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Dissociation between exercise-induced reduction in liver fat and changes in hepatic and peripheral glucose homoeostasis in obese patients with non-alcoholic fatty liver disease

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posted on 2022-08-10, 11:43 authored by Daniel J. Cuthbertson, Fariba Shojaee-Moradie, Victoria S. Sprung, Helen Jones, Chris PughChris Pugh, Paul Richardson, Graham J. Kemp, Mark Barrett, Nicola C. Jackson, E. Louise Thomas, Jimmy D. Bell, A Margot Umpleby

 Non-alcoholic fatty liver disease (NAFLD) is associated with multi-organ (hepatic, skeletal muscle, adipose tissue) insulin resistance (IR). Exercise is an effective treatment for lowering liver fat but its effect on IR in NAFLD is unknown. We aimed to determine whether supervised exercise in NAFLD would reduce liver fat and improve hepatic and peripheral (skeletal muscle and adipose tissue) insulin sensitivity. Sixty nine NAFLD patients were randomized to 16 weeks exercise supervision (n=38) or counselling (n=31) without dietary modification. All participants underwent MRI/spectroscopy to assess changes in body fat and in liver and skeletal muscle triglyceride, before and following exercise/counselling. To quantify changes in hepatic and peripheral insulin sensitivity, a pre-determined subset (n=12 per group) underwent a two-stage hyperinsulinaemic euglycaemic clamp pre- and post-intervention. Results are shown as mean [95% confidence interval (CI)]. Fifty participants (30 exercise, 20 counselling), 51 years (IQR 40, 56), body mass index (BMI) 31 kg/m2 (IQR 29, 35) with baseline liver fat/water % of 18.8% (IQR 10.7, 34.6) completed the study (12/12 exercise and 7/12 counselling completed the clamp studies). Supervised exercise mediated a greater reduction in liver fat/water percentage than counselling [Δ mean change 4.7% (0.01, 9.4); P<0.05], which correlated with the change in cardiorespiratory fitness (r=–0.34, P=0.0173). With exercise, peripheral insulin sensitivity significantly increased (following high-dose insulin) despite no significant change in hepatic glucose production (HGP; following low-dose insulin); no changes were observed in the control group. Although supervised exercise effectively reduced liver fat, improving peripheral IR in NAFLD, the reduction in liver fat was insufficient to improve hepatic IR 

Funding

Funding was provided by the European Foundation for the Study of Diabetes, Rheindorfer 29 Weg 3, 40591 Dusseldorf, Germany

History

Published in

Clinical Science

Publisher

Portland Press

Version

  • AM (Accepted Manuscript)

Citation

Cuthbertson, D.J., Shojaee-Moradie, F., Sprung, V.S., Jones, H., Pugh, C.J., Richardson, P., Kemp, G.J., Barrett, M., Jackson, N.C., Thomas, E.L., Bell, J.D. & Umpleby, M. (2016) 'Dissociation between exercise-induced reduction in liver fat and changes in hepatic and peripheral glucose homoeostasis in obese patients with non-alcoholic fatty liver disease', Clinical Science, 130(2), pp.93-104

Electronic ISSN

1470-8736

Cardiff Met Affiliation

  • Cardiff School of Sport and Health Sciences

Cardiff Met Authors

Christopher J.A. Pugh

Cardiff Met Research Centre/Group

  • Cardiovascular Physiology

Copyright Holder

  • © The Publisher

Language

  • en

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