Context Randomised controlled trials in non-alcoholic fatty liver disease (NAFLD) have shown that regular exercise, even without calorie restriction, reduces liver steatosis. A previous study has shown that 16 weeks supervised exercise training in NAFLD did not affect total VLDL kinetics.
Objective:To determine the effect of exercise training on intrahepatocellular fat (IHCL) and the kinetics of large triglyceride-(TG)-rich VLDL 1 and smaller denser VLDL 2 which has a lower TG content.Design A 16 week randomised controlled trial.
Patients 27 sedentary patients with NAFLD.Intervention Supervised exercise with moderate-intensity aerobic exercise or conventional lifestyle advice (control).Main outcome Very low density lipoprotein1 (VLDL 1 ) and VLDL 2 -TG and apolipoproteinB (apoB) kinetics investigated using stable isotopes before and after the intervention.
Results:In the exercise group VO 2max increased by 31Ϯ6% (meanϮSEM) and IHCL decreased from 19.6% (14.8, 30.0) to 8.9% (5.4, 17.3) (median (IQR)) with no significant change in VO 2max or IHCL in the control group (change between groups pϽ0.001 and pϭ0.02, respectively). Exercise training increased VLDL 1 -TG and apoB fractional catabolic rates, a measure of clearance, (change between groups pϭ0.02 and pϭ0.01, respectively), and VLDL 1 -apoB production rate (change between groups pϭ0.006), with no change in VLDL 1 -TG production rate. Plasma TG did not change in either group.
Conclusion:An increased clearance of VLDL 1 may contribute to the significant decrease in liver fat following 16 weeks of exercise in NAFLD. A longer duration or higher intensity exercise interventions may be needed to lower plasma TG and VLDL production rate.