Exercise Versus Standard Therapy in Steatotic Liver Disease Spectrum: A Systematic Review, Meta-Analysis, and...

Area of Science:

• Hepatology
• Metabolic Diseases
• Exercise Physiology

Background:

• Metabolic dysfunction-associated steatotic liver disease (MASLD) is a prevalent condition affecting nearly 25% of the global population.
• MASLD is strongly associated with obesity, metabolic syndrome, and unhealthy dietary habits.
• Understanding the impact of lifestyle interventions like exercise is crucial for MASLD management.

Purpose of the Study:

• To systematically review and meta-analyze the effects of exercise on clinical outcomes in patients with MASLD.
• To evaluate exercise as a therapeutic intervention for MASLD.

Main Methods:

• Systematic literature search of randomized controlled trials (RCTs), post-hoc analyses, and quasi-experimental studies up to September 2023.
• Meta-analysis using a random-effects model to pool data, calculating mean differences (MD) or risk ratios (RR) with 95% confidence intervals (CI).
• Included 21 RCTs, 4 post-hoc analyses, and 1 quasi-experimental study involving 1124 patients.

Main Results:

• Exercise significantly reduced Body Mass Index (BMI), serum cholesterol, ALT, AST, FIB-4 score, and NAFLD fibrosis score.
• Exercise led to a significant increase in HDL cholesterol.
• No significant differences were observed in weight or HOMA-IR; meta-regression indicated age increased HOMA-IR and higher BMI reduced HDL.

Conclusions:

• Exercise demonstrates significant benefits for key clinical outcomes in MASLD patients.
• Physical activity should be considered a fundamental component of MASLD treatment strategies.
• Exercise interventions can improve liver enzymes, fibrosis markers, and lipid profiles in individuals with MASLD.