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Cited by 77Liver Disease Diagnosis and TreatmentExercise and Physiological ResponsesPhysical Activity and Health

Weight-loss-independent benefits of exercise on liver steatosis and stiffness in Japanese men with NAFLD

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Oh, Sechang, Tsujimoto, Takehiko, Kim, Bokun, Uchida, Fumihiko, Suzuki, Hideo, Iizumi, Seiichiro, Isobe, Tomonori, Sakae, Takeji +2 more·2021·JHEP Reports
DOI 10.1016/j.jhepr.2021.100253PMC PMC8059085
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Abstract

BACKGROUND & AIMS: A weight-loss-independent beneficial effect of exercise on non-alcoholic fatty liver disease (NAFLD) management has been reported, but the underlying mechanism is unknown. To help determine this mechanism, the effects of exercise on individual tissues (liver, adipose tissue, and skeletal muscle) were retrospectively studied. METHODS: Data from Japanese obese men with NAFLD in a 3-month exercise regimen were analysed and compared with those in a 3-month dietary restriction program designed to achieve weight loss. The underlying mechanism was studied in a smaller subcohort. RESULTS: Independent of the effect of weight loss, the exercise regimen reduced liver steatosis by 9.5% and liver stiffness by 6.8% per 1% weight loss, and resulted in a 16.4% reduction in FibroScan-AST score. Improvements in these hepatic parameters were closely associated with anthropometric changes (reduction in adipose tissue and preservation of muscle mass), increases in muscle strength (+11.6%), reductions in inflammation and oxidative stress (ferritin: -22.3% and thiobarbituric acid: -12.3%), and changes in organokine concentrations (selenoprotein-P: -11.2%, follistatin: +17.1%, adiponectin: +8.9%, and myostatin: -21.6%) during the exercise regimen. Moreover, the expression of target genes of the transcription factor Nrf2, an oxidative stress sensor, was higher in monocytes, suggesting that Nrf2 is activated. Large amounts of high-intensity exercise were effective at further reducing liver steatosis and potentiating improvements in pathophysiological parameters (liver enzyme activities and organokine profiles). CONCLUSIONS: The weight-loss-independent benefits of exercise include anti-steatotic and anti-stiffness effects in the livers of patients with NAFLD. These benefits seem to be acquired through the modification of inter-organ crosstalk, which is characterised by improvements in organokine imbalance and reductions in inflammation and oxidative stress. LAY SUMMARY: We investigated the effects of exercise on non-alcoholic fatty liver disease (NAFLD) that were not related to weight loss. We found that exercise had considerable weight-loss-independent benefits for the liver through a number of mechanisms. This suggests that exercise is important for NAFLD patients, regardless of whether they lose weight.

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  • An RCT showed that a 3-month aerobic exercise regimen (three 90-minute sessions/week) reduced liver steatosis and liver stiffness, independent of weight loss.

    “An RCT showed that a 3-month aerobic exercise regimen (three 90-minute sessions/week) reduced liver steatosis and liver stiffness, independent of weight loss. 314”

    From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [314]

    The Exercise regimen section describes three 90-minute aerobic sessions per week for three months, and the Results report reductions in steatosis and stiffness beyond those associated with weight loss. However, the Participants section says men undertook exercise or dietary restriction depending on their preference, so calling this an RCT is not supported. (LLM, conf=0.94)

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Authors
Oh, S., Tsujimoto, T., Kim, B., Uchida, F., Suzuki, H., Iizumi, S., Isobe, T., Sakae, T., Tanaka, K., & Shoda, J.
Affiliations
  • University of Tsukuba (JP)
  • Shimane University (JP)
  • Inje University (KR)
  • University of Tsukuba Hospital (JP)
Corresponding author
Shoda, Junichi
ORCID
Venue
JHEP Reports
Publisher
Elsevier BV
Published
2021-06
Volume
3
Issue
3
Pages
100253
ISSN
2589-5559 (ISSN-L)
DOI
10.1016/j.jhepr.2021.100253
PMC
PMC8059085
OpenAlex
W3127779032
Cited by
77
References
7
Citations by year
2026: 11 · 2025: 13 · 2024: 18 · 2023: 15 · 2022: 16 · 2021: 4
FWCI
9.55
Type
journal article
Language
en
Open access
Licence
Locations
  • JHEP Reports (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Institutional Repositories DataBase (IRDB) (acceptedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Terrestrial Environment Research Center (University of Tsukuba) (submittedVersion, cc-by)
Funders
Ministry of Education, Culture, Sports, Science and Technology (18K17918, 20K11644, 18H03172, 20H04119)
Topics
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
non-alcoholic fatty liver disease, physical activity, hepatic steatosis, liver stiffness, organ crosstalk, oxidative stress, inflammation, Nrf2, high-intensity exercise, muscle mass, adipose tissue, Japanese men

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