Exercise-induced improvements in liver fat and endothelial function are not sustained 12 months following cessation of exercise supervision in nonalcoholic fatty liver disease

Research output: Contribution to journalArticlepeer-review


  • C. J.A. Pugh
  • V. S. Sprung
  • H. Jones
  • P. Richardson
  • F. Shojaee-Moradie
  • A. M. Umpleby
  • D. J. Green
  • M. I. Trenell
  • G. J. Kemp
  • D. J. Cuthbertson

Colleges, School and Institutes

External organisations

  • Cardiff Metropolitan University
  • University of Liverpool
  • University Hospital Aintree
  • Liverpool John Moores University
  • Royal Liverpool University Hospital
  • University of Surrey
  • The University of Western Australia
  • Research Institute for Sport and Exercise Sciences
  • Department of Sports Science
  • Aspire Academy
  • Newcastle University


Supervised exercise reduces liver fat and improves endothelial function, a surrogate of cardiovascular disease (CVD) risk, in nonalcoholic fatty liver disease (NAFLD). We hypothesised that after a 16-week supervised exercise program, patients would maintain longer-term improvements in cardiorespiratory fitness, liver fat and endothelial function. Ten NAFLD patients (5/5 males/females, age 51±13 years, body mass index 31±3 kg m -2 (mean±s.d.)) underwent a 16-week supervised moderate-intensity exercise intervention. Biochemical markers, cardiorespiratory fitness (VO 2peak), subcutaneous, visceral and liver fat (measured by magnetic resonance imaging and spectroscopy respectively) and brachial artery flow-mediated dilation (FMD) were assessed at baseline, after 16 weeks of supervised training and 12 months after ending supervision. Despite no significant change in body weight, there were significant improvements in VO 2peak (6.5 ml kg -1 min -1 (95% confidence interval 2.8, 10.1); P=0.003), FMD (2.9% (1.5, 4.2); P=0.001), liver transaminases (P<0.05) and liver fat (-10.1% (-20.6, 0.5); P=0.048) immediately after the 16-week supervised training. Nevertheless, 12 months after ending supervision, VO 2peak (0.9 ml kg -1 min -1 (-3.3, 5.1); P=0.65), FMD (-0.07% (-2.3, 2.2); P=0.95), liver transaminases (P>0.05) and liver fat (1.4% (-13.0, 15.9); P=0.83) were not significantly different from baseline. At 12 months following cessation of supervision, exercise-mediated improvements in liver fat and other cardiometabolic variables had reversed with cardiorespiratory fitness at baseline levels. Maintenance of high cardiorespiratory fitness and stability of body weight are critical public health considerations for the treatment of NAFLD (Clinicaltrials.gov identifier: NCT01834300).


Original languageEnglish
Pages (from-to)1927-1930
Number of pages4
JournalInternational Journal of Obesity
Issue number12
Publication statusPublished - 21 Jul 2016