The role of moderate- and high-intensity supervised aerobic training in reducing steatosis and hepatic fibrosis in patients with non-alcoholic fatty liver disease; a randomized controlled trial

AIM: This study aimed to compare the effect of the same volume of moderate- and high-intensity aerobic exercise on patients' liver steatosis and fibrosis. BACKGROUND: Exercise is known strategy to deal with non-alcoholic fatty liver disease (NAFLD). METHODS: This Randomized Control Trial was performed on 60 patients randomly assigned to three arms of the study (1:1:1). Fibrosis and steatosis of liver including Control Attenuated Parameter (CAP) determined using Transient Elastography (TE). The control group was advised to adjust their lifestyle, as a routine management. The intervention groups additionally, participated on supervised exercise programs with two different intensities but the same volume of 1000 KCal per week. The intensities of 50% and 70% of V02 reserve were considered for moderate-intensity and vigorous programs, respectively. RESULTS: On six-month follow-up, none of outcomes were statistically significant among three arms of study. However, changes in some outcomes were reached to statistically significant difference in follow-up in comparison with baseline. The mean of CAP score changes was -19.43 (31.43) (P=0.03), 9.92 (26.81) (P=0.21), and 14.61 (18.03) (P=0.01) in control, moderate- and high-intensity groups, respectively. In the high-intensity group, in addition to steatosis, this difference was also observed in the rate of fibrosis. Besides, the level of serum aminotransferases in the group with moderate exercise after six months had a significant decrease compared to baseline. (P=0.01) CONCLUSION: Improvement in steatosis and fibrosis was more evident in high- intensity group. As the rate of drop out was high, caution is needed in interpretation of the results.