Calcaterra Valeria, Magenes Vittoria Carlotta, Vandoni Matteo, Berardo Clarissa, Marin Luca, Bianchi Alice, Cordaro Erika, Silvestro Giustino Simone, Silvestri Dario, Carnevale Pellino Vittoria, Cereda Cristina, Zuccotti Gianvincenzo
Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy.
Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy.
Children (Basel). 2022 Aug 5;9(8):1174. doi: 10.3390/children9081174.
Non-alcoholic fatty liver disease (NAFLD) is an important health concern during childhood; indeed, it is the most frequent cause of chronic liver diseases in obese children. No valid pharmacological therapies for children affected by this condition are available, and the recommended treatment is lifestyle modification, usually including nutrition and exercise interventions. In this narrative review, we summarized up-to-date information on the benefits of physical exercise on NAFLD in children and adolescents with obesity. The role of exercise as non-pharmacological treatment was emphasized in order to provide recent advances on this topic for clinicians not deeply involved in the field. Several studies on obese children and adults confirm the positive role of physical activity (PA) in the treatment of NAFLD, but to date, there are no pediatric randomized clinical trials on exercise versus usual care. Among the pathogenic mechanisms involved in the PA effects on NAFLD, the main players seem to be insulin resistance and related inflammation, oxidative stress, and gut dysbiosis, but further evaluations are necessary to deeply understand whether these factors are correlated and how they synergistically act. Thus, a deeper research on this theme is needed, and it would be extremely interesting.
非酒精性脂肪性肝病（NAFLD）是儿童期一个重要的健康问题；事实上，它是肥胖儿童慢性肝病最常见的病因。目前尚无针对患此病儿童的有效药物治疗方法，推荐的治疗方法是改变生活方式，通常包括营养和运动干预。在这篇叙述性综述中，我们总结了体育锻炼对肥胖儿童和青少年非酒精性脂肪性肝病益处的最新信息。强调了运动作为非药物治疗的作用，以便为未深入涉足该领域的临床医生提供该主题的最新进展。多项针对肥胖儿童和成人的研究证实了体育活动（PA）在非酒精性脂肪性肝病治疗中的积极作用，但迄今为止，尚无关于运动与常规护理对比的儿科随机临床试验。在体育活动对非酒精性脂肪性肝病影响的致病机制中，主要因素似乎是胰岛素抵抗及相关炎症、氧化应激和肠道菌群失调，但需要进一步评估以深入了解这些因素是否相关以及它们如何协同作用。因此，需要对这一主题进行更深入的研究，这将非常有趣。
