The effect of different intensities of chronic aerobic training on changes in liver index enzymes in patients with non-alcoholic fatty liver disease in men and women with different ages, systematic review and meta-analysis

Document Type : Review Article

Authors
Haniyeh Iranpur 1
Mahdi Ghafari 2
Mohammad Faramarzi 3
Mostafa Rahimi 2
1 MSc in Sports Physiology, Shahrekord University, Department of Sports Sciences
2 Assistant Professor in Sports Physiology, Shahrekord University, Department of Sports Science
3 Professor in Sports Physiology, University of Isfahan, Department of Sports Science
10.22089/spj.2021.10197.2124
Abstract
Several studies have examined the effect of chronic aerobic training on factors associated with non-alcoholic fatty liver disease. The aim of this study was to determine the effect of different intensities of chronic aerobic training (low, medium and high) on alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and gamma glutamine transferase in men and women of different ages. Done in 1400. Databases, ScienceDirect, PubMed, Scopus and Google Scholar were searched along with keywords. A total of 120 non-review articles with appropriate quality of aerobic training were reviewed and 22 articles were meta-analyzed. Accordingly, 1560 people with an average (52 ± 10 years) Fatty liver disease was examined. The effects of the intervention were evaluated using SMD and stochastic effects model. In the results of meta-analysis of aerobic training in general with any intensity significantly reduces the levels of aspartate aminotransferase, alkaline phosphatase and gamma glutamine transferase. Alanine aminotransferase levels decreased more in high-intensity training than in moderate-intensity training (P = 0.01). Aspartate aminotransferase levels decreased more in moderate-intensity training (P = 0.001) than in high-intensity training (P = 0.03). The effect of high-intensity and moderate-intensity training on gamma glutamine transferase levels was not significant (P = 0.2).
Keywords: Non-alcoholic fatty liver, Alanine aminotransferase, Aspartate aminotransferase, Aerobic training, training intensity
Keywords
ALT
AS
ALP
GGT
aerobic exercise
training intensity
  1. Ito T, Ishigami M, Zou B, Tanaka T, Takahashi H, Kurosaki M, et al. The epidemiology of NAFLD and lean NAFLD in Japan: a meta-analysis with individual and forecasting analysis. Hepatol Int. 2021; Apr;15(2) :1-14.
  2. Motamed N, Khoonsari M, Panahi M, Rezaie N, Maadi M, Tameshkel FS, et al. The incidence and risk factors of non-alcoholic fatty liver disease: a cohort study from Iran. 2020;20(2):1-10.
  3. Gunjal C, Sharma A, Kaushik GG, Maheriya M. Relationship of Adiponectin with Liver Enzymes in NAFLD Subjects. AGE (2014).;48(8.42):49-2.
  4. Feter N, Alt R, Häfele CA, da Silva MC, Rombaldi AJJE. Effect of combined physical training on cognitive function in people with epilepsy: results from a randomized controlled trial. Epilespiya. 2020;61(8):1649-58.
  5. Tondpa Khaghani B, Dehkhoda MR, Amani Shalamzari S. Improvement of aerobic power and health status in overweight patients with non-alcoholic fatty liver disease with high intensity interval training. J Payavard Salamat. 2019;13(1):71-80.
  6. Labaf S, Shamsoddini A, Hollisaz MT, Sobhani V, Shakibaee A. Effects of neurodevelopmental therapy on gross motor function in children with cerebral palsy. Pyavard Salamat. 2015;9(2):36.
  7. Tohidi M, Harati H, Hadaegh F, Mehrabi Y, Azizi D. Association of liver enzymes with incident type 2 diabetes: Tehran lipid and glucose study. Journal Of Diabetes and Metabolic Disorders. 2007;7(2):167-76. (In Persian). 
  8. Afsordeh K, Ranjbar R, Alizadeh AJRiM. Effect of aerobic training and vitamin D supplements on fatty liver and lipid profiles in women with fatty liver. Medicine of School of journal Quarterly. 2019;43(1):8-14. (In Persian).
  9. Norton K, Norton L, Sadgrove D. Position statement on physical activity and exercise intensity terminology. Journal of Science and Medicine in Sport. 2010;13(5):496-502.
  10. Al-Jiffri O, Al-Sharif F, El-Kader S, Ashmawy EJAhs. Weight reduction improves markers of hepatic function and insulin resistance in type-2 diabetic patients with non-alcoholic fatty liver. African Health Sciences. 2013;13(3):667-72.
  11. Bacchi E, Negri C, Targher G, Faccioli N, Lanza M, Zoppini G, et al. Both resistance training and aerobic training reduce hepatic fat content in type 2 diabetic subjects with nonalcoholic fatty liver disease (the RAED2 randomized trial). 2013;58(4):1287-95.
  12. Balducci S, Cardelli P, Pugliese L, D’Errico V, Haxhi J, Alessi E, et al. Volume-dependent effect of supervised exercise training on fatty liver and visceral adiposity index in subjects with type 2 diabetes: the Italian diabetes exercise study (IDES). Diabetes Research and Clinical Practice. 2015;109(2):355-63.
  13. Bhat G, Baba CS, Pandey A, Kumari N, Choudhuri GJWjoh. Life style modification improves insulin resistance and liver histology in patients with non-alcoholic fatty liver disease. World J Hepatol.2012;4(7):209.

