한빛사 논문
Ho Soo Chun1,2, Minjong Lee1,2,*, Hye Ah Lee3, Seo Yeong Oh1, Hyo Jeong Baek1, Jae Won Moon1, Yeon Jeong Kim4, Jinha Lee4, Hyoeun Kim5, Hwi Young Kim1,2, Kwon Yoo1,2, Tae Hun Kim1,2, Seung Up Kim4,6,*
1Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea;
2Department of Internal Medicine, Ewha Womans University Medical Center, Seoul, Korea
3Clinical Trial Center, Ewha Womans University Seoul Hospital, Seoul, Korea;
4Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
5Department of Health Promotion, Health Promotion Center, Severance Hospital, Yonsei University Health System, Seoul, Korea;
6Yonsei Liver Center, Severance Hospital, Seoul, Korea
*Co-correspoondence to Minjong Lee or Seung Up Kim
Abstract
Background Aims
International guidelines recommend physical activity for subjects with nonalcoholic fatty liver disease (NAFLD). This study investigated the association of physical activity with risk of liver fibrosis, sarcopenia, and cardiovascular disease (CVD) in NAFLD.
Methods
In this multicenter, retrospective study, 11,690 NAFLD subjects who underwent a health screening program and were assessed for physical activity (metabolic equivalent task [MET]-min/week) between 2014 and 2020 were recruited. Liver fibrosis was assessed using the fibrosis-4 index, NAFLD fibrosis score, and FibroScan-AST score. Sarcopenia using multi-frequency bioelectric impedance analysis and CVD risk using atherosclerotic CVD (ASCVD) risk score and coronary artery calcium (CAC) score were calculated.
Results
The prevalence of fibrosis, sarcopenia, high probability of ASCVD, and high CAC score significantly decreased with increasing quartiles of physical activity (all P for trend<0.001). In a fully-adjusted model, physical activity above 600 MET-min/week (≥3rd quartile) was independently associated with a reduced risk of fibrosis (adjusted odds ratio [aOR]=0.59; 95% CI=0.40–0.86), sarcopenia (aOR=0.72; 95% CI=0.58–0.88), high probability of ASCVD (aOR=0.58; 95% CI=0.46–0.73), and high CAC score (aOR=0.32; 95% CI=0.13–0.83; all P<0.05). Additionally, increasing amounts of physical activity was significantly associated with a risk reduction between fibrosis, sarcopenia, and high probability of ASCVD (all P for trend<0.001). In subjects with sarcopenic obesity or lean NAFLD, physical activity was also independently associated with a reduced risk of fibrosis and high probability of ASCVD (all P<0.05).
Conclusions
Physical activity showed a protective effect against fibrosis, sarcopenia, and CVD in NAFLD.
Keywords : Nonalcoholic fatty liver disease, physical activity, liver fibrosis, sarcopenia, cardiovascular disease
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