High cardiorespiratory fitness is an independent predictor of the reduction in liver fat during a lifestyle intervention in non-alcoholic fatty liver disease (original) (raw)

High cardiorespiratory fitness is an independent predictor of the reduction in liver fat during a lifestyle intervention in non-alcoholic fatty liver disease

Loading

  1. K Kantartzis1,
  2. C Thamer1,
  3. A Peter1,
  4. J Machann2,
  5. F Schick2,
  6. C Schraml2,
  7. A Königsrainer3,
  8. I Königsrainer3,
  9. S Kröber4,
  10. A Niess5,
  11. A Fritsche1,
  12. H-U Häring1,
  13. N Stefan1
  14. 1
    Department of Internal Medicine, Division of Endocrinology, Diabetology, Vascular Medicine, Nephrology and Clinical Chemistry, University of Tübingen, Germany
  15. 2
    Section on Experimental Radiology, University of Tübingen, Germany
  16. 3
    Department of General, Visceral and Transplant Surgery, University of Tübingen, Germany
  17. 4
    Institute of Pathology, University of Tübingen, Germany
  18. 5
    Department of Internal Medicine, Division of Sports Medicine, University of Tübingen, Germany
  19. Correspondence to Dr N Stefan, Department of Internal Medicine, Otfried-Müller-Str 10, D-72076 Tübingen, Germany; norbert.stefan{at}med.uni-tuebingen.de

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 (VO2,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 VO2,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.

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Linked Articles

Read the full text or download the PDF:

Log in using your username and password

Read the full text or download the PDF:

Log in using your username and password