Institute for Physical Activity and Nutrition, Deakin University Faculty of Health, Geelong, Victoria, Australia.
Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
BMJ Open Diabetes Res Care. 2022 Oct;10(5). doi: 10.1136/bmjdrc-2022-002950.
Non-alcoholic fatty liver disease (NAFLD) is highly prevalent (~75%) in people with type 2 diabetes (T2D). Since exercise and weight loss (WL) are recommended for the management of both NAFLD and T2D, this study examined whether progressive resistance training (PRT) plus WL could lead to greater improvements in the fatty liver index (FLI), an indicator of NAFLD, compared with WL alone in older adults with T2D.
This study represents a secondary analysis of a 12-month, two-arm randomised controlled trial including 36 overweight and obese adults (60-80 years) with T2D randomly allocated to supervised PRT plus WL (hypocaloric diet) (n=19) or WL plus sham (stretching) (n=17) for 6 months (phase I), followed by 6-months home-based training with ad libitum diet (phase II). FLI, which is an algorithm based on waist circumference, body mass index, triglycerides and gamma-glutamyl transferase, was assessed at baseline and every 3 months. Linear mixed models were used to analyse between-group differences over time, adjusting for baseline values.
At baseline, the mean±SD FLI was 76.6±18.5 and the likelihood of NAFLD (FLI >60) in all participants was 86%. Following phase I, both groups had similar statistically significant improvements in FLI (mean change (95% CI): PRT+WL, -12 (-20 to -4); WL, -9 (-15 to -4)), with no significant between-group difference. After the subsequent 6-month home-based phase, the improvements in FLI tended to persist in both groups (PRT+WL, -7 (-11 to -2); WL, -4 (-10 to 1)), with no between-group differences.
In older overweight adults with T2D, PRT did not enhance the benefits of WL on FLI, a predictor of NAFLD.
ACTRN12622000640707.
非酒精性脂肪性肝病（NAFLD）在 2 型糖尿病（T2D）患者中非常普遍（~75%）。由于运动和体重减轻（WL）被推荐用于 NAFLD 和 T2D 的管理，因此本研究旨在检查在超重和肥胖的 T2D 成年人中，与单独 WL 相比，渐进式抗阻训练（PRT）加 WL 是否可以导致脂肪肝指数（FLI）的更大改善，FLI 是 NAFLD 的一个指标。
这是一项为期 12 个月的、双臂随机对照试验的二次分析，共纳入 36 名超重和肥胖的 T2D 成年人（60-80 岁），他们被随机分配接受监督 PRT 加 WL（低热量饮食）（n=19）或 WL 加假（伸展）（n=17）治疗 6 个月（第 I 阶段），随后进行 6 个月的家庭基础训练，饮食不限（第 II 阶段）。FLI 是一种基于腰围、体重指数、甘油三酯和γ-谷氨酰转移酶的算法，在基线和每 3 个月进行评估。线性混合模型用于分析随时间的组间差异，并调整基线值。
在基线时，平均±SD FLI 为 76.6±18.5，所有参与者患 NAFLD（FLI>60）的可能性为 86%。第 I 阶段后，两组的 FLI 均有相似的统计学显著改善（PRT+WL 组的平均变化（95%CI）：-12（-20 至-4）；WL 组：-9（-15 至-4）），两组间无显著差异。在随后的 6 个月家庭基础阶段后，两组的 FLI 改善趋势均持续存在（PRT+WL 组：-7（-11 至-2）；WL 组：-4（-10 至 1）），两组间无差异。
在超重的 T2D 成年患者中，PRT 并未增强 WL 对 FLI 的益处，FLI 是 NAFLD 的预测指标。
ACTRN12622000640707。
