The Preliminary Research On The Effect And Mechanism Of Improving Fatty Liver By Weight Reduction Exercise On Obese Patients

PurposeThe practice of weight reduction exercise has proved that exercise cansignificantly decrease the incidence of obesity, improve the obese patients’ bodymorphology, fasting blood lipid, fasting blood insulin and the degree of fatty liver.But no one knows how exercise improve fatty liver and what is the mechanism. Thisstudy employs exercise intervention on obese patients to observe the effect of weightreduction exercise and discuss the possible mechanism of exercise improving fattyliver as well as the relationship between fatty liver and related factors.MethodsForty-four obese patients were recruited to participate in aerobic exercise withmoderate and low intensity for reducing their body weight. Before exercise training,we examined their body morphology index, heart rate, blood pressure, fasting bloodglucose, fasting blood insulin, fasting blood lipid, liver function indicators includingAST and ALT, ketone body, fatty liver by ultrasonic diagnosis and cardiovascularsystem function by exercise load test ECG. Based on the subjects’ health conditionand the results of exercise load test, we set a personality exercise prescription for eachindividual. We chose heart rate as a monitor indicator during weight reductionexercise plan. The target HR for each subject was determined by following formula：resting HR+HR reserve[(maximal HR-resting HR)×(20%～40%)]. All subjects tookpart in4weeks weight reduction plan, twice every day and2hours once by moderateand low intensity aerobic exercise. Same measurement and examine had been carriedout after4weeks. According to subjects’ basal metabolism, they were offeredreasonable daily calories and nutrition. The data have been analyzed by17.0statisticalpackage. It is significantly changed by P<0.01and obviously changed by P<0.05.Results(1)Changes in Body Shape Indices of Obese Patients after Exercise-Induced WeightLossThe body weight, body fat percentage, fat weight, waistline， hip, thighcircumferences, waist-to-height ratio, upper arm skinfold and scapular skinfold hasdecreased a lot on obese patients after4-week weight reduction exercise plan (highlysignificant). Among them, the rate of change of body fat percentage, fat weight, upperarm skinfold and scapular skinfold decreased the most obviously. Body fat percentagedecreased17.37%for male,10.92%for female and14.14%for all subjects. Fatweight decreased23.63%for male,17.11%for female and20.37%for all subjects.Upper arm skinfold decreased17.32%for male,14.32%for female and15.82%forall subjects. Scapular skinfold decreased19.81%for male,17.46%for female and18.88%for all subjects. Waistline decreased6.48%for male,6.44%for female and6.46%for all subjects, which decreased the most obviously of circumferences.(2)Changes in Hemo-Biochemical Indices of Obese Patients after Exercise-InducedWeight LossAfter4-week weight control, the fasting blood lipid of obese patients hadimproved a lot and the fasting blood insulin decreased significantly. Male subjects: the level of TC and LDL-C had a obviously decrease (P<0.05); TG and FIN decreasedsignificantly (P<0.01); the changes of FBG and HDL-C were no significant (P>0.05).Female subjects: the level of TC，HDL-C and FIN decreased significantly (P<0.01);FBG and LDL-C had a obviously decrease (P<0.05); the change of TG was nosignificant (P>0.05). Although all subjects’ HDL-C decreased, the HDL-C/LDL-Cratio increased evidently (P<0.01).(3)Changes in Hepatic Function Indices of Obese Patients after Exercise-InducedWeight LossAfter4weeks weight reduction exercise plan, AST and ALT decreased obviously.ALT decreased to the normal range for male(P<0.01). AST in female had a decreasetrend and it almost decreased to the normal range.(4)Changes in the Degree of Fatty Liver of Obese Patients after Exercise-InducedWeight LossThe degree of fatty liver had decreased a lot after4-week weight reduction(P=0.02). There were11cases of severe fatty liver before weight loss and it decreasedto2cases after4weeks (P=0.007). It shows that aerobic exercise with moderate andlow intensity has a positive role in improving and treating fatty liver.(5)Changes in Ketone Body of Obese Patients after Exercise-Induced Weight LossThere was no significant change in ketone body after4weeks weight loss plan. Itmay suggest that aerobic exercise does not increase the liver’s ability to oxidize anddecompose fat.(6)Relevance between Fatty Liver and Influencing FactorsThere was a significant positive correlation between fatty liver and the degree ofobesity, obesity duration, TG, insulin and body fat percentage, but it showed nostatistical correlation between fatty liver and ketone body.Conclusions(1) It prompt that4-week weight reduction exercise with diet control can effectivelyreduce obese patients’ body morphology indices, including body weight, body fatpercentage, fat weight and waistline.(2) It prompt that4-week weight reduction exercise with diet control can significantlyimprove lipid metabolism and insulin resistance, which has an active role inpromoting obese patients’ health.(3) It is a utility way to markedly improve hepatic function and reduce the severity offatty liver by4-week weight reduction exercise with diet control.(4) The effects of aerobic exercise to relieve fatty liver lie in the fact that exercisereduces fat amount rather than increases the liver’s ability to oxidize anddecompose fat.(5) Fatty liver is significantly correlated with the degree of obesity, obesity duration,TG, insulin and body fat percentage...