Takahashi Hirokazu, Kotani Kazuhiko, Tanaka Kenichi, Egucih Yuichiro, Anzai Keizo
Division of Metabolism and Endocrinology, Faculty of Medicine, Saga University, Saga, Japan.
Liver Center, Saga University Hospital, Saga University, Saga, Japan.
Front Endocrinol (Lausanne). 2018 Oct 15;9:588. doi: 10.3389/fendo.2018.00588. eCollection 2018.
Exercise training ameliorates nonalcoholic fatty liver disease (NAFLD) as well as obesity and metabolic syndrome. Although it is difficult to eliminate the effects of body weight reduction and increased energy expenditure-some pleiotropic effects of exercise training-a number of studies involving either aerobic exercise training or resistance training programs showed ameliorations in NAFLD that are independent of the improvements in obesity and insulin resistance. studies have identified effects of exercise training on the liver, which may help to explain the "direct" or "independent" effect of exercise training on NAFLD. Exercise training increases peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1α) expression, improves mitochondrial function and leads to reduced hepatic steatosis, inflammation, fibrosis, and tumor genesis. Crosstalk between the liver and adipose tissue, skeletal muscle and the microbiome is also a possible mechanism for the effect of exercise training on NAFLD. Although numerous studies have reported benefits of exercise training on NAFLD, the optimal duration and intensity of exercise for the prevention or treatment of NAFLD have not been established. Maintaining adherence of patients with NAFLD to exercise training regimes is another issue to be resolved. The use of comprehensive analytical approaches to identify biomarkers such as hepatokines that specifically reflect the effect of exercise training on liver functions might help to monitor the effect of exercise on NAFLD, and thereby improve adherence of these patients to exercise training. Exercise training is a robust approach for alleviating the pathogenesis of NAFLD, although further clinical and experimental studies are required.
运动训练可改善非酒精性脂肪性肝病(NAFLD)以及肥胖症和代谢综合征。尽管很难消除体重减轻和能量消耗增加的影响(运动训练的一些多效性作用),但许多涉及有氧运动训练或抗阻训练计划的研究表明,NAFLD得到改善,且这种改善独立于肥胖和胰岛素抵抗的改善。多项研究已确定运动训练对肝脏的影响,这可能有助于解释运动训练对NAFLD的“直接”或“独立”作用。运动训练可增加过氧化物酶体增殖物激活受体γ共激活因子1α(PGC1α)的表达,改善线粒体功能,并导致肝脏脂肪变性、炎症、纤维化和肿瘤发生减少。肝脏与脂肪组织、骨骼肌和微生物群之间的相互作用也是运动训练对NAFLD产生影响的一种可能机制。尽管许多研究报告了运动训练对NAFLD的益处,但尚未确定预防或治疗NAFLD的最佳运动持续时间和强度。保持NAFLD患者对运动训练方案的依从性是另一个有待解决的问题。使用综合分析方法来识别生物标志物,如能特异性反映运动训练对肝功能影响的肝因子,可能有助于监测运动对NAFLD的影响,从而提高这些患者对运动训练的依从性。运动训练是减轻NAFLD发病机制的一种有效方法,不过还需要进一步的临床和实验研究。