 

  1. Cassidy S, Thoma C, Hallsworth K, Parikh J, Hollingsworth KG, Taylor R, et al. High intensity intermittent exercise improves cardiac structure and function and reduces liver fat in patients with type 2 diabetes: a randomised controlled trial. 2016;59(1):56-66.
  2. Goodpaster BH, DeLany JP, Otto AD, Kuller L, Vockley J, South-Paul JE, et al. Effects of diet and physical activity interventions on weight loss and cardiometabolic risk factors in severely obese adults: a randomized trial. JAMA. 2010;304(16):1795-802.
  3. Keating SE, Hackett DA, Parker HM, O’Connor HT, Gerofi JA, Sainsbury A, et al. Effect of aerobic exercise training dose on liver fat and visceral adiposity. J Hepatol

 2015;63(1):174-82.

  1. Oh S, So R, Shida T, Matsuo T, Kim B, Akiyama K, et al. High-intensity aerobic exercise improves both hepatic fat content and stiffness in sedentary obese men with nonalcoholic fatty liver disease. Scientific Reports. 2017;7(1):1-12.
  2. Pugh CJ, Cuthbertson DJ, Sprung VS, Kemp GJ, Richardson P, Margot Umpleby A, et al. Exercise training improves cutaneous microvascular function in nonalcoholic fatty liver disease. Am J Physiol Endocrinol Metab. 2013;305(1):E50-E8.
  3. Pugh CJ, Sprung VS, Kemp GJ, Richardson P, Shojaee-Moradie F, Umpleby AM, et al. Exercise training reverses endothelial dysfunction in nonalcoholic fatty liver disease. Am J Physiol Heart Circ Physiol. 2014;307(9):H1298-H306.
  4. Shah K, Stufflebam A, Hilton TN, Sinacore DR, Klein S, Villareal DTJO. Diet and exercise interventions reduce intrahepatic fat content and improve insulin sensitivity in obese older adults. Intervention and Prevention. 2009;17(12):2162-8.
  5. Shojaee-Moradie F, Cuthbertson D, Barrett M, Jackson N, Herring R, Thomas E, et al. Exercise training reduces liver fat and increases rates of VLDL clearance but not VLDL production in NAFLD. J Clin Endocrinol Metab. 2016;101(11):4219-28.
  6. Baba CS, Alexander G, Kalyani B, Pandey R, Rastogi S, Pandey A, et al. Effect of exercise and dietary modification on serum aminotransferase levels in patients with nonalcoholic steatohepatitis. Gastroenterology and Hepatology. 2006;21(1):191-8.
  7. St. George A, Bauman A, Johnston A, Farrell G, Chey T, George JJH. Independent effects of physical activity in patients with nonalcoholic fatty liver disease. American Hepatology. 2009;50(1):68-76.
  8. Sullivan S, Kirk EP, Mittendorfer B, Patterson BW, Klein SJH. Randomized trial of exercise effect on intrahepatic triglyceride content and lipid kinetics in nonalcoholic fatty liver disease. Hepatology. 2012;55(6):1738-45.
  9. Tamura Y, Tanaka Y, Sato F, Choi JB, Watada H, Niwa M, et al. Effects of diet and exercise on muscle and liver intracellular lipid contents and insulin sensitivity in type 2 diabetic patients. J Clin Endocrinol Metab. 2005;90(6):3191-6.
  10. Thompson D, Markovitch D, Betts JA, Mazzatti D, Turner J, Tyrrell RM. Time course of changes in inflammatory markers during a 6-mo exercise intervention in sedentary middle-aged men: a randomized-controlled trial. Journal of Applied Physiology. 2010;108(4):769-79.
