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Comparative efficacy of exercise training processes in improving nonalcoholic fatty liver disease: a systematic review and meta-analysis
Meta-analysis of 21 NAFLD RCTs (n=1,733) finds pooled reductions in weight, BMI, ALT, and AST with exercise training, with subgroup narrative that ≥20-week programmes showed additional lipid and glucose improvements; probiotic co-intervention exploratory.
Design
- 21 RCTs, n = 1,733 biopsy/clinical NAFLD populations
- Pooled aerobic, resistance, and HIIT prescriptions
Pooled mean differences (abstract)
- Weight: MD −3.46 kg (95% CI −4.98 to −1.94)
- BMI: MD −0.89 kg/m² (95% CI −1.61 to −0.17)
- ALT: MD −6.66 U/L (95% CI −10.04 to −3.27)
- AST: MD −3.14 U/L (95% CI −5.93 to −0.35)
- ≥20 weeks: authors summarise extra pooled gains for TC, TG, and fasting glucose (inspect CIs)
Evidence hygiene
Trial heterogeneity in imaging endpoints, supervision, and co-interventions (e.g., probiotics)—use next to weight-stable TRE trials, not as a merge.
Publication
Yu X, Wang Y, Lai J, Song T, et al. Ir J Med Sci. 2023 Feb;192(1):131-142. Epub 2022 Apr 2. PMID 35366201.
Outcomes
- Random-effects meta-analysis across 21 NAFLD RCTs: weight MD −3.46 kg (95% CI −4.98 to −1.94) and BMI MD −0.89 kg/m² (95% CI −1.61 to −0.17) vs control.
- Liver enzymes: ALT MD −6.66 U/L (95% CI −10.04 to −3.27) and AST MD −3.14 U/L (95% CI −5.93 to −0.35) vs control in pooled exercise arms.