Reljic D, Konturek P C, Herrmann H J, Siebler J, Neurath M F, Zopf Y
Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nurnberg, Germany.
German Center Immunotherapy (DZI), University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nurnberg, Germany.
J Physiol Pharmacol. 2021 Dec;72(6). doi: 10.26402/jpp.2021.6.10. Epub 2022 Apr 24.
Non-alcoholic fatty liver disease (NAFLD) and cardiometabolic disorders are highly prevalent in obese individuals. Physical exercise is an important element in obesity and metabolic syndrome (MetS) treatment. However, the vast majority of individuals with obesity do not meet the general physical activity recommendations (i.e. 150 min of moderate activity per week). The present study aimed to investigate the impact of a highly time-saving high-intensity interval training (HIIT) protocol (28 min time requirement per week) on NAFLD fibrosis (NFS) and cardiometabolic risk scores in obese patients with MetS and elevated NFS values. Twenty-nine patients performed HIIT on cycle ergometers (5 x 1 min at an intensity of 80 - 95% maximal heart rate) twice weekly for 12 weeks and were compared to a control group without exercise (CON, n = 17). Nutritional counseling for weight loss was provided to both groups. NFS, cardiometabolic risk indices, MetS z-score, cardiorespiratory fitness (VO) and body composition were assessed before and after intervention. The HIIT (-4.3 kg, P < 0.001) and CON (-2.3 kg, P = 0.003) group significantly reduced body weight. There were no significant group differences in relative weight reduction (HIIT: -3.5%, CON: -2.4%). However, only the HIIT group improved NFS (-0.52 units, P = 0.003), MetS z-score (-2.0 units, P < 0.001), glycemic control (HbA1c: -0.20%, P = 0.014) and VO2max (+3.1 mL/kg/min, P < 0.001). Decreases in NFS (-0.50 units, P = 0.025) and MetS z-score (-1.4 units, P = 0.007) and the increment in VO (3.3 mL/kg/min, P < 0.001) were significantly larger in the HIIT than in the CON group. In conclusion, only 28 min of HIIT per week can elicit significant improvements in NFS and a several cardiometabolic health indices in obese MetS patients with increased NFS grades. Our results underscore the importance of exercise in NAFLD and MetS treatment and suggest that our low-volume HIIT protocol can be regarded as viable alternative to more time-consuming exercise programs.
非酒精性脂肪性肝病（NAFLD）和心血管代谢紊乱在肥胖个体中高度普遍。体育锻炼是肥胖和代谢综合征（MetS）治疗的重要组成部分。然而，绝大多数肥胖个体未达到一般身体活动建议（即每周150分钟的中等强度活动）。本研究旨在调查一种高度节省时间的高强度间歇训练（HIIT）方案（每周需要28分钟）对患有MetS且非酒精性脂肪性肝病纤维化（NFS）值升高的肥胖患者的NFS和心血管代谢风险评分的影响。29名患者在自行车测力计上进行HIIT（每周两次，每次5分钟，强度为最大心率的80 - 95%），持续12周，并与无运动的对照组（CON，n = 17）进行比较。两组均提供了减肥营养咨询。在干预前后评估NFS、心血管代谢风险指数、MetS z评分、心肺适能（VO）和身体成分。HIIT组（-4.3 kg，P < 0.001）和CON组（-2.3 kg，P = 0.003）体重均显著减轻。相对体重减轻方面两组无显著差异（HIIT组：-3.5%，CON组：-2.4%）。然而，只有HIIT组改善了NFS（-0.52单位，P = 0.003）、MetS z评分（-2.0单位，P < 0.001）、血糖控制（糖化血红蛋白：-0.20%，P = 0.014）和最大摄氧量（+3.1 mL/kg/min，P < 0.001）。HIIT组NFS的降低（-0.50单位，P = 0.025）、MetS z评分的降低（-1.4单位，P = 0.007）以及VO的增加（3.3 mL/kg/min，P < 0.001）均显著大于CON组。总之，对于NFS等级升高的肥胖MetS患者，每周仅28分钟的HIIT就能显著改善NFS和多项心血管代谢健康指标。我们的结果强调了运动在NAFLD和MetS治疗中的重要性，并表明我们的小运动量HIIT方案可被视为耗时更长的运动计划的可行替代方案。
