Effectiveness of two physical activity programs on non-alcoholic fatty liver disease. a randomized controlled clinical trial
DOI:
https://doi.org/10.31053/1853.0605.v76.n1.21638Palavras-chave:
liver steatosis, aerobic exercise, resistance training, clinical trial,Resumo
Introduction: To estimate the effectiveness of two physical activity programs on NAFLD.
Methods: Participants come from a survey conducted in southern Italy. Subjects with moderate or severe NAFLD were invited to participate. After giving informed consent, they completed a questionnaire, underwent ultrasonography and anthropometric measurements. Then they were randomized an Aerobic or a Combined Exercise program and followed up for six months. The first group followed a program of moderate aerobic activity lasting 30 minutes, 5 days per week. The second group did aerobic training with the addition of muscle training involving the large muscle groups, stimulating them to make more intense efforts, for a duration of 60 minutes, at least, 3 days a week. Compliance with the programs was measured. A mixed linear model was applied to the data.
Results: Compliance with Aerobic Exercise was homogeneous and increased over time. Combined Program compliance was equal to 100%. There was no significant difference in the NAFLD mean score by treatment at baseline and after six months. However, there was a significant reduction in the NAFLD mean score for treatments after six months. The NAFLD measured score was reduced by 22% in the Aerobic treatment group when confronted with the other program. In the Combined program, after 6 months, results showed to be less effective than the Aerobic Exercise in reducing the NAFLD score.
Conclusions: An aerobic exercise program is a realistic intervention which could be included as a part of primary prevention of several chronic diseases.
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Referências
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.
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