Bagnato Claudia Beatrice, Bianco Antonella, Bonfiglio Caterina, Franco Isabella, Verrelli Nicola, Carella Nicola, Shahini Endrit, Zappimbulso Marianna, Giannuzzi Vito, Pesole Pasqua Letizia, Ancona Anna, Giannelli Gianluigi
Laboratory of Movement and Wellness, National Institute of Gastroenterology IRCCS "Saverio de Bellis", 70013 Castellana Grotte, BA, Italy.
Data Science, National Institute of Gastroenterology IRCCS "Saverio de Bellis", 70013 Castellana Grotte, BA, Italy.
Nutrients. 2024 Dec 6;16(23):4225. doi: 10.3390/nu16234225.
Steatotic liver disease associated with metabolic dysfunction (MASLD) affects up to about 30% of the general adult population and is closely related to obesity and the metabolic syndrome. Cortisol, a stress-related hormone contributing to hepatic fat accumulation and insulin resistance, also promotes progression of the disease. The study aims to investigate the impact of lifestyle modifications on cortisol levels and hepatic steatosis in patients with MASLD. In a 16-week three-arm randomized trial, 42 patients were randomly assigned to three groups who received dietary advice (CG), dietary advice combined with aerobic exercise (AE + DA), or dietary advice with high-intensity interval training (HIIT + DA). Before the start, after 2 months of intervention, and at the end of the project, medical evaluations, routine biochemical assessments, and psychological questionnaires were analyzed. At baseline and at the end of 4 months, hepatic steatosis was evaluated by Fibroscan. In the study population, severe hepatic steatosis (74%) and obesity (98%) were prevalent at the beginning of the study. A statistically significant (-value = 0.001) reduction in circulating cortisol levels was observed over time in the two groups doing exercise, especially in HIIT + DA (-value = 0.006). Hepatic steatosis, assessed by Fibroscan, disappeared in 10 participants (CAP value < 248, -value = 0.003). CAP values and waist circumference decreased in all groups, statistically significantly in the AE + DA group (-value = 0.005; -value = 0.04, respectively). The study emphasizes the benefits of combining diet and exercise in managing MASLD. HIIT + DA significantly decreased cortisol levels, while AE + DA was the most potent intervention for reducing hepatic steatosis.
与代谢功能障碍相关的脂肪性肝病（MASLD）影响着约30%的成年普通人群，且与肥胖和代谢综合征密切相关。皮质醇是一种与应激相关的激素，它会导致肝脏脂肪堆积和胰岛素抵抗，也会促进该疾病的进展。该研究旨在调查生活方式改变对MASLD患者皮质醇水平和肝脂肪变性的影响。在一项为期16周的三臂随机试验中，42名患者被随机分为三组，分别接受饮食建议（CG组）、饮食建议结合有氧运动（AE + DA组）或饮食建议结合高强度间歇训练（HIIT + DA组）。在研究开始前、干预2个月后以及项目结束时，对医学评估、常规生化检查和心理问卷进行了分析。在基线和4个月结束时，通过Fibroscan评估肝脂肪变性情况。在研究人群中，研究开始时严重肝脂肪变性（74%）和肥胖（98%）很普遍。随着时间的推移，在进行运动的两组中观察到循环皮质醇水平有统计学意义的降低（P值 = 0.001），尤其是在HIIT + DA组（P值 = 0.006）。通过Fibroscan评估，10名参与者的肝脂肪变性消失（CAP值 < 248，P值 = 0.003）。所有组的CAP值和腰围均下降，在AE + DA组有统计学意义（P值分别为 = 0.005；P值 = 0.04）。该研究强调了饮食和运动相结合对管理MASLD的益处。HIIT + DA显著降低了皮质醇水平，而AE + DA是减少肝脂肪变性最有效的干预措施。
