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Updated: Jan 17, 2026

Optimized Analysis of In Vivo and In Vitro Hepatic Steatosis
Published on: March 11, 2017
Dose‒response relationship between exercise and hepatic steatosis: A systematic review with Bayesian network
Xinyun Tan1, Huihui Zou2, Manjie Guo3
1Health Management Medicine Center and Nursing Department, the Third Xiangya Hospital of Central South University, Changsha 410013, China; Xiangya School of Nursing, Central South University, Changsha 410013, China.
Background:
Current guidelines offer unclear recommendations on exercise types and doses for metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to: (a) identify the most effective exercise type; (b) model the dose‒response relationship between exercise and hepatic steatosis; (c) determine the minimum clinically significant dose.
Methods:
We searched PubMed, Web of Science, Embase, the Cochrane Library, CINAHL, Scopus, Rehabilitation & Sports Medicine Source, clinicaltrials.gov, China Knowledge Network Infrastructure (CNKI), Wanfang, VIP, and Sinomed databases from establishment to May 27, 2025 for randomized controlled trials on exercise interventions in MASLD. Network meta-analysis and dose‒response network meta-analysis were used.
Results:
Among 24 studies (961 participants), combined aerobic‒resistance exercise showed the highest surface under the cumulative ranking curve (0.81). A non-linear dose‒response revealed benefits plateauing at 630 metabolic equivalents (METs)-min/week (mean = -0.68, 95%CI: -0.95 to -0.40) and peaking at 850 MET-min/week (mean = -0.72, 95%CI: -0.97 to -0.49). Optimal doses were 640 MET-min/week for combined aerobic‒resistance exercise, 880 for high-intensity circuit training, and 590 for moderate-intensity continuous training. High-intensity interval training showed progressive benefits, while resistance exercise required exceeding 640 MET-min/week. The minimum clinically significant dose was 460 MET-min/week, but combined aerobic‒resistance exercise achieved this at only 130 MET-min/week.
Conclusion:
A non-linear curve underscores key dose thresholds for efficacy and safety: 460 (minimum), 630 (cost-effective), and 850 MET-min/week (plateau). These equate to moderate-intensity exercise (4.5 METs) for 20, 30, or, 40 min 5 times/week, or vigorous-intensity exercise (7.5 METs) for 30 min 2, 3, or 4 times/week. Combined aerobic‒resistance exercise offered both efficacy and dose advantages.
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