Effect of high-intensity interval training on clinical parameters in patients with metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis of randomized controlled trials

High-intensity interval training (HIIT) has potential health benefits in the treatment of many chronic diseases. However, the efficacy of HIIT in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear. This systematic review and meta-analysis aimed to assess the impact of HIIT on intrahepatic lipids (IHLs) , liver enzymes, and metabolic profiles in individuals with MASLD. All randomized-controlled trials (RCT) that evaluated and compared the effects of HIIT on clinical parameters in patients with MASLD were searched using the PubMed, EMBASE, WOS, and Cochrane databases. Data analysis and integration were performed using RevMan 5.3 (Cochrane Collaboration, Copenhagen, Denmark) and Stata version 18 software (StataCorp LLC, College Station, Texas, USA), and outcomes were assessed using the standardized mean difference (SMD). Our results showed that compared with other types of exercise or no exercise, HIIT could reduce the levels of IHL [SMD: -0.56%, 95% confidence interval (CI): -0.99 to -0.13, P  = 0.01], BMI (SMD: -0.31, 95% CI: -0.62 to -0.01, P  = 0.04), alanine aminotransferase (ALT) (SMD: -0.61, 95% CI: -0.95 to -0.26, P  = 0.0006), and aspartate aminotransaminase (AST) (SMD: -0.43, 95% CI: -0.81 to -0.05, P  = 0.03) in patients with MASLD. In addition, subgroup analyses showed that HIIT had a positive impact on clinical indicators in patients with MASLD with an intervention duration of less than equal to 8 weeks. This study supports the idea that HIIT can significantly reduce IHL, BMI, ALT, and AST levels, and further studies are needed to assess the long-term adherence and treatment effects of HIIT.