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Aerobic Exercise Training Leads to MASH Resolution as Defined by the MASH Resolution Index
Theja Channapragada1, Sarah Batra2, Breianna L Hummer2,3
1Department of Medicine, Penn State Health-Milton S. Hershey Medical Center, Hershey, PA, USA.
Purpose:
Exercise training is recommended for all patients with metabolic dysfunction-associated steatotic liver disease. Whether exercise training improves liver histology independent of body weight loss remains controversial. Given the increasing reliance on non-invasive biomarkers as a surrogate for liver histology, we investigated the relationship between exercise training and improvement in liver histology using the MASH Resolution Index (MASH-RI), a validated composite score of multiple biomarkers, in a post hoc analysis of the NASHFit trial.
Methods:
This study randomized adults with biopsy-proven MASH to moderate-intensity aerobic exercise training or standard of care for 20 weeks. Mediterranean-informed dietary counseling was provided to each group. Change in the MASH-RI was measured and compared between the two groups (n = 23).
Results:
Applying the MASH-RI, those who performed exercise training achieved MASH resolution nearly three times more often (33% vs. 13%, p < 0.01) versus those who received standard of care. Exercise training improved individual biomarkers included in the MASH-RI, including ALT, AST, and MRI-PDFF.
Conclusion:
Exercise training leads to MASH resolution, as defined by the MASH-RI at greater rates than standard lifestyle counseling. Future research is needed to determine how best to use the MASH-RI as a therapeutic monitoring tool to gauge response to lifestyle intervention.
Clinical Trial Registration:
NCT03518294.
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