von Loeffelholz Christian, Roth Johannes, Coldewey Sina M, Birkenfeld Andreas L
Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, 07747 Jena, Germany.
Septomics Research Center, Jena University Hospital, 07747 Jena, Germany.
Biomedicines. 2021 Dec 7;9(12):1853. doi: 10.3390/biomedicines9121853.
Sedentary behavior constitutes a pandemic health threat contributing to the pathophysiology of obesity and type 2 diabetes (T2D). Sedentarism is further associated with liver disease and particularly with nonalcoholic/metabolic dysfunction associated fatty liver disease (NAFLD/MAFLD). Insulin resistance (IR) represents an early pathophysiologic key element of NAFLD/MAFLD, prediabetes and T2D. Current treatment guidelines recommend regular physical activity. There is evidence, that physical exercise has impact on a variety of molecular pathways, such as AMP-activated protein kinase and insulin signaling as well as glucose transporter 4 translocation, modulating insulin action, cellular substrate flow and in particular ectopic lipid and glycogen storage in a positive manner. Therefore, physical exercise can lead to substantial clinical benefit in persons with diabetes and/or NAFLD/MAFLD. However, experience from long term observational studies shows that the patients' motivation to exercise regularly appears to be a major limitation. Strategies to integrate everyday physical activity (i.e., nonexercise activity thermogenesis) in lifestyle treatment schedules might be a promising approach. This review aggregates evidence on the impact of regular physical activity on selected molecular mechanisms as well as clinical outcomes of patients suffering from IR and NAFLD/MAFLD.
久坐行为构成了一种全球性的健康威胁，会导致肥胖和2型糖尿病（T2D）的病理生理过程。久坐不动还与肝脏疾病相关，尤其是与非酒精性/代谢功能障碍相关脂肪性肝病（NAFLD/MAFLD）有关。胰岛素抵抗（IR）是NAFLD/MAFLD、糖尿病前期和T2D早期病理生理的关键因素。当前的治疗指南推荐定期进行体育锻炼。有证据表明，体育锻炼会对多种分子途径产生影响，如AMP激活的蛋白激酶和胰岛素信号传导以及葡萄糖转运蛋白4易位，以积极的方式调节胰岛素作用、细胞底物流动，特别是异位脂质和糖原储存。因此，体育锻炼可给糖尿病和/或NAFLD/MAFLD患者带来显著的临床益处。然而，长期观察研究的经验表明，患者定期锻炼的积极性似乎是一个主要限制因素。将日常体力活动（即非运动活动产热）纳入生活方式治疗计划的策略可能是一种有前景的方法。这篇综述汇总了关于定期体育锻炼对IR和NAFLD/MAFLD患者选定分子机制以及临床结局影响的证据。