  11. Zhang H-J, He J, Pan L-L, Ma Z-M, Han C-K, Chen C-S, et al. Effects of moderate and vigorous exercise on nonalcoholic fatty liver disease: a randomized clinical trial. JAMA Internal Medicine. 2016;176(8):1074-82.
  12. Zhang S-t, Zheng J, Peng H-w, Cai X-l, Pan X-t, Li H-q, et al. Physical activity intervention for non-diabetic patients with non-alcoholic fatty liver disease: a meta-analysis of randomized controlled trials. Gastroenterology. 2020;20(1):1-12.
  13. Orci LA, Gariani K, Oldani G, Delaune V, Morel P, Toso CJCg, et al. Exercise-based interventions for nonalcoholic fatty liver disease: a meta-analysis and meta-regression. 2016;14(10):1398-411.
  14. van der Windt DJ, Sud V, Zhang H, Tsung A, Huang HJGe. The effects of physical exercise on fatty liver disease. 2018;18(2):89.
  15. Hashida R, Kawaguchi T, Bekki M, Omoto M, Matsuse H, Nago T, et al. Aerobic vs. resistance exercise in non-alcoholic fatty liver disease: a systematic review. 2017;66(1):142-52.
  16. Takahashi H, Kotani K, Tanaka K, Egucih Y, Anzai KJFie. Therapeutic approaches to nonalcoholic fatty liver disease: Exercise intervention and related mechanisms. 2018;9:588.
  17. Yao J, Meng M, Yang S, Li F, Anderson RM, Liu C, et al. Effect of aerobic and resistance exercise on liver enzyme and blood lipids in Chinese patients with nonalcoholic fatty liver disease: a randomized controlled trial. 2018;11(5):4867-74.
  18. Elmieh A, Rafizadeh B, Khanbabakhani H. Effect of aerobic interval training and consumption of chicory extract on levels of liver enzymes in obese boys with non-alcoholic fatty liver. Journal of Applied Exercise Physiology. 2019;15(30):103-14.
  19. Guo R, Liong EC, So KF, Fung M-L, Tipoe GLJH, International PD. Beneficial mechanisms of aerobic exercise on hepatic lipid metabolism in non-alcoholic fatty liver disease. 2015;14(2):139-44.
  20. Nath P, Panigrahi MK, Sahu MK, Narayan J, Sahoo RK, Patra AA, et al. Effect of exercise on NAFLD and its risk factors: comparison of moderate versus low intensity exercise. 2020;8(2):120.
  21. Diniz TA, de Lima Junior EA, Teixeira AA, Biondo LA, da Rocha LAF, Valadão IC, et al. Aerobic training improves NAFLD markers and insulin resistance through AMPK-PPAR-α signaling in obese mice. 2021;266:118868.
  22. Yao J, et al. Effect of aerobic and resistance exercise on liver enzyme and blood lipids in Chinese patients with nonalcoholic fatty liver disease: a randomized controlled trial. 2018;11(5):4867-74.
  23. Abdelbasset WK, et al. A randomized controlled trial on the effectiveness of 8-week high-intensity interval exercise on intrahepatic triglycerides, visceral lipids, and health-related quality of life in diabetic obese patients with nonalcoholic fatty liver disease. 2019;98(12).
  24. Hosseini Kakhk A, Khalegh Zadeh H, Nematy M, Hamedi Nia M. The effect of combined aerobic- resistance training on lipid profile and liver enzymes in patients with non-alcoholic fatty liver under nutrition diet. J Sport Physiology. 2015;7(27):65-84. (In Persian).
  25. Iraji H, Minasian V, Kelishadi RJSP. Effect of two exercise modalities on some liver enzymes and lipid profile of adolescents with fatty liver. J Sport Physiology.2020;12(47):37-54.

 

  • Receive Date 20 May 2021
  • Revise Date 04 December 2021
  • Accept Date 20 December 2021