Improvement in histological endpoints of MAFLD following a 12-week aerobic exercise intervention
Abstract
Summary Background Lifestyle interventions are the primary treatment for metabolic (dysfunction) associated fatty liver disease (MAFLD). However, the histological and cardiometabolic effects of aerobic exercise in MAFLD remain unclear. Aims To assess the effects of a 12‐week aerobic exercise intervention on histological and cardiometabolic endpoints in MAFLD. Methods Patients with biopsy‐confirmed MAFLD participated in a 12‐week aerobic exercise intervention. Liver histology, cardiorespiratory fitness (estimated V̇O 2max ), physical activity, anthropometry and biochemical markers were assessed at baseline, intervention completion, and 12 and 52 weeks after intervention completion. Results Twenty‐four patients completed the exercise intervention (exercise group n = 16, control group n = 8). In the exercise group, 12 weeks of aerobic exercise reduced fibrosis and hepatocyte ballooning by one stage in 58% ( P = 0.034) and 67% ( P = 0.020) of patients, with no changes in steatosis ( P = 1.000), lobular inflammation ( P = 0.739) or NAFLD activity score ( P = 0.172). Estimated V̇O 2max increased by 17% compared to the control group ( P = 0.027) but this level of improvement was not maintained at 12 or 52 weeks after the intervention. Patients with fibrosis and ballooning improvement increased estimated V̇O 2max by 25% ( P = 0.020) and 26% ( P = 0.010), respectively. Anthropometric reductions including body mass ( P = 0.038), waist circumference ( P = 0.015) and fat mass ( P = 0.007) were also observed, but no patient achieved 7%‐10% weight loss. Conclusion This study highlights the potential benefits of a 12‐week aerobic exercise intervention in improving histological endpoints of MAFLD. The development of strategies to ensure continued engagement in aerobic exercise in MAFLD are needed.
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Should patients continue to complete guideline-based amounts of aerobic exercise over a longer duration, fibrosis improvement may follow.
“Based on this, it seems reasonable to conclude that should patients continue to complete guideline-based amounts of aerobic exercise over a longer duration, fibrosis improvement may follow [35, 36].”
From Aerobic Exercise Training Leads to MASH Resolution as Defined by the MASH Resolution Index (2026) · cites this paper as [36]
The Results report fibrosis improvement after a 12-week aerobic exercise intervention, and the Conclusions say the benefits were not sustained at one year without continued prescribed exercise. These findings support the possibility that continued exercise could help, but the paper does not establish that guideline-based amounts over a longer duration would produce fibrosis improvement; that is the citing authors’ extrapolation. (LLM, conf=0.83)
Experimental — accuracy not yet measuredOwing to limited clinical trial data, it is currently unclear whether exercise training can independently improve liver histology.
“Owing to limited clinical trial data, it is currently unclear whether exercise training can independently improve liver histology. 318,319”
From EASL-EASD-EASO Clinical Practice Guidelines on the management of metabolic dysfunction-associated steatotic liver disease (MASLD). (2024) · cites this paper as [318]
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One size does not fit all; practical, personal tailoring of the diet to <scp>NAFLD</scp> patients
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Aerobic Exercise Training Leads to MASH Resolution as Defined by the MASH Resolution Index
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- Authors
- O’Gorman, P., Naimimohasses, S., Monaghan, A., Kennedy, M., Melo, A. M., Ní Fhloinn, D., Doherty, D. G., Beddy, P., Finn, S. P., Moore, J. B., Gormley, J., & Norris, S.
- Affiliations
- Trinity College Dublin (IE)
- Department of Hepatology St James’s Hospital Dublin Ireland
- St. James's Hospital (IE)
- University of Leeds (GB)
- Corresponding author
- O’Gorman, Philip
- ORCID
- Venue
- Alimentary Pharmacology & Therapeutics
- Publisher
- Wiley
- Published
- 2020-07-27
- Volume
- 52
- Issue
- 8
- Pages
- 1387-1398
- ISSN
- 0269-2813 (ISSN-L)
- 1365-2036
- OpenAlex
- W3045799557
- Cited by
- 94
- References
- 53
- Citations by year
- 2026: 11 · 2025: 12 · 2024: 21 · 2023: 15 · 2022: 16 · 2021: 15 · 2020: 4
- FWCI
- 8.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alimentary Pharmacology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Arrow@dit (Dublin Institute of Technology) (acceptedVersion)
- Trinity's Access to Research Output (TARA) (Trinity College Dublin) (submittedVersion)
- Funders
- Health Research Board (HRA‐POR‐2015‐1185)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Keywords
- non-alcoholic fatty liver disease, aerobic exercise, liver histopathology, liver fibrosis, hepatocyte ballooning, cardiorespiratory fitness, NAFLD activity score, steatosis, cardiometabolic effects, lifestyle intervention, weight loss
- MeSH terms
- Adult, Aged, Biopsy, Body Composition, Exercise Therapy, Female, Humans, Ireland, Liver, Male, Middle Aged, Weight Loss, Exercise, Treatment Outcome, Waist Circumference, Non-alcoholic Fatty Liver Disease
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