Sreenivasa Baba Chalamalasetty, Alexander George, Kalyani Bikkasani, Pandey Rakesh, Rastogi Sujata, Pandey Amaresh, Choudhuri Gourdas
Department of Gastroenterology, Sandjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
J Gastroenterol Hepatol. 2006 Jan;21(1 Pt 1):191-8. doi: 10.1111/j.1440-1746.2005.04233.x.
Nonalcoholic steatohepatitis (NASH) is commonly associated with overweight and insulin resistance. Aerobic exercise is known to reduce insulin resistance. We studied the effect of regular aerobic exercise on serum aminotransferase levels in patients with NASH.
Sixty-five (mean age 38.7+/-9.5 years; 46 [78%] males) out of 94 patients diagnosed with NASH participated in the study. Each patient was advised regular aerobic exercise for 30 min duration per day, and trained to achieve a heart rate of 60-70% of his/her maximal heart rate for at least 5 days a week. In addition, those with a high body mass index (BMI) were advised a moderately energy-restricted diet. Patients were followed up monthly for at least 3 months by BMI, waist-hip ratio (WHR), waist circumference (WC), aspartate aminotransferase (AST) and alanine aminotransferase (ALT).
Forty-three (72.8%) patients had a high BMI. Central obesity (WHR >or=0.90 cm in men and >or=0.85 cm in women) was present in 58 (98.3%) patients and metabolic syndrome in 12 (20.3%) patients. In the 44 patients who complied regularly with the exercise program, serum ALT normalized in 20 (45%; P<0.05), and mean AST and ALT values declined from 70.5 and 104.0-41.5 (P<0.001) and 63.2 (P<0.001), respectively. Overweight patients lost a mean 3.1 kg (range 0-13 kg) weight and showed a decline in BMI (28.7 vs 27.5; P<0.001) and WC (99.4 cm vs 96.1 cm; P=0.001). Serum ALT did not normalize in any of the 15 patients who failed to comply with the exercise program; their pre- and post-AST (82.8 and 81.2, respectively) and ALT (98.0 and 96.1, respectively) levels, BMI (27.5 and 27.6, respectively) and WHR (0.99 cm and 0.99 cm, respectively) did not show any significant change at 3 months, and also for an extended mean follow-up period of 5.3 months.
Moderate intensity aerobic exercise helps in normalizing ALT levels in patients with NASH.
非酒精性脂肪性肝炎（NASH）通常与超重和胰岛素抵抗相关。有氧运动已知可降低胰岛素抵抗。我们研究了规律有氧运动对NASH患者血清转氨酶水平的影响。
94例诊断为NASH的患者中有65例（平均年龄38.7±9.5岁；46例[78%]为男性）参与了本研究。建议每位患者每天进行30分钟的规律有氧运动，并训练使其心率达到其最大心率的60 - 70%，每周至少5天。此外，对体重指数（BMI）高的患者建议适度限制能量饮食。通过BMI、腰臀比（WHR）、腰围（WC）、天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）对患者进行至少3个月的每月随访。
43例（72.8%）患者BMI高。58例（98.3%）患者存在中心性肥胖（男性WHR≥0.90 cm，女性WHR≥0.85 cm），12例（20.3%）患者存在代谢综合征。在44例定期遵守运动计划的患者中，20例（45%；P<0.05）血清ALT恢复正常，AST和ALT的平均水平分别从70.5和104.0降至41.5（P<0.001）和63.2（P<0.001）。超重患者平均体重减轻3.1 kg（范围0 - 13 kg），BMI（28.7对27.5；P<0.001）和WC（99.4 cm对96.1 cm；P = 0.001）下降。15例未遵守运动计划的患者中，血清ALT均未恢复正常；3个月时以及延长至平均5.3个月的随访期内，他们的AST（分别为82.8和81.2）和ALT（分别为98.0和96.1）水平、BMI（分别为27.5和27.6）以及WHR（分别为0.99 cm和0.99 cm）均未显示任何显著变化。
中等强度有氧运动有助于使NASH患者的ALT水平恢复正常。
