Life style modification improves insulin resistance and liver histology in patients with non-alcoholic fatty liver disease

Ganesh Bhat, Chalamalasetty Sreenivasa Baba, Amaresh Pandey, Neeraj Kumari, Gourdas Choudhuri

Research output: Contribution to journalArticle

33 Citations (Scopus)

Abstract

Aim: To study the effect of regular aerobic exercise on insulin resistance, serum aminotransferase and liver histology in nonalcoholic fatty liver disease (NAFLD) patients. Methods: 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/m2). 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. Results: Seventy percent (42/60) patients were overweight or obese; 95% (57/60) had central obesity (WC > 90 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/m2 to 25.0 ± 3.3 kg/m2, 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 (P < 0.01). 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, rs = 0.90) and liver histology (P = 0.03, rs = 0.73). Conclusion: Life style modification improves insulin resistance resulting in improvement in ALT and liver histology in NAFLD patients.

Original languageEnglish
Pages (from-to)209-217
Number of pages9
JournalWorld Journal of Hepatology
Volume4
Issue number7
DOIs
Publication statusPublished - 01-12-2012
Externally publishedYes

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Insulin Resistance
Life Style
Histology
Liver
Waist Circumference
Alanine Transaminase
Body Mass Index
Exercise
Non-alcoholic Fatty Liver Disease
Biopsy
Abdominal Obesity
Aspartate Aminotransferases
Transaminases
Homeostasis
Heart Rate
Diet
Serum

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

Bhat, Ganesh ; Baba, Chalamalasetty Sreenivasa ; Pandey, Amaresh ; Kumari, Neeraj ; Choudhuri, Gourdas. / Life style modification improves insulin resistance and liver histology in patients with non-alcoholic fatty liver disease. In: World Journal of Hepatology. 2012 ; Vol. 4, No. 7. pp. 209-217.
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abstract = "Aim: To study the effect of regular aerobic exercise on insulin resistance, serum aminotransferase and liver histology in nonalcoholic fatty liver disease (NAFLD) patients. Methods: 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/m2). 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. Results: Seventy percent (42/60) patients were overweight or obese; 95{\%} (57/60) had central obesity (WC > 90 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/m2 to 25.0 ± 3.3 kg/m2, 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 (P < 0.01). 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, rs = 0.90) and liver histology (P = 0.03, rs = 0.73). Conclusion: Life style modification improves insulin resistance resulting in improvement in ALT and liver histology in NAFLD patients.",
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Life style modification improves insulin resistance and liver histology in patients with non-alcoholic fatty liver disease. / Bhat, Ganesh; Baba, Chalamalasetty Sreenivasa; Pandey, Amaresh; Kumari, Neeraj; Choudhuri, Gourdas.

In: World Journal of Hepatology, Vol. 4, No. 7, 01.12.2012, p. 209-217.

Research output: Contribution to journalArticle

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T1 - Life style modification improves insulin resistance and liver histology in patients with non-alcoholic fatty liver disease

AU - Bhat, Ganesh

AU - Baba, Chalamalasetty Sreenivasa

AU - Pandey, Amaresh

AU - Kumari, Neeraj

AU - Choudhuri, Gourdas

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Aim: To study the effect of regular aerobic exercise on insulin resistance, serum aminotransferase and liver histology in nonalcoholic fatty liver disease (NAFLD) patients. Methods: 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/m2). 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. Results: Seventy percent (42/60) patients were overweight or obese; 95% (57/60) had central obesity (WC > 90 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/m2 to 25.0 ± 3.3 kg/m2, 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 (P < 0.01). 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, rs = 0.90) and liver histology (P = 0.03, rs = 0.73). Conclusion: Life style modification improves insulin resistance resulting in improvement in ALT and liver histology in NAFLD patients.

AB - Aim: To study the effect of regular aerobic exercise on insulin resistance, serum aminotransferase and liver histology in nonalcoholic fatty liver disease (NAFLD) patients. Methods: 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/m2). 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. Results: Seventy percent (42/60) patients were overweight or obese; 95% (57/60) had central obesity (WC > 90 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/m2 to 25.0 ± 3.3 kg/m2, 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 (P < 0.01). 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, rs = 0.90) and liver histology (P = 0.03, rs = 0.73). Conclusion: Life style modification improves insulin resistance resulting in improvement in ALT and liver histology in NAFLD patients.

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