）和腰臀比（分别为0.99 cm和0.99 cm）在3个月时没有显示出任何显著变化，并且在5.3个月的延长平均随访期内也没有显示出任何显著变化。中等强度的有氧运动有助于NASH患者ALT水平正常化。(c)2006年Blackwell Publishing Asia Pty Ltd
Background: Nonalcoholic steatohepatitis (NASH) is commonly associated with overweight and insulin resistance. Aerobic exercise is known to reduce insulin resistance. We studied the effect of regular aerobic exercise on serum aminotransferase levels in patients with NASH.Methods: Sixty-five (mean age 38.7 +/- 9.5 years; 46 [78%] males) out of 94 patients diagnosed with NASH participated in the study. Each patient was advised regular aerobic exercise for 30 min duration per day, and trained to achieve a heart rate of 60-70% of his/her maximal heart rate for at least 5 days a week. In addition, those with a high body mass index (BMI) were advised a moderately energy-restricted diet. Patients were followed up monthly for at least 3 months by BMI, waist-hip ratio (WHR), waist circumference (WC), aspartate aminotransferase (AST) and alanine aminotransferase (ALT).Results: Forty-three (72.8%) patients had a high BMI. Central obesity (WHR >= 0.90 cm in men and >= 0.85 cm in women) was present in 58 (98.3%) patients and metabolic syndrome in 12 (20.3%) patients. In the 44 patients who complied regularly with the exercise program, serum ALT normalized in 20 (45%; P < 0.05), and mean AST and ALT values declined from 70.5 and 104.0-41.5 (P < 0.001) and 63.2 (P < 0.001), respectively. Overweight patients lost a mean 3.1 kg (range 0-13 kg) weight and showed a decline in BMI (28.7 vs 27.5; P < 0.001) and WC (99.4 cm vs 96.1 cm; P = 0.001). Serum ALT did not normalize in any of the 15 patients who failed to comply with the exercise program; their pre- and post-AST (82.8 and 81.2, respectively) and ALT (98.0 and 96.1, respectively) levels, BMI (27.5 and 27.6, respectively) and WHR (0.99 cm and 0.99 cm, respectively) did not show any significant change at 3 months, and also for an extended mean follow-up period of 5.3 months.Conclusions: Moderate intensity aerobic exercise helps in normalizing ALT levels in patients with NASH. (c) 2006 Blackwell Publishing Asia Pty Ltd