Life style modification improves insulin resistance and liver histology in patients with non-alcoholic fatty liver disease
| Autor: | Gourdas Choudhuri, Neeraj Kumari, Chalamalasetty Sreenivasa Baba, Ganesh Bhat, Amaresh Pandey |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Hepatology business.industry Fatty liver Disease medicine.disease digestive system diseases Insulin resistance Endocrinology Internal medicine Nonalcoholic fatty liver disease medicine Aerobic exercise Original Article In patient Metabolic syndrome Liver histology business |
| Zdroj: | World Journal of Hepatology. 4:209 |
| ISSN: | 1948-5182 |
| DOI: | 10.4254/wjh.v4.i7.209 |
| Popis: | To study the effect of regular aerobic exercise on insulin resistance, serum aminotransferase and liver histology in nonalcoholic fatty liver disease (NAFLD) patients.Sixty (mean age 40.0 ± 8.5 years, 75% male) NAFLD patients were included in the study. After baseline anthropometric measurement i.e., body mass index (BMI), waist circumference (WC); all patients were advised regular aerobic exercise for 30 min/d, for at least 5 d/wk and trained to achieve around 70% of his maximal heart rate. In addition, moderately energy restricted diet was advised to patients with high BMI (25 kg/m(2)). Monthly follow up was done by measuring BMI, WC, aspartate aminotransferase, and alanine aminotransferase (ALT). Insulin resistance was calculated using homeostasis model assessment (HOMA) of insulin resistance (HOMA-IR) model, at baseline and after 6 mo. Insulin resistance was arbitrarily considered altered when it was ≥ 2. Liver biopsy was done in a section of patients at baseline and after 6 mo.Seventy percent (42/60) patients were overweight or obese; 95% (57/60) had central obesity (WC90 cm in men,80 cm in women). In the 45 exercise compliant patients insulin resistance decreased from 6.4 ± 6.1 to 1.3 ± 1.0, BMI from 26.7 ± 3.3 kg/m(2) to 25.0 ± 3.3 kg/m(2), WC from 95.7 ± 8.9 cm to 90.8 ± 7.3 cm and ALT from 84.8 ± 43.5 U/L to 41.3 ± 18.2 U/L (P0.01). In 15 exercise noncompliant patient's insulin resistance, BMI, WC and ALT did not show significant change at 6 mo follow up. Six of 8 patients in compliant group on repeat liver biopsy showed significant change in steatosis and necroinflammation. Nonalcoholic steatohepatitis scores improved form 5.3 ± 1.5 to 3.35 ± 1.5. The decline in insulin resistance correlated with decline in ALT (P = 0.01, r(s) = 0.90) and liver histology (P = 0.03, r(s) = 0.73).Life style modification improves insulin resistance resulting in improvement in ALT and liver histology in NAFLD patients. |
| Databáze: | OpenAIRE |
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