Effects of high-intensity interval and moderate-intensity continuous aerobic exercise on diabetic obese patients with nonalcoholic fatty liver disease: A comparative randomized controlled trial.

Walid Kamal Abdelbasset, Sayed A Tantawy, Dalia M Kamel, Bader A Alqahtani, Tamer E Elnegamy, Gaber S Soliman, Ahmed A Ibrahim

Journal: Medicine 2020;99(10):e19471

PMID: 32150108

Free Full Text on PubMed Central View on PubMed

Plain Language Summary

Non-alcoholic fatty liver disease (NAFLD) is a condition linked to obesity and is characterised by high amounts of fat in the liver. This can lead to a high rate of mortality, but it can be improved by diet and exercise. It is unclear as to the best form of exercise for the improvement of NAFLD. This randomised control trial aimed to assess the effects of high-intensity interval exercise (HII) versus moderate-intensity exercise on liver fat content in 47 diabetic obese patients with NAFLD over 8 weeks. The results showed that regardless of exercise treatment, both improved measures of NAFLD and there were no differences between the two groups. Interestingly blood sugar control was also improved with both exercise treatments. It was concluded that both exercise regimes improved contributors to NAFLD, with no differences between the two treatments. This study would be useful to health professionals when recommending exercise to diabetic obese patients especially those with NAFLD, giving them the option of HII or MIC to improve their condition.

Abstract

BACKGROUND

Some studies assessed the effect of aerobic exercise on diabetic obese patients with hepatic disease, while very limited studies compared high-intensity interval (HII) versus moderate-intensity continuous (MIC) on diabetic obese patients with non-alcoholic fatty liver disease (NAFLD).

OBJECTIVES

This study was designed to assess the effects of HII versus MIC on intrahepatic triglycerides (IHTG) and visceral lipids in diabetic obese patients with NAFLD.

DESIGN

Randomized controlled trial.

METHODS

Forty-seven diabetic obese individuals with NAFLD were enrolled in this study. The individuals were randomly divided into 16 in HII group, 15 in MIC group, and 16 in the controls. HII group received HII exercise, MIC group received 8-week MIC exercise while the control group did not receive any exercise intervention. IHTG and visceral lipids were assessed pre- and post-intervention.

RESULTS

Baseline and clinical characteristics showed nonsignificant difference among the 3 groups (P > .05). Both HII and MIC groups showed a significant reduction in hepatic fat and visceral lipids (P < .05), while the controls showed nonsignificant difference (P > .05) after completing the study intervention. Postintervention analysis showed nonsignificant changes between the HII and MIC groups (P > .05).

CONCLUSIONS

Exercise training wither HII or MIC aerobic exercise reduces IHGT and visceral lipids in diabetic obese patients with NAFLD. No differences were observed between the effects of both exercise programs on diabetic obese patients with NAFLD.

Address: Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia.; Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt.; Department of Physiotherapy, College of Medical and Health Sciences, Ahlia University, Manama, Kingdom of Bahrain.; Department of Physiotherapy, Centre of Radiation, Oncology and Nuclear Medicine.; Department of Physiotherapy, College of Medical and Health Sciences, Ahlia University, Manama, Kingdom of Bahrain.; Department of Physiotherapy for Women's Health.; Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia.; Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt.; Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences in Al-Qurayyat, Jouf University.; Department of Physical Therapy, Kasr Al-Aini Hospital, Cairo University, Giza, Egypt.; Department of Physical Therapy, College of Applied Medical Sciences, Hail University, Hail, Saudi Arabia.

DOI: 10.1097/MD.0000000000019471

Patient Centred Factor

Mediators: Non-alcoholic fatty liver disease

Clinical Imbalances

Detoxification and Biotransformation Immune and inflammation

Laboratory Testing

Blood

Modifiable Lifestyle Factors

Exercise and movement

Jadad Score

Allocation Concealment

Yes

Nutrition Evidence Keywords

Obesity Type 2 diabetes mellitus High-density lipoproteins Non-alcoholic fatty liver disease ALT Low-density lipoproteins Alanine transaminase HDL's LDL's Intrahepatic triglycerides IHTG's

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https://medlineplus.gov/diabetestype2.html

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MeSH Terms: Adult, Diabetes Mellitus, Type 2, Female, High-Intensity Interval Training, Humans, Lipids, Male, Middle Aged, Non-alcoholic Fatty Liver Disease, Obesity, Treatment Outcome