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.

Walid Kamal Abdelbasset, Sayed A Tantawy, Dalia M Kamel, Bader A Alqahtani, Gaber S Soliman

Journal: Medicine 2019;98(12):e14918

PMID: 30896648

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Plain Language Summary

There is a strong positive correlation between obesity with type 2 diabetes and non-alcoholic fatty liver disease (NAFLD), and combined with low levels of exercise is associated with an increased risk of mortality and morbidity. The aim of this randomised controlled trial was to evaluate the effectiveness of 8-weeks of high-intensity interval (HII) exercise on various blood markers and quality of life in diabetic obese patients with NAFLD. 32 patients were randomly assigned to 2 groups: 16 patients received medical treatment with a program of HII aerobic exercise 3 times per week for 8 weeks (HII group), whilst the control group consisted of 16 patients who received medical treatment only. Aerobic capacity, body mass index (BMI), intrahepatic triglycerides, visceral adipose tissue (abdominal fat), blood lipids, insulin resistance and ALT (a measure of liver function) all improved significantly more in the HII as compared to the control group. The intervention also led to a significantly better health related quality of life in the HII group. The authors discuss a reduction of plasma lipids and an increase of insulin sensitivity as underlying mechanisms, and conclude that these results emphasise the vital role of aerobic exercise training in diabetic patients with NAFLD.

Abstract

BACKGROUND

Medications are limited for patients with nonalcoholic fatty liver disease (NAFLD). It has been reported that aerobic exercise is effective in reducing the characteristics of NAFLD, although unclear data have ascertained the effects of high-intensity interval aerobic exercise on health-related quality of life (HRQoL) in diabetic obese patients with NAFLD.

OBJECTIVES

This a randomized controlled trial aimed to ascertain the effectiveness of 8-week high-intensity interval exercise on intrahepatic triglycerides (IHTG), visceral lipids and HRQoL in diabetic obese patients with NAFLD.

STUDY DESIGN

Between August and December 2017, 32 diabetic obese patients with NAFLD aged 45 to 60 years (21 men and 11 women) were enrolled in this study. They were randomly assigned to 2 groups, 16 patients in each group, high-intensity interval (HII) exercise and control groups. The HII group received a program of HII aerobic exercise for 8 weeks with medications of NAFLD and the control group received only medications without any type of exercise intervention. The test of IHTG, visceral lipids, and HRQoL were recorded at the initial assessment and at the end of the program after 8 weeks.

RESULTS

There were significant differences between the 2 groups at the end of the study. These study findings exhibited significant improvements in IHTG, VO2peak, visceral lipids, glycohemoglobin, plasma glucose, and all dimensions of HRQoL in the HII group (P <.05), But there was non-significant improvement in any measure in the control group (P >.05) after the 8-week intervention.

CONCLUSION

Eight-week high-intensity interval aerobic exercise has a beneficial effect on IHTG, visceral lipids, and HRQoL in diabetic obese patients with NAFLD. Effort and awareness should be dedicated to encouraging the active lifestyle among different population, especially 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, Faculty of Physical Therapy.; 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, Saudi Arabia.

DOI: 10.1097/MD.0000000000014918

Patient Centred Factor

Mediators: Exercise

Clinical Imbalances

Hormonal Detoxification and Biotransformation

Laboratory Testing

Blood

Modifiable Lifestyle Factors

Exercise and movement

Jadad Score

Nutrition Evidence Keywords

HIIT High intensity interval training

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MeSH Terms: Blood Glucose, Body Weights and Measures, Cardiorespiratory Fitness, Diabetes Mellitus, Female, High-Intensity Interval Training, Humans, Lipids, Liver, Male, Middle Aged, Obesity, Quality of Life, Socioeconomic Factors, Triglycerides