Objectively Measured Physical Activity Is Inversely Associated With Nonalcoholic Fatty Liver Disease: The Rotterdam Study

The aim of the current study was to examine the independent association of physical activity with nonalcoholic fatty liver disease (NAFLD) and aminotransferases while adjusting for obesity and diet. Cross-sectional data from 32,391 participants aged ≥ 20 years in the Korea National Health and Nutrition Examination Surveys (KNHANES) was analyzed by logistic regression models and general linear models. Physical activity was assessed from the questionnaire by health-enhancing physical activity (HEPA). The physical activity was negatively associated with NAFLD and lean NAFLD after adjustment for multiple factors with an odds ratio of 0.7 (95% CI, 0.6–0.8) and 0.5 (95% CI, 0.4–0.7) comparing the most active (HEPA active) and the least active (inactive) participants. Among the participants with NAFLD, physical activity also showed an independent negative association with alanine aminotransferase (ALT) levels but not with aspartate aminotransferase levels. These independent associations were not observed when comparing the minimally active and inactive participants except for the risk of lean NAFLD. Physical activity is independently associated with the degree of hepatocellular injury in patients with NAFLD as well as the risk of NAFLD and lean NAFLD in the general population. Sufficiently active physical activity greater than a minimally active level may be needed to lower the risk of NAFLD and ALT levels.

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Relation of Physical Activity to Prevalence of Nonalcoholic Fatty Liver Disease Independent of Cardiometabolic Risk

The American Journal of Cardiology ◽

10.1016/j.amjcard.2014.09.044 ◽

2015 ◽

Vol 115 (1) ◽

pp. 34-39 ◽

Cited By ~ 16

Author(s):

Ebenezer T. Oni ◽

Rohan Kalathiya ◽

Ehimen C. Aneni ◽

Seth S. Martin ◽

Michael J. Blaha ◽

...

Keyword(s):

Physical Activity ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Fatty Liver Disease ◽

Cardiometabolic Risk ◽

Nonalcoholic Fatty Liver

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Physical Activity Is Prospectively Associated With Adolescent Nonalcoholic Fatty Liver Disease

Journal of Pediatric Gastroenterology and Nutrition ◽

10.1097/mpg.0000000000000904 ◽

2016 ◽

Vol 62 (1) ◽

pp. 110-117 ◽

Cited By ~ 3

Author(s):

Emma L. Anderson ◽

Abigail Fraser ◽

Laura D. Howe ◽

Mark P. Callaway ◽

Naveed Sattar ◽

...

Keyword(s):

Physical Activity ◽

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Fatty Liver Disease ◽

Nonalcoholic Fatty Liver

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Nonalcoholic Fatty Liver Disease in The Rotterdam Study: About Muscle Mass, Sarcopenia, Fat Mass, and Fat Distribution

Journal of Bone and Mineral Research ◽

10.1002/jbmr.3713 ◽

2019 ◽

Vol 34 (7) ◽

pp. 1254-1263 ◽

Cited By ~ 5

Author(s):

Louise Johanna Maria Alferink ◽

Katerina Trajanoska ◽

Nicole Stephanie Erler ◽

Josje Dorothea Schoufour ◽

Robert Jacobus Knegt ◽

...

Keyword(s):

Liver Disease ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Muscle Mass ◽

Fat Mass ◽

Fatty Liver Disease ◽

Fat Distribution ◽

Rotterdam Study ◽

Nonalcoholic Fatty Liver

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Noninvasive Markers of Improvement of Liver Steatosis Achieved by Weight Reduction in Patients with Nonalcoholic Fatty Liver Disease

Romanian Journal Of Internal Medicine ◽

10.1515/rjim-2015-0008 ◽

2015 ◽

Vol 53 (1) ◽

pp. 56-64 ◽

Cited By ~ 1

Author(s):

Ionel Copaci ◽

Ioana Lupescu ◽

Elena Caceaune ◽

Grethi Chiriac ◽

G. Ismail

Keyword(s):

Physical Activity ◽

Liver Disease ◽

Waist Circumference ◽

Fatty Liver ◽

Nonalcoholic Fatty Liver Disease ◽

Weight Reduction ◽

Fatty Liver Disease ◽

Liver Steatosis ◽

Moderate Intensity ◽

Nonalcoholic Fatty Liver

Abstract Nonalcoholic fatty liver disease (NAFLD) is strongly associated with insulin resistance and metabolic syndrome, which are linked to obesity. The aim of the study was to assess if weight reduction through 12 months of lifestyle intervention and exercise would lead to improvement of steatosis. Methods. In a prospective observational study 86 overweight subjects (51 men, 35 women) with steatosis were recruited, after excluding other etiologies. Patients were assigned a caloric goal and a daily fat goal. Physical activity focused on moderate-intensity activities. Blood samples (biochemistry, HOMA-IR, cytokine levels, steatotest) were collected at entry and months 6 and 12. All subjects underwent abdominal CT scan before commencement and after 12 months to assess visceral and subcutaneous adipose tissue (VAT/SAT) area. Results. After 12 months baseline descriptive characteristics (weight, BMI, waist circumference) decreased significantly. Biochemical parameters that decreased significantly were: GGT (40.0 ± 18.0 vs 31.1 ± 13; p = 0.01), ALT (58.5 ± 23.5 vs 32,7 ± 14.8; p = 0.001), cholesterol (236.4 ± 54.8 vs 204.8 ± 91; p = 0.05), LDL (160.1 ± 47.4 vs 125.3 ± 40; p = 0.05) and HOMA-R (4.86 ± 0.63 vs 3 ± 0.41; p = 0.018). Steatotest improved significantly (0.68 ± 0.16 vs 0.38 ± 0.14; p = 0.02). Modification of adipocytokines was significant for leptin (p = 0.018) and adiponectin (p = 0.003). Factors associated with regression of steatosis were weight, BMI, ALT, waist circumference, GGT, HOMA, leptin, VAT and steatotest. Multivariate logistic regression showed the following factors related to improved steatosis: BMI < 25 kg/m2, ALT < 42 U/L, leptin < 10.5 ng/ml and adiponectin > 8.4 μg/ml. Conclusions. Overweight persons who achieve significant reductions in body weight through 12 months of physical activity and low caloric diet can decrease liver fat, VAT and SAT. Even in those with minimal weight loss ALT levels, steatosis, adipokines and cardiovascular risk factors improved.

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