Association of Physical Activity With Risk of Liver Fibrosis, Sarcopenia, and Cardiovascular Disease in Nonalcoholic Fatty Liver Disease

• Published in: Clinical gastroenterology and hepatology Vol. 21; no. 2; pp. 358 - 369.e12
• Main Authors: Chun, Ho Soo, Lee, Minjong, Lee, Hye Ah, Oh, Seo Yeong, Baek, Hyo Jeong, Moon, Jae Won, Kim, Yeon Jeong, Lee, Jinha, Kim, Hyoeun, Kim, Hwi Young, Yoo, Kwon, Kim, Tae Hun, Kim, Seung Up
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2023
• Subjects: Cardiovascular Disease; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - etiology; Exercise; Fibrosis; Gastroenterology and Hepatology; Humans; Liver Cirrhosis - complications; Liver Cirrhosis - diagnosis; Liver Cirrhosis - epidemiology; Liver Fibrosis; Non-alcoholic Fatty Liver Disease - complications; Non-alcoholic Fatty Liver Disease - diagnosis; Non-alcoholic Fatty Liver Disease - epidemiology; Nonalcoholic Fatty Liver Disease; Physical Activity; Retrospective Studies; Sarcopenia; Sarcopenia - complications; Sarcopenia - epidemiology; Cardiovascular Disease; NAFLD; OR; CAC; aOR; ASCVD; CI; Physical Activity; CVD; Liver Fibrosis; Sarcopenia; SI; Nonalcoholic Fatty Liver Disease; FIB-4; MeS; NFS; ASM; FAST; MET; US; BMI; coronary artery calcium; atherosclerotic cardiovascular disease; odds ratio; adjusted odds ratio; body mass index; NAFLD fibrosis score; sarcopenia index; ultrasound; FibroScan-aspartate aminotransferase; metabolic syndrome; fibrosis-4; confidence interval; appendicular skeletal muscle mass; metabolic equivalent task
• ISSN: 1542-3565; 1542-7714; 1542-7714
• DOI: 10.1016/j.cgh.2021.12.043

International guidelines recommend physical activity for subjects with nonalcoholic fatty liver disease (NAFLD). This study investigated the association of physical activity with risk of liver fibrosis, sarcopenia, and cardiovascular disease (CVD) in NAFLD. In this multicenter, retrospective study, 11,690 NAFLD subjects who underwent a health screening program and were assessed for physical activity (metabolic equivalent task [MET]-min/week) between 2014 and 2020 were recruited. Liver fibrosis was assessed by using the fibrosis-4 index, NAFLD fibrosis score, and FibroScan-AST score, sarcopenia by using multi-frequency bioelectric impedance analysis, and CVD risk by using atherosclerotic CVD (ASCVD) risk score, and coronary artery calcium (CAC) score were calculated. The prevalence of fibrosis, sarcopenia, high probability of ASCVD, and high CAC score significantly decreased with increasing quartiles of physical activity (all P for trend <.001). In a fully adjusted model, physical activity above 600 MET-min/week (≥third quartile) was independently associated with a reduced risk of fibrosis (adjusted odds ratio [aOR] = 0.59; 95% confidence interval [CI], 0.40–0.86), sarcopenia (aOR = 0.72; 95% CI, 0.58–0.88), high probability of ASCVD (aOR = 0.58; 95% CI, 0.46–0.73), and high CAC score (aOR = 0.32; 95% CI, 0.13–0.83; all P <.05). In addition, increasing amounts of physical activity were significantly associated with risk reduction between fibrosis, sarcopenia, and high probability of ASCVD (all P for trend <.001). In subjects with sarcopenic obesity or lean NAFLD, physical activity was also independently associated with reduced risk of fibrosis and high probability of ASCVD (all P <.05). Physical activity showed a protective effect against fibrosis, sarcopenia, and CVD in NAFLD.