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Lookup NU author(s): Dr Dave Houghton, Dr Kate HallsworthORCiD, Dr Christian Thoma, Dr Sophie Cassidy, Dr Timothy Hardy, Dr Sarah Heaps, Dr Kieren Hollingsworth, Professor Roy Taylor, Professor Chris Day, Dr Steven MassonORCiD, Professor Stuart McPhersonORCiD, Professor Quentin AnsteeORCiD, Professor Mike TrenellORCiD
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© 2017 AGA Institute Background & Aims Exercise is an important component of obesity-associated disorders and has been shown to reduce markers of nonalcoholic fatty liver disease (NAFLD). However, little is known about how these effects are influenced by alcohol intake. The authors performed a randomized controlled trial to investigate the effects of exercise on hepatic triglyceride content (HTGC) and metabolism in overweight or obese patients who consume alcohol. Methods The authors performed a prospective study of 27 patients (mean 54 ± 11 years of age, body mass index [BMI] 31 ± 4 kg/m2) with >5% HTGC in the United Kingdom, consuming alcohol (mean 221 ± 75 g/week). Anthropometry, body composition, HTGC, and abdominal fat were measured using plethysmography and magnetic resonance imaging. Subjects were assigned to groups that exercised (3 times/week on nonconsecutive days) for 12 weeks (n = 14) or continued standard care (control group, n = 13), maintaining baseline weight and alcohol consumption. The exercise program consisted of aerobic exercise (static cycling) and a circuit of resistance exercise (free weights and machines). Patients were examined at baseline and at 12 weeks; data collected on HTGC, body composition, metabolic control, circulating inflammatory, and fibrosis markers were assessed at baseline and at 12 weeks. Between-group differences were evaluated using an unpaired t test and within-group differences using a paired t test. The primary outcomes for this study were changes in HTGC between baseline and 12 weeks. Results After 12 weeks, there was no significant difference between the exercise and control groups in HTGC (reduction of 0.1% ± 2.1% in exercisers vs increase of 0.5 ± 2.1% in control group; P >.05). At week 12, the exercise group had significant reductions in subcutaneous fat (loss of 23 ± 28 cm2 in the exercisers vs increase of 12 ± 19 cm2 in the control group; P <.01), and whole body fat (loss of 2.1 ± 1.1 kg in the exercisers vs increase of 0.2 ± 2.1 kg; P <.01). The exercise group also had a significantly greater increase in lean body mass (increase of 1.9 ± 1.4 kg for the exercisers vs increase of 0.7 ± 1.5 kg for the control group; P <.01) and a significantly greater reduction in level of cytokeratin 18 (reduction of 49 ± 82 U/L in exercisers vs increase of 17 ± 38 U/L in control group; P <.05). There were no differences between groups in changes in metabolic factors or markers of inflammation. Conclusions In a randomized controlled trial of obese individuals who consume alcohol, exercise significantly improved body composition and reduced hepatocyte apoptosis (cytokeratin 18), but did not reduce HTGC. This finding could indicate that alcohol consumption reduces the effects of exercise on NAFLD observed in previous studies. Clinical care teams should look to use exercise as part of the management strategy for people consuming alcohol, but optimal benefit may be as an adjunct to alcohol reduction and weight management strategies. (ISRCTN.com, Number: ISRCTN90597099).
Author(s): Houghton D, Hallsworth K, Thoma C, Cassidy S, Hardy T, Heaps S, Hollingsworth KG, Taylor R, Day CP, Masson S, McPherson S, Anstee QM, Trenell MI
Publication type: Article
Publication status: Published
Journal: Clinical Gastroenterology and Hepatology
Year: 2017
Volume: 15
Issue: 10
Pages: 1596-1603.e3
Print publication date: 01/10/2017
Online publication date: 10/05/2017
Acceptance date: 02/04/2016
ISSN (print): 1542-3565
ISSN (electronic): 1542-7714
Publisher: W.B. Saunders
URL: https://doi.org/10.1016/j.cgh.2017.05.001
DOI: 10.1016/j.cgh.2017.05.001
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