Effect Of Different Modalities Of Exercise On Patients With Non-alcoholic Fatty Liver

Objective:The aim of this study was to compare the effect of different modalities of exercise (aerobic exercise and resistance exercise) on metabolic control (blood glucose, lipid profile, and blood pressure), insulin resistance, body composition, visceral adipose tissue area and liver regression after 20 weeks of exercise among patients with non-alcoholic fatty liver, on the basis of healthy diet.Methods:103 patients with non-alcoholic fatty liver were randomly assigned to 3 groups of moderate-intensity exercise (3 times a week,50 minutes per session, consecutive 20 weeks): aerobic group (n=34), resistance group (n=34), and control group (n=35). All patients received healthy diet education before formal exercise. Control group also received exercise-related education.Results:103 patients were enrolled in the study, after 20 weeks,88 patients were finally analyzed:aerobic group (n=29), resistance group (n=28), and control group (n=31). There was no significant difference (P>0.05) in all variables of three groups at baseline. HDL was statistically significant (P<0.05) across three groups; compared to the control group, both aerobic and resistance exercise groups displayed greater elevation in HDL (P<0.05). After exercise, the difference value of HDL, muscle mass, visceral adipose tissue and total area(20-week later minus baseline) across three groups were statistically significant (P<0.05); Within groups, in resistance group, HOMA-IR, HDL, muscle mass, visceral adipose tissue and total area was significantly different before and after the 20-week intervention (P-0.031, P=0.027, P<0.001, P<0.001, P<0.001, respectively), After 5 months, there was no statistical significance in the fatty degree of liver fat among three groups(P>0.05).Conclusions:1. Both aerobic and resistance exercise had no effect on blood glucose and insulin resistance. But there was a beneficial trend in the two exercise groups and resistance group was better. Within the resistance group, after 5 months exercise, insulin resistance was improved.2. Compared to control group, aerobic and resistance exercise can improve HDL level significantly.3. Within aerobic group, exercise can reduce ALT level significantly.4. This study showed that both resistance and aerobic exercise had no effect blood pressure.5. After 5 months, both aerobic exercise and resistance exercise may reduce visceral adipose tissue and total area. And resistance exercise had a better reduction. Within aerobic group, subcutaneous adipose tissue was also significantly reduced, besides the reduction of visceral adipose tissue and total area, which can be achieved in resistance group.6. Compared to aerobic and control group, resistance exercise can increase muscle mass significantly.7. This research showed that there was no statistical significance on the regression of liver fat among three groups.8. Both aerobic and resistance exercise can improve lipids and reduce abdominal visceral adipose tissue, which are recommended exercise modalities; Resistance exercise has significant advantage in enhancing muscle mass, so for elderly patients, because of the reduction of muscle mass and strength, resistance exercise is recommended.