Eficiencia de dos programas de actividad fisica sobre la esteatosis hepatica no alcoholica. un trial clinico randomizato

Autores/as

DOI:

https://doi.org/10.31053/1853.0605.v76.n1.21638

Palabras clave:

esteatosis hepática, ejercicio aeróbico, entrenamiento de resistencia, ensayo clínico

Resumen

Introducción: Estimar la eficiencia de dos programas de actividad física sobre la NAFLD

Métodos: Sujetos con NAFLD moderada o severa que habían participado a un estudio de pobación en el sur de Italia fueron invitados a participar. Fue completado un cuestionario, se tomaron medidas antropométricas y se realizó una ecografia hepática. Cada participante proveyó el consenso informato. Los participantes fueron aleatorizados a un programa aerobico (actividad aerobica moderada per 30 minutos, 5 veces a la semana) o un programa mixto (aerobico más entrenamiento de la fuerza de los grandes grupos musculares, 60 minutos, tres veces a la semana). Fue medida la adherencia a los programas y se aplicó un modelo linear mixto a los datos.

Resultados: El programa aerobico tuvo muy buena adherencia y esta aumentó con el tiempo mientras el programa mixto tuvo 100% de adherencia. No hubo diferencias estadísticamente significativas en el score de NAFLD al enrolamiento, mientras hubo diferencias estadísticamente significativas en el score medio de NAFLD después de 6 meses pero el score en el grupo del programa aerobico tuvo una reducción del 22% más intensa que el programa mixto. Este último programa por lo tanto se ha mostrado menos efectivo que el programa aerobico.

Conclusión: Un programa de actividad física aerobica es un tratamiento realístico que podría ser efectuado no solo para la NAFLD sino también como prevención primaria de otras enfermedades crónicas.

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Biografía del autor/a

Isabella Franco, National Institute of Gastroenterology, “Saverio de Bellis” Research Hospital

Laboratory of Epidemiology and Biostatistics

Antonella Bianco, National Institute of Gastroenterology, “Saverio de Bellis” Research Hospital

Laboratory of Epidemiology and Biostatistics

Maria del Pilar Dìaz, Universidad Nacional de Córdoba, CONICET, Facultad de Ciencias Médicas

Instituto de Investigaciones en Ciencias de la Salud (INICSA)

Caterina Bonfiglio, National Institute of Gastroenterology, “Saverio de Bellis” Research Hospital

Laboratory of Epidemiology and Biostatistics

Marisa Chiloiro, National Institute of Gastroenterology, “Saverio de Bellis” Research Hospital

Department of Radiology

Sonia Alejandra Pou, Universidad Nacional de Córdoba, CONICET, Facultad de Ciencias Médicas

Instituto de Investigaciones en Ciencias de la Salud (INICSA)

Julia Becaria Coquet, Universidad Nacional de Córdoba, CONICET, Facultad de Ciencias Médicas

Instituto de Investigaciones en Ciencias de la Salud (INICSA)

Antonella Mirizzi, National Institute of Gastroenterology, “Saverio de Bellis” Research Hospital

Laboratory of Epidemiology and Biostatistics

Alessandro Nitti, National Institute of Gastroenterology, “Saverio de Bellis” Research Hospital

Laboratory of Epidemiology and Biostatistics

Angelo Campanella, National Institute of Gastroenterology, “Saverio de Bellis” Research Hospital

Laboratory of Epidemiology and Biostatistics

Carla Maria Leone, National Institute of Gastroenterology, “Saverio de Bellis” Research Hospital

Laboratory of Epidemiology and Biostatistics

Maria Gabriella Caruso, National Institute of Gastroenterology, “Saverio de Bellis” Research Hospital

Laboratory of Nutritional Biochemistry

Mario Correale, National Institute of Gastroenterology, “Saverio de Bellis” Research Hospital

Laboratory of Clinical Chemistry

Alberto Ruben Osella, Laboratoria di Epidemiologia e Biostatistica IRCCS Saverio de Bellis

Medico Cirujano. FCM UNC 1980

Doctor en Medicina y Cirujia, FCM UNC 1990

MSc Bioestadistica, Università diu Milano 1994

Actualmente: Jefe del Laboratorio di Epidemiologia e Biostatistica. IRCCS Saverio de Bellis

Citas

Loomba R, Sanyal AJ. The global NAFLD epidemic. Nat Rev Gastroenterology Hepatology 2013; 10: 686-690.

Chalasani N, Diehl AM, Brunt EM, Cusi K, Charlton M, Sanyal AJ. The diagnosis and management of non-alcoholic fatty liver disease: practice Guideline by the American Association for the Study of Liver Diseases, American College of Gastroenterology, and the American Gastroenterological Association. Hepatology 2012; 55: 2005-2023.

Loomba R, Abraham M, Unalp A, Wilson L, Lavine J, Doo E, Bass NM; Nonalcoholic Steatohepatitis Clinical Research Network. Non-alcoholic Steatohepatitis Clinical Research Network. Association between diabetes, family history of diabetes, and risk of non-alcoholic steatohepatitis and fibrosis. Hepatology 2012; 56:943-951.

Kim D, Choi SY, Park EH, Lee W, Kang JH, Kim W, Kim YJ, Yoon JH, Jeong SH, Lee DH, Lee HS, Larson J, Therneau TM, Kim WR. Non-alcoholic fatty liver disease is associated with coronary artery calcification. Hepatology 2012; 56:605-613.

Bedogni G, Miglioli L, Masutti F, Tiribelli C, Marchesini G, Bellentani S. Prevalence of and risk factors for nonalcoholic fatty liver disease: the Dionysos nutrition and liver study. Hepatology 2005; 42: 44-52.

Tamura Y, Tanaka Y, Sato F, Choi JB, Watada H, Niwa M, Kinoshita J, Ooka A, Kumashiro N, Igarashi Y, Kyogoku S, Maehara T, Kawasumi M, Hirose T, Kawamori R. Effects of diet and exercise on muscle and liver intracellular lipid contents and insulin sensitivity in type 2 diabetic patients. J Clin Endocrinol Metab 2005; 90: 3191-3196.

Thoma C, Day CP, Trenell MI. Lifestyle interventions for the treatment of non-alcoholic fatty liver disease in adults: a systematic review. Journal of Hepatology 2012; 56:255-266.

Vilar Gomez E, Rodriguez De Miranda A, Gra Oramas B, Arus Soler E, Llanio Navarro R, Calzadilla Bertot L, Yasells Garcia A, Del Rosario Abreu Vazquez M. Clinical trial: a nutritional supplement Viusid, in combination with diet and exercise, in patients with non-alcoholic fatty liver disease. Aliment Pharmacol Ther 2009; 30: 999–1009.

Eckard C, Cole R, Lockwood J, Torres DM, Williams CD, Shaw JC, Harrison SA. Prospective histopathologic evaluation of lifestyle modification in non-alcoholic fatty liver disease: a randomized trial. Therap Adv Gastroenterol 2013; 6:249–259.

Lazo M, Solga SF, Horska A, Bonekamp S, Diehl AM, Brancati FL, Wagenknecht LE, Pi-Sunyer FX, Kahn SE, Clark JM; Fatty Liver Subgroup of the Look AHEAD Research Group. A Effect of a 12-month intensive lifestyle intervention on hepatic steatosis in adults with type 2 diabetes. Diabetes Care 2010; 33: 2156-2163.

Cortez-Pinto H, Machado M. Impact of body weight, diet and lifestyle on non-alcoholic fatty liver disease. Expert Rev Gastroenterology Hepatology 2008; 2: 217-231.

Johnson NA, Sachinwalla T, Walton DW, Smith K, Armstrong A, Thompson MW, George J. Aerobic exercise training reduces hepatic and visceral lipids in obese individuals without weight loss. Hepatology 2009; 50: 1105-1112.

Hallsworth K, Fattakhova G, Hollingsworth KG, Thoma C, Moore S, Taylor R, Day CP, Trenell MIResistance exercise reduces liver fat and its mediators in non-alcoholic fatty liver disease independent of weight loss. Gut 2011; 60: 1278-1283.

Bacchi E, Negri C, Targher G, Faccioli N, Lanza M, Zoppini G, Zanolin E, Schena F, Bonora E, Moghetti P. Both resistance training and aerobic training reduce hepatic fat content in type 2 diabetic subjects with non-alcoholic fatty liver disease (the RAED2 Randomized Trial). Hepatology 2013; 58:1287-1295.

Cozzolongo R, Osella AR, Elba S, Petruzzi J, Buongiorno G, Giannuzzi V, Leone G, Bonfiglio C, Lanzilotta E, Manghisi OG, Leandro G; NUTRIHEP Collaborating Group, Donnaloia R, Fanelli V, Mirizzi F, Parziale L, Crupi G, Detomaso P, Labbate A, Zizzari S, Depalma M, Polignano A, Lopinto D, Daprile G.Epidemiology of HCV infection in the general population: a survey in a southern Italian town. Am J Gastroenterol 2009; 104:2740-2746

Chiloiro M, Caruso MG, Cisternino AM, Inguaggiato R, Reddavide R, Bonfiglio C, Guerra V, Notarnicola M, De Michele G, Correale M, Noviello MR, Misciagna G.Ultrasound evaluation and correlates of fatty liver disease: A population Study in a Mediterranean Area. Metab Syndr Relat Disord 2013; 11: 349-358.

Skinner HA, Sheu WJ. Reliability of alcohol use indices. The Lifetime Drinking History and the MAST. J Stud Alcohol 1982; 43: 1157-1170.

International Physical Activity Questionnaire. https://sites.google.com/site/theipaq/accessed August 20, 2016

Laukkanen R, Oja P, Pasanen M, Vuori I. Validity of a two kilometre walking test for estimating maximal aerobic power in overweight adults. Int J Obes Relat Metab Disord 1992; 16: 263-268.

Canadian Society for Exercise Physiology. The Canadian Physical Activity, Fitness & Lifestyle Approach: CSEP-Health & Fitness Program’s Health Related Appraisal & Counselling Strategy, 3rd Edition. Toronto: Canadian Society for Exercise Physiology 2003

Hoeger WW, Hopkins DR. A comparison of the sit and reach and the modified sit and reach in the measurement of flexibility in women. Res Q Exerc Sport 1992; 63: 191-195.

Chiloiro M, Misciagna G. Ultrasonographic Anthropometry: An Application to the Measurement of Liver and Abdominal Fat. In: Preedy VR (ed). Handbook of Anthropometry, Physical Measures of Human Form in Health and Disease. New York: Springer 2012: 2227-2242.

Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, Nieman DC, Swain DP; American College of Sports Medicine. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc 2011; 43:1334-1359.

Zelber-Sagi S, Nitzan-Kaluski D, Goldsmith R, Webb M, Zvibel I, Goldiner I, Blendis L, Halpern Z, Oren R. Role of leisure-time physical activity in non-alcoholic fatty liver disease: a population-based study. Hepatology 2008; 48:1791-1798.

Schenk S, Horowitz JF. Acute exercise increases triglyceride synthesis in skeletal muscle and prevents fatty acid-induced insulin resistance. J Clin Invest 2007; 117: 1690-1698.

Keating SE, Hackett DA, Parker HM, O'Connor HT, Gerofi JA, Sainsbury A, Baker MK, Chuter VH, Caterson ID, George J, Johnson NA.Effect of aerobic exercise training dose on liver fat and visceral adiposity. J Hepatol 2015; 63:174-182.

Non-alcoholic Fatty Liver Disease Study Group, Lonardo A, Bellentani S, Argo CK, Ballestri S, Byrne CD, Caldwell SH, Cortez-Pinto H, Grieco A, Machado MV, Miele L, Targher G. Epidemiological modifiers of non-alcoholic fatty liver disease: Focus on high-risk groups. Dig Liver Dis 2015; 47: 997-1006.

Montori VM, Guyatt GH. Intention-to-treat principle. CMAJ 2001; 165:1339-1341.

Joy D, Thava VR, Scott B. Diagnosis of fatty liver disease: is biopsy necessary? Eur J Gastroenterol Hepatol 2003; 15:539-543.

Wieckowska A, McCullough AJ, Feldstein AE. Non-invasive diagnosis and monitoring of non-alcoholic steatohepatitis: present and future. Hepatology 2007; 46:582-589.

Publicado

2019-02-27

Cómo citar

1.
Franco I, Bianco A, Dìaz M del P, Bonfiglio C, Chiloiro M, Pou SA, Becaria Coquet J, Mirizzi A, Nitti A, Campanella A, Leone CM, Caruso MG, Correale M, Osella AR. Eficiencia de dos programas de actividad fisica sobre la esteatosis hepatica no alcoholica. un trial clinico randomizato. Rev Fac Cien Med Univ Nac Cordoba [Internet]. 27 de febrero de 2019 [citado 19 de abril de 2024];76(1):26-3. Disponible en: https://revistas.unc.edu.ar/index.php/med/article/view/21638

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