High cardiorespiratory fitness is an independent predictor of the reduction in liver fat during a lifestyle intervention in non-alcoholic fatty liver disease
Abstract
OBJECTIVE: Lifestyle intervention with diet modification and increase in physical activity is effective for reducing hepatic steatosis in patients with non-alcoholic fatty liver disease (NAFLD). However, for a similar weight loss, there is a large variability in the change in liver fat. We hypothesised that cardiorespiratory fitness may predict the response to the intervention. DESIGN: Longitudinal study with increase in physical activity and diet modification. SETTING: University teaching hospital. PATIENTS: 50 adults with NAFLD and 120 controls at risk for metabolic diseases. MAIN OUTCOME MEASURES: Total-, subcutaneous abdominal- and visceral adipose tissue by magnetic resonance tomography, liver fat by 1HMR spectroscopy and cardiorespiratory fitness (VO(2,max)) by a maximal cycle exercise test at baseline and after 9 months of follow-up. RESULTS: In all subjects total-, subcutaneous abdominal- and visceral adipose tissue decreased and fitness increased (all p<0.0001) during the intervention. The most pronounced changes were found for liver fat (-31%, p<0.0001). Among the parameters predicting the change in liver fat, fitness at baseline emerged as the strongest factor, independently of total- and visceral adipose tissue as well as exercise intensity (p = 0.005). In the group of subjects with NAFLD at baseline, a resolution of NAFLD was found in 20 individuals. For 1 standard deviation increase in VO(2,max) at baseline the odds ratio for resolution of NAFLD was 2.79 (95% confidence interval, 1.43-6.33). CONCLUSIONS: Cardiorespiratory fitness, independently of total adiposity, body fat distribution and exercise intensity, determines liver fat content in humans, suggesting that fitness and liver fat are causally related to each other. Moreover, measurement of fitness at baseline predicts the effectiveness of a lifestyle intervention in reducing hepatic steatosis in patients with NAFLD.
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Endurance training can lower intrahepatic lipid content.
“Recent data suggest that endurance training is also able to lower IHL content (Kantartzis et al., 2009)”
From Calorie Restriction-like Effects of 30 Days of Resveratrol Supplementation on Energy Metabolism and Metabolic Profile in Obese Humans (2011) · cites this paper as Kantartzis et al., 2009
Fitness affects the response to calorie reduction; obese individuals with a high baseline cardiorespiratory fitness might have a greater reduction in liver fat with diet-induced weight loss.
“Additionally, fitness affects the response to calorie reduction; obese individuals with a high baseline cardiorespiratory fitness might have a greater reduction in liver fat with diet-induced weight loss.138”
From Lipid-induced insulin resistance: unravelling the mechanism (2010) · cites this paper as [138]
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- Authors
- Kantartzis, K., Thamer, C., Peter, A., Machann, J., Schick, F., Schraml, C., Konigsrainer, A., Konigsrainer, I., Krober, S., Niess, A., Fritsche, A., Haring, H.-U., & Stefan, N.
- Affiliations
- University of Tübingen (DE)
- Corresponding author
- Stefan, N
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2008-12-11
- Volume
- 58
- Issue
- 9
- Pages
- 1281-1288
- ISSN
- 0017-5749 (ISSN-L)
- OpenAlex
- W1970765180
- Cited by
- 273
- References
- 58
- Citations by year
- 2026: 4 · 2025: 2 · 2024: 8 · 2023: 10 · 2022: 17 · 2021: 12 · 2020: 19 · 2019: 15 · 2018: 21 · 2017: 19 · 2016: 17 · 2015: 15 · 2014: 16 · 2013: 18 · 2012: 25
- FWCI
- 13.61
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gut (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- 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
- cardiorespiratory fitness, non-alcoholic fatty liver disease, hepatic steatosis, liver fat reduction, lifestyle intervention, physical activity, dietary change, VO2max, adipose tissue, visceral adipose tissue, subcutaneous abdominal fat, predictors of treatment response
- MeSH terms
- Adult, Body Composition, Combined Modality Therapy, Diet, Reducing, Exercise Test, Exercise Therapy, Fatty Liver, Female, Follow-Up Studies, Glucose Tolerance Test, Humans, Life Style, Male, Middle Aged, Magnetic Resonance Spectroscopy, Physical Fitness, Linear Models, Logistic Models, Case-Control Studies, Treatment Outcome, Intra-Abdominal Fat, Subcutaneous Fat, Abdominal, Whole Body Imaging
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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