Exercise reduces clotting risk in patients with non-alcoholic fatty liver disease

Exercise may help some patients with non-alcoholic fatty liver disease (NAFLD) reduce their risk of developing blood clots, a new study finds Penn State College of Medicine researchers. While diet and physical activity have always been recommended treatments for these patients, the researchers said their findings confirm that exercise has a multitude of benefits, many of which extend beyond the liver, and should be included as part of NAFLD treatment.

The condition, NAFLD, where too much fat builds up in liver cells, affects almost a billion adults worldwide. Patients with NAFLD have an increased risk of heart disease, stroke, cancer, and blood clots. Currently, there are no approved drug treatments or cures for this common condition.

Dr Jonathan StineAssociate Professor of Medicine and Public Health Sciences at the Faculty of Medicine and Transplant Hepatologist at Penn State Health Milton S. Hershey Medical Center, conducted a clinical trial to study how exercise programs affect the health of patients with non-alcoholic steatohepatitis (NASH) – an aggressive form of NAFLD. Twenty-four patients completed the study, which required two-thirds of participants to complete a 20-week aerobic exercise program and dietary advice.

At the end of the trial, participants who completed the exercise program – which consisted of five 30-minute moderate-intensity exercise sessions per week – had a significantly reduced amount of activator inhibitor. plasminogen 1 (PAI-1), a protein that helps blood clots stay formed, compared to control group participants who received standard clinical care.

“NAFLD and NASH patients have an increased risk of developing blood clots in the veins of the legs, lungs, or liver,” said Stine, who noted that blood clots affect nearly 900,000 Americans each year. “If these occur, they can have serious consequences, including an increased risk of hospitalization or death. The results of our study illustrate the importance of prescribing physical activity to NAFLD and NASH patients as a means of improving their general state of health.

In addition to measuring the risk of clotting, the researchers also found that exercise led to a greater decrease in liver fat, a greater increase in the body’s ability to deliver oxygen to skeletal muscles during exercise. (cardiorespiratory fitness), changes in blood sugar and insulin levels, reduced body fat and improved quality of life. The research team noted that these benefits appeared to be independent of weight loss or dietary changes. the results were published in Hepatology.

To build on the findings, Stine, a Penn State Cancer Institute researcher, is conducting another clinical trial, sponsored by the National Institutes of Health, to study how different “doses” of exercise affect the metabolic function and health of NAFLD patients. Stine plans to launch the trial in May 2022.

“There is no cure or effective drug therapies for NAFLD,” Stine said. “Through this research, we hope to develop additional guidance for clinicians on the optimal amount of exercise for these patients and explore the biology that explains why physical activity is an effective therapy.”

Ian Schreibman, Alison Faust, Jessica DahmusBenajmin Stern, Christopher Soriano, Gloriany Rivas, Breianna Hummer, Scottish KimballNate Geyer, Vernon Chinchilli, Catherine Schmitz and Christophe Sciamanna from Penn State College of Medicine; and Rohit Loomba of the University of California, San Diego also contributed to this research. Information on conflicts of interest can be found in the manuscript.

This study was supported by funds from the National Institutes of Health and in part by a grant from the Pennsylvania Department of Health using Tobacco CURE funds. This project was also supported by Penn State Institute for Clinical and Translational Sciences through the National Center for Advancing Translational Sciences of the National Institutes of Health (grant numbers UL1 TR002014).

Learn more about liver disease research at Penn State College of Medicine.

Learn more about the hepatology study.

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