Alkol Dışı Steatohepatit Hastalarında Aerobik ve Dirençli Egzersiz Eğitiminin Hepatik Fonksiyonlar, İnflamatuvar Belirteçler ve Fonksiyonel Kapasite Üzerine Etkisi

Abstract

This study aimed to examine the post-intervention and long-term effects of a combined exercise intervention on liver function, inflammatory markers, and functional capacity in individuals with early-stage non-alcoholic steatohepatitis (NASH). A total of 23 participants were included: intervention group (n=12; 45.9±9.3 years) and control group (n=11; 48.0±6.9 years). Assessments were conducted at baseline, and at the 2nd, 4th, 6th, and 12th months. Liver steatosis and stiffness were assessed through radiological imaging, along with biochemical analyses, body composition, physical fitness, and psychosocial parameters. The intervention group followed a 4-month supervised aerobic and resistance exercise program with a physiotherapist and adhered to a diet plan. The control group followed a home-based moderate-intensity aerobic exercise and dietary routine. After four months, liver fat decreased by ~50% in the intervention group and 16% in the control group (p<0.001). Liver stiffness improved by one stage in the intervention group (p=0.002). ALT and AST levels dropped significantly in both groups (p=0.025; p=0.011, respectively). TNF- α and IL-6 levels showed a trend toward reduction in the intervention group, approaching statistical significance (p=0.051; p=0.066, respectively). TGF-β increased in the control group but decreased in the intervention group (p=0.043). Galectin-3 levels significantly dropped in both groups (p=0.021). Liver parameters and physical fitness gains were largely maintained during follow-up. The personalized combined exercise and diet model improves liver health and physical fitness in individuals with NASH. Physiotherapists' individualized exercise planning and follow-up significantly contribute to this process, and regular monitoring plays a critical role.