The effect of exercise training on intrahepatic triglyceride and hepatic insulin sensitivity: A systematic review and meta-analysis
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Summary This systematic review and meta‐analysis determined the impact of structured exercise training, and the influence of associated weight loss, on intrahepatic triglyceride (IHTG) in individuals with non‐alcoholic fatty liver disease (NAFLD). It also examined its effect on hepatic insulin sensitivity in individuals with or at increased risk of NAFLD. Analyses were restricted to studies using magnetic resonance spectroscopy or liver biopsy for the measurement of IHTG and isotope‐labelled glucose tracer for assessment of hepatic insulin sensitivity. Pooling data from 17 studies (373 exercising participants), exercise training for one to 24 weeks (mode: 12 weeks) elicits an absolute reduction in IHTG of 3.31% (95% CI: −4.41 to −2.22%). Exercise reduces IHTG independent of significant weight change (−2.16 [−2.87 to −1.44]%), but benefits are substantially greater when weight loss occurs (−4.87 [−6.64 to −3.11]%). Furthermore, meta‐regression identified a positive association between percentage weight loss and absolute reduction in IHTG (β = 0.99 [0.62 to 1.36], P < 0.001). Pooling of six studies (94 participants) suggests that exercise training also improves basal hepatic insulin sensitivity (mean change in hepatic insulin sensitivity index: 0.13 [0.05 to 0.21] mg m−2 min−1 per μU mL−1), but available evidence is limited, and the impact of exercise on insulin‐stimulated hepatic insulin sensitivity remains unclear.
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Exercise decreases hepatic steatosis.
“exercise is known to decrease hepatic steatosis [24]”
A recent meta-analysis described reduced intrahepatic TG content in humans subjected to aerobic exercise interventions.
“as supported by a recent meta-analysis that described reduced intrahepatic TG content in humans subjected to aerobic exercise interventions [24].”
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- Authors
- Sargeant, J. A., Gray, L. J., Bodicoat, D. H., Willis, S. A., Stensel, D. J., Nimmo, M. A., Aithal, G. P., & King, J. A.
- Affiliations
- Loughborough University (GB)
- University of Leicester (GB)
- University of Birmingham (GB)
- Nottingham University Hospitals NHS Trust (GB)
- Corresponding author
- King, J. A.
- ORCID
- Venue
- Obesity Reviews
- Publisher
- Wiley
- Published
- 2018-08-09
- Volume
- 19
- Issue
- 10
- Pages
- 1446-1459
- ISSN
- 1467-7881 (ISSN-L)
- 1467-789X
- OpenAlex
- W2799588585
- Cited by
- 105
- References
- 68
- Citations by year
- 2026: 6 · 2025: 14 · 2024: 13 · 2023: 18 · 2022: 21 · 2021: 14 · 2020: 13 · 2019: 5 · 2014: 1
- FWCI
- 1.14
- Type
- journal article
- Language
- en
- Open access
- green
- dspace.lboro.ac.uk
- Licence
- Locations
- Obesity Reviews (publishedVersion)
- PubMed (publishedVersion)
- Loughborough University Institutional Repository (Loughborough University) (submittedVersion, cc-by-nc-nd)
- Nottingham ePrints (University of Nottingham) (submittedVersion, cc-by)
- Figshare (submittedVersion, cc-by)
- Loughborough University Research Repository (Loughborough University) (submittedVersion, cc-by-nc-nd)
- Leicester Research Archive (University of Leicester) (submittedVersion, other-oa)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- Funders
- Medical Research Council (MR/N005953/1)
- Topics
- Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- exercise training, intrahepatic triglyceride, hepatic insulin sensitivity, non-alcoholic fatty liver disease, weight loss, hepatic steatosis, insulin resistance
- MeSH terms
- Exercise Therapy, Humans, Insulin Resistance, Liver, Triglycerides, Treatment Outcome, Non-alcoholic Fatty Liver Disease
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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