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Zeng Y, Zhang X, Luo W, Sheng Y. Effect of exercise intervention on clinical parameters in patients with non-alcoholic fatty liver disease and type 2 diabetes mellitus: a meta-analysis of randomized controlled trials. Eur J Gastroenterol Hepatol 2024; 36:1-12. [PMID: 37942754 DOI: 10.1097/meg.0000000000002662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
The effect of exercise on clinical parameters in patients with non-alcoholic fatty liver disease (NAFLD) combined with type 2 diabetes mellitus (T2DM) is unknown. In this meta-analysis, we identified and evaluated the effect of exercise on clinical parameters (BMI, ALT, lipid metabolism, glucose metabolism) in patients with NAFLD combined with T2DM. We conducted a comprehensive search of Medline, Embase, Web of Science, Cochrane Database of Systematic Reviews, and CNKI in December 2022. Data from relevant randomized controlled trials were collected according to inclusion and exclusion criteria. 6 eligible studies with 238 subjects were finally included. We used Review Manager 5.3 for meta-analysis. The study found that exercise improved BMI, ALT, TC, LDL-C, HbA1c, and HOMA-IR, TG, but did not significantly improve HDL-C. Subgroup analysis showed that high-intensity interval training significantly improved BMI (SMD: -0.43, 95% CI: -0.80, -0.06), ALT (SMD: -4.63, 95% CI: -8.42, -0.83), TC (SMD: -0.94, 95% CI: -1.82, -0.07), LDL-C (SMD: -0. 87, 95% CI: -1.26, -0.49), HbA1c (SMD: -1.12, 95% CI: -1.75, -0.48), HOMA-IR (SMD: -0.59, 95% CI: -0.94, -0.25); moderate-intensity continuous training improved ALT (SMD: -3.96, 95% CI: -7.71, -0.21), TG (SMD: -1.59, 95% CI: -2.58, -0.61), HbA1c (SMD: -0.71, 95% CI: -1.37, -0.05), HOMA-IR (SMD: -1.73, 95% CI: -3.40, -0. 06), and to some extent HDL-C levels (SMD: 0.53, 95% CI: 0.04, 1.02); resistance training improved LDL-C (SMD: -2.06, 95% CI: -3.14, -0.98). In conclusion, exercise improved indicators in patients with NAFLD combined with T2DM, but the improvement indicators varied by type of exercise.
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Affiliation(s)
- Yu Zeng
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University
| | - Xuemei Zhang
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University
| | - Wenling Luo
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University
| | - Yunjian Sheng
- Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University
- Infection & Immunity Laboratory, The Affiliated Hospital of Southwest Medical University, Luzhou, China
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2
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and Alternative Medicine EBC. Retracted: Effect of Moderate-Intensity Aerobic Exercise on Hepatic Fat Content and Visceral Lipids in Hepatic Patients with Diabesity: A Single-Blinded Randomised Controlled Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2023; 2023:9829387. [PMID: 37854275 PMCID: PMC10581836 DOI: 10.1155/2023/9829387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 09/23/2023] [Indexed: 10/20/2023]
Abstract
[This retracts the article DOI: 10.1155/2020/1923575.].
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Recchia F, Leung CK, Yu AP, Leung W, Yu DJ, Fong DY, Montero D, Lee CH, Wong SHS, Siu PM. Dose-response effects of exercise and caloric restriction on visceral adiposity in overweight and obese adults: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 2023; 57:1035-1041. [PMID: 36669870 PMCID: PMC10423480 DOI: 10.1136/bjsports-2022-106304] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To determine and compare the dose-response effects of exercise and caloric restriction on visceral adipose tissue in overweight and obese adults, while controlling for the weekly energy deficit induced by the interventions. METHODS PubMed, Embase, CINAHL and Web of Science were searched for randomised controlled trials comparing exercise or caloric restriction against eucaloric controls in overweight or obese adults. The primary outcome was the change in visceral fat measured by CT or MRI. Meta-analyses and meta-regressions were performed to determine the overall effect size (ES) and the dose-dependent relationship of exercise and caloric restriction on visceral fat. Heterogeneity, risk of bias and the certainty of evidence were also assessed. RESULTS Forty randomised controlled trials involving 2190 participants were included. Overall, exercise (ES -0.28 (-0.37 to -0.19); p<0.001; I2=25%) and caloric restriction (ES -0.53 (-0.71 to -0.35); p<0.001; I2=33%) reduced visceral fat compared with the controls. Exercise demonstrated a dose-response effect of -0.15 ((-0.23 to -0.07); p<0.001) per 1000 calories deficit per week, whereas the effect of caloric restriction was not dose-dependent (ES 0.03 (-0.12 to 0.18); p=0.64). Most of the studies showed a moderate risk of bias. CONCLUSIONS These findings support the dose-dependent effects of exercise to reduce visceral fat in overweight and obese adults. Caloric restriction did not demonstrate a dose-response relationship, although this may be attributed to the smaller number of studies available for analysis, compared with exercise studies. PROSPERO REGISTRATION NUMBER CRD42020210096.
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Affiliation(s)
- Francesco Recchia
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Chit K Leung
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Angus P Yu
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Welton Leung
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Danny J Yu
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Daniel Y Fong
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - David Montero
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Chi-Ho Lee
- Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Stephen H S Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Parco M Siu
- Division of Kinesiology, School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
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Ramírez-Manent JI, Altisench Jané B, Tomás Salvà M, Arroyo Bote S, González San Miguel HM, López-González ÁA. Influence of Educational Level and Healthy Habits on the Prevalence of Diabesity in a Spanish Working Population. Nutrients 2022; 14:nu14194101. [PMID: 36235753 PMCID: PMC9573222 DOI: 10.3390/nu14194101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 09/26/2022] [Accepted: 09/29/2022] [Indexed: 11/05/2022] Open
Abstract
Background: Diabesity is a growing problem internationally. Taking into account the importance of physical activity and diet in its prevention and treatment, the objective of this study was to delve into the impact of healthy habits on diabesity. Methods: A descriptive, cross-sectional study was carried out in 386,924 Spanish adult workers. Obesity was determined according to eleven different formulas. Life habits were also valued; sociodemographic variables; and educational level; as well as analytical and clinical variables such as blood pressure and blood glucose levels. The association between the different variables was performed using the chi-square and the Student’s t-tests when the samples were independent. A multivariate analysis was performed using the multinomial logistic regression test by calculating the odds ratio and a 95% confidence interval. The Hosmer–Lemeshow goodness-of-fit test was also performed. Results: The overall prevalence of diabesity ranged between 0.3% (95% CI 0.3–0.4) when obesity was assessed according to the abdominal volume index and 8.3% (95% CI 8.2–8.4) when evaluated according to the CUN-BAE (Clínica Universitaria de Navarra Body Adiposity Estimator) formula. The prevalence of diabesity was also higher in workers with a non-heart-healthy diet and in those who did not exercise regularly. Conclusions: The most disadvantaged socioeconomic classes are those with the highest prevalence of diabesity. It is important to prioritise prevention in populations and communities with the most unfavourable social and environmental conditions to reduce the burden of diabesity.
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Affiliation(s)
- José Ignacio Ramírez-Manent
- Faculty of Medicine, University Balearic Islands, 07009 Palma, Balearic Islands, Spain
- IDISBA, Balearic Islands Health Research Institute Foundation, 07004 Palma, Balearic Islands, Spain
- General Practitioner Department, Balearic Islands Health Service, 07003 Palma, Balearic Islands, Spain
| | - Bárbara Altisench Jané
- General Practitioner Department, Balearic Islands Health Service, 07003 Palma, Balearic Islands, Spain
- Correspondence:
| | - Matías Tomás Salvà
- Investigation Group ADEMA SALUD IUNICS, 07003 Palma, Balearic Islands, Spain
- Faculty of Dentistry, University School ADEMA, 07009 Palma, Balearic Islands, Spain
| | - Sebastiana Arroyo Bote
- Investigation Group ADEMA SALUD IUNICS, 07003 Palma, Balearic Islands, Spain
- Faculty of Dentistry, University School ADEMA, 07009 Palma, Balearic Islands, Spain
| | - Hilda María González San Miguel
- Investigation Group ADEMA SALUD IUNICS, 07003 Palma, Balearic Islands, Spain
- Faculty of Dentistry, University School ADEMA, 07009 Palma, Balearic Islands, Spain
| | - Ángel Arturo López-González
- IDISBA, Balearic Islands Health Research Institute Foundation, 07004 Palma, Balearic Islands, Spain
- Investigation Group ADEMA SALUD IUNICS, 07003 Palma, Balearic Islands, Spain
- Faculty of Dentistry, University School ADEMA, 07009 Palma, Balearic Islands, Spain
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Li M, Zheng Q, Miller JD, Zuo P, Yuan X, Feng J, Liu C, Bao S, Lou Q. Aerobic training reduces pancreatic fat content and improves β-cell function: A randomized controlled trial using IDEAL-IQ magnetic resonance imaging. Diabetes Metab Res Rev 2022; 38:e3516. [PMID: 34963031 DOI: 10.1002/dmrr.3516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 10/14/2021] [Accepted: 12/08/2021] [Indexed: 11/09/2022]
Abstract
AIMS To explore the effects of six months of moderate-intensity aerobic exercise on pancreatic fat content and its impact on β-cell function. MATERIALS AND METHODS A total of 106 patients with type 2 diabetes mellitus were randomized to either a moderate-intensity aerobic training group (three times a week, including 5 min warm-up, 50 min aerobic dancing, and 5 min relaxation, n = 53) or control group (n = 53) with 6-month intervention. The primary endpoint was change in pancreatic fat content. An intention-to-treat analysis was conducted. RESULTS Eighty-six patients completed the study with 43 patients in the aerobic training group. The average age, HbA1c, and pancreatic fat content for all participants (106 patients) were 66.39 ± 5.59 years, 7.05 ± 1.24%, and 10.35 ± 9.20%, respectively. Nearly half (49.06%) of patients were males. Subjects in the aerobic training group saw a significant reduction in pancreatic fat content when compared to controls (p = 0.001). In logistic regression models containing age, diabetes duration, change in BMI, smoking/drinking status, changes in lipid indices, and other abdominal fat content, only reduction in pancreatic fat content (p < 0.05) was an independent protective factor for β-cell function and HbA1c. CONCLUSIONS Six months of moderate-intensity aerobic training significantly reduced the pancreatic fat content. The reduction of pancreatic fat content was an independent protective factor for β-cell function and HbA1c.
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Affiliation(s)
- Min Li
- Department of Endocrinology, The First Affiliated Hospital of Hainan Medical University, Haikou, China
- Nursing College, Nanjing University of Chinese Medicine, Nanjing, China
| | - Qidong Zheng
- Department of Internal Medicine, Yuhuan Second People's Hospital, Yuhuan, China
| | - Joshua D Miller
- Division of Endocrinology and Metabolism, Department of Medicine, Renaissance School of Medicine at Stony Brook University, New York, USA
| | - Panpan Zuo
- School of Nursing, Taizhou Polytehnic College, Taizhou, China
| | - Xiaodan Yuan
- Department of Healthy Education, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jitao Feng
- Department of Radiology, Nanjing Pukou Hospital of Traditional Chinese Medicine, Nanjing, China
| | - Chao Liu
- Research Center of Endocrine and Metabolic Diseases, Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Shan Bao
- Department of Gynaecology and Obstetrics, Hainan General Hospital, Haikou, China
| | - Qingqing Lou
- Department of Endocrinology, The First Affiliated Hospital of Hainan Medical University, Haikou, China
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Fernández T, Viñuela M, Vidal C, Barrera F. Lifestyle changes in patients with non-alcoholic fatty liver disease: A systematic review and meta-analysis. PLoS One 2022; 17:e0263931. [PMID: 35176096 PMCID: PMC8853532 DOI: 10.1371/journal.pone.0263931] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 01/30/2022] [Indexed: 12/12/2022] Open
Abstract
Background Non-alcoholic fatty liver disease is a liver condition that is increasing worldwide and expected to become the number one cause of cirrhosis and hepatocellular carcinoma in the next 5 years. Currently there are no successful or approved pharmacological treatments. Weight loss is the first-line therapy as a 7 to 10% reduction improves steatosis, inflammation, hepatocyte ballooning, and fibrosis. To achieve this, lifestyle interventions including daily exercise and diet must be encouraged. We aimed to assess the effects of diet, exercise, or a combination of both compared to conventional treatment in patients with non-alcoholic fatty liver disease. Methods and finding A literature search was performed in CENTRAL, EMBASE, and PubMed. Randomized controlled trials comparing lifestyle changes with conventional treatment were included, without date restriction. Two authors searched studies according to eligibility criteria, extracted data, and assessed study quality. Subgroup analysis was made by type of intervention, duration of intervention and supervision. We calculated mean differences between the intervention and the control group with their corresponding 95% confidence intervals. Quality of the evidence was assessed using the Cochrane Risk of bias tool. This study is registered in PROSPERO, number CRD42020184241, and checked with the PRISMA checklist. 30 RCTs met the inclusion criteria. Compared to conventional treatment, combined exercise with diet seems to elicit greater reductions in ALT (MD: -13.27 CI 95% -21.39, -5.16), AST (MD: -7.02 CI 95% -11.26, -2.78) and HOMA-IR (MD: -2.07 CI 95% -2.61, -1.46) than diet (ALT MD: -4.48 CI 95% -1.01, -0.21; HOMA-IR MD: -0.61 CI 95% -1.01, -0.21) and exercise (ALT and AST non-significant; HOMA-IR MD = -0.46 CI 95% -0.8, -0.12) alone. Additionally, exercise improved quality of life, cardiorespiratory fitness, and weight (MD: -2.64 CI 95% -5.18, -0.09). Conclusion Lifestyle changes are effective in the treatment of NAFLD. Diet and exercise combined are superior to these interventions alone in improving liver enzymes and HOMA-IR.
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Affiliation(s)
- Tiziana Fernández
- Departamento Ciencias de la Salud, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
- * E-mail:
| | - Macarena Viñuela
- Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Catalina Vidal
- Departamento de Ortopedia y Traumatología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Barrera
- Departamento de Gastroenterología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
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Battista F, Ermolao A, van Baak MA, Beaulieu K, Blundell JE, Busetto L, Carraça EV, Encantado J, Dicker D, Farpour-Lambert N, Pramono A, Bellicha A, Oppert JM. Effect of exercise on cardiometabolic health of adults with overweight or obesity: Focus on blood pressure, insulin resistance, and intrahepatic fat-A systematic review and meta-analysis. Obes Rev 2021; 22 Suppl 4:e13269. [PMID: 33960110 PMCID: PMC8365642 DOI: 10.1111/obr.13269] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/06/2021] [Accepted: 04/10/2021] [Indexed: 12/17/2022]
Abstract
This systematic review examined the impact of exercise intervention programs on selected cardiometabolic health indicators in adults with overweight or obesity. Three electronic databases were explored for randomized controlled trials (RCTs) that included adults with overweight or obesity and provided exercise-training interventions. Effects on blood pressure, insulin resistance (homeostasis model of insulin resistance, HOMA-IR), and magnetic resonance measures of intrahepatic fat in exercise versus control groups were analyzed using random effects meta-analyses. Fifty-four articles matched inclusion criteria. Exercise training reduced systolic and diastolic blood pressure (mean difference, MD = -2.95 mmHg [95% CI -4.22, -1.68], p < 0.00001, I2 = 63% and MD = -1.93 mmHg [95% CI -2.73, -1.13], p < 0.00001, I2 = 54%, 60 and 58 study arms, respectively). Systolic and diastolic blood pressure decreased also when considering only subjects with hypertension. Exercise training significantly decreased HOMA-IR (standardized mean difference, SMD = -0.34 [-0.49, -0.18], p < 0.0001, I2 = 48%, 37 study arms), with higher effect size in subgroup of patients with type 2 diabetes (SMD = -0.50 [95% CI: -0.83, -0.17], p = 0.003, I2 = 39%). Intrahepatic fat decreased significantly after exercise interventions (SMD = -0.59 [95% CI: -0.78, -0.41], p < 0.00001, I2 = 0%), with a larger effect size after high-intensity interval training. In conclusion, exercise training is effective in improving cardiometabolic health in adults with overweight or obesity also when living with comorbitidies.
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Affiliation(s)
- Francesca Battista
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padua, Italy
| | - Andrea Ermolao
- Sport and Exercise Medicine Division, Department of Medicine, University of Padova, Padua, Italy
| | - Marleen A van Baak
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University, Maastricht, The Netherlands
| | - Kristine Beaulieu
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - John E Blundell
- Appetite Control and Energy Balance Research Group (ACEB), School of Psychology, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - Luca Busetto
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO).,Department of Medicine, University of Padova, Padua, Italy
| | - Eliana V Carraça
- Faculdade de Educação Física e Desporto, CIDEFES, Universidade Lusófona de Humanidades e Tecnologias, Lisbon, Portugal
| | - Jorge Encantado
- APPsyCI - Applied Psychology Research Center Capabilities & Inclusion, ISPA - University Institute, Lisbon, Portugal
| | - Dror Dicker
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO).,Department of Internal Medicine D, Hasharon Hospital, Rabin Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nathalie Farpour-Lambert
- Obesity Management Task Force (OMTF), European Association for the Study of obesity (EASO).,Obesity Prevention and Care Program Contrepoids, Service of Endocrinology, Diabetology, Nutrition and Patient Education, Department of Internal Medicine, University Hospitals of Geneva and University of Geneva, Geneva, Switzerland
| | - Adriyan Pramono
- NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Human Biology, Maastricht University, Maastricht, The Netherlands
| | - Alice Bellicha
- INSERM, Nutrition and Obesities: Systemic Approaches (NutriOmics), Sorbonne University, Paris, France.,UFR SESS-STAPS, University Paris-Est Créteil, Créteil, France
| | - Jean-Michel Oppert
- Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière hospital, Department of Nutrition, Institute of Cardiometabolism and Nutrition, Sorbonne University, Paris, France
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