Metabolism: clinical and experimental · 2026
High-intensity interval training and moderate-intensity continuous training are effective, feasible, and safe for patients with metabolic dysfunction-associated steatotic liver disease (MASLD): A systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Wang Bo, Zeng Xinyu, Deng Hengzhi, Qiu Bopeng, Xu Kai, Tao Meiling, Zhang Yilin, Zheng Huakun, Xu Qingshuo, Li Shuo, Zhong Yuming, Zhang Xing, Li Hansen, Yan Henghao, Song Jian, Zhang Zengyu, Liang Zhide, Sun Qiyu, Wu Bitai, Zhang Xinuan, Batrakoulis Alexios, Reljic Dejan, Yin Mingyue
Аннотация
PURPOSE: This meta-analysis evaluated the efficacy and feasibility of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and identified key moderators.
METHODS: Controlled trials were systematically searched (PubMed, Web of Science, CNKI; initially in Feb 2025 and updated Jan 2026). Random-effects meta-analyses used SMDs; risk of bias, methodological quality, and evidence certainty were systematically assessed.
RESULTS: Thirty-seven trials (1546 participants, 51% female, moderate quality) showed HIIT significantly improved 12 outcomes vs. controls, including body composition (g - 0.94 to -0.52), cardiometabolic parameters (-1.56 to 1.34), and liver markers (-1.06 to -0.50), while MICT benefited 18 outcomes, including body composition (-0.84 to -0.60), cardiometabolic parameters (-1.42 to 1.79), and liver markers (-0.72 to -0.67). HIIT was superior for total cholesterol reduction (g - 0.44, p < 0.05). Subgroup analyses identified significant moderation by obesity status, training frequency, exercise modality, and progression. Meta-regression revealed MICT effects moderated by age, BMI, and prescription parameters (e.g., session duration, weekly time, program length), with significant associations for body fat, lipids, and glycemic control changes. Exploratory nonlinear meta-regression showed distinct dose-response patterns for liver enzyme biomarker improved emerging beyond baseline, 260-280 MET-min per MICT session. Feasibility was high (adherence 83.4%, completion 83.9%), and safety was relatively high.
CONCLUSION: Both HIIT and MICT effectively improve anthropometric, metabolic parameters, and liver function indicators in patients with MASLD, while demonstrating high feasibility and safety. Moderators' analyses identified key moderators and dose-response, informing evidence-based exercise prescription considerations for MASLD management.
REGISTERED: PROSPERO (CRD42025646755).
METHODS: Controlled trials were systematically searched (PubMed, Web of Science, CNKI; initially in Feb 2025 and updated Jan 2026). Random-effects meta-analyses used SMDs; risk of bias, methodological quality, and evidence certainty were systematically assessed.
RESULTS: Thirty-seven trials (1546 participants, 51% female, moderate quality) showed HIIT significantly improved 12 outcomes vs. controls, including body composition (g - 0.94 to -0.52), cardiometabolic parameters (-1.56 to 1.34), and liver markers (-1.06 to -0.50), while MICT benefited 18 outcomes, including body composition (-0.84 to -0.60), cardiometabolic parameters (-1.42 to 1.79), and liver markers (-0.72 to -0.67). HIIT was superior for total cholesterol reduction (g - 0.44, p < 0.05). Subgroup analyses identified significant moderation by obesity status, training frequency, exercise modality, and progression. Meta-regression revealed MICT effects moderated by age, BMI, and prescription parameters (e.g., session duration, weekly time, program length), with significant associations for body fat, lipids, and glycemic control changes. Exploratory nonlinear meta-regression showed distinct dose-response patterns for liver