Moderate-Intensity Aerobic vs Resistance Exercise and Dietary Modification in Patients With Nonalcoholic Fatty Liver Disease: A Randomized Clinical Trial.
Moderate-Intensity Aerobic vs Resistance Exercise and Dietary Modification in Patients With Nonalcoholic Fatty Liver Disease: A Randomized Clinical Trial.
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DOI：
10.14309/ctg.0000000000000316
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发表时间：
2021-03
影响因子：
3.6
通讯作者：
Charatcharoenwitthaya N
中科院分区：
文献类型：
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作者：
Charatcharoenwitthaya P;Kuljiratitikal K;Aksornchanya O;Chaiyasoot K;Bandidniyamanon W;Charatcharoenwitthaya N
这项随机试验旨在比较中等强度有氧运动与抗阻运动结合饮食调整对非酒精性脂肪性肝病（NAFLD）患者的影响。NAFLD患者被随机分配（1：1）到一个为期12周的中等强度有氧或阻力运动的监督训练计划，饮食干预包括每月由营养师进行个人营养咨询。在基线和12周时测量瞬时弹性成像、人体测量、身体组成、心肺适应性、生化和葡萄糖耐量。有氧组18名受试者每周平均运动3.35 ± 0.30次，阻力组17名受试者每周平均运动3.39 ± 0.28次。在完成训练计划后，两组的肝脏脂肪含量相似地降低（P < 0.001）。有氧运动组较基线的平均相对降低为-10.3%（95%置信区间为-18.2至-2.40），阻力组为-12.6%（-20.5至-4.69）。有氧组和阻力组分别有9例（50%）和9例（53%）肝脏脂肪变性（定义为受控衰减参数>248 dB/m）消失。两个运动组的全身和肌肉胰岛素敏感性指数均有所改善，腰围均有所减小。每周运动次数与肝脏脂肪含量的绝对减少相关（r = 0.52; P = 0.001）。每周运动训练≥3次可显著减少肝脏脂肪蓄积，与体重减轻无关。中等强度的有氧训练和饮食调整的抗阻训练对于减少NAFLD患者的肝内脂肪和改善潜在的胰岛素抵抗同样有效。
This randomized trial aimed to compare the effects of moderate-intensity aerobic vs resistance exercise with dietary modification in patients with nonalcoholic fatty liver disease (NAFLD). Patients with NAFLD were randomly assigned (1:1) to a 12-week supervised training program of moderate-intensity aerobic or resistance exercise with dietary intervention consisting of monthly individual nutritional counseling by a dietician. Transient elastography, anthropometry, body composition, cardiorespiratory fitness, biochemistries, and glucose tolerance were measured at baseline and 12 weeks. Eighteen subjects exercised for an average of 3.35 ± 0.30 sessions a week in the aerobic group, and 17 subjects exercised an average of 3.39 ± 0.28 sessions a week in the resistance group. After completion of the training program, hepatic fat content was similarly reduced in both groups (P < 0.001). The mean relative reduction from baseline in the aerobic group was −10.3% (95% confidence interval −18.2 to −2.40) and the resistance group was −12.6% (−20.5 to −4.69). Liver steatosis (defined as controlled attenuation parameter >248 dB/m) disappeared in 9 (50%) of the aerobic group and in 9 (53%) of the resistance group. Whole-body and muscle insulin sensitivity indexes were improved, and waist circumference was reduced comparably in both exercise groups. The number of exercise sessions per week was correlated with the absolute reduction in hepatic fat content (r = 0.52; P = 0.001). Weekly exercise training ≥3 sessions substantially attenuates liver fat accumulation independent of weight loss. Moderate-intensity aerobic training and resistance training with dietary modification are equally effective for reducing intrahepatic fat and improving underlying insulin resistance among patients with NAFLD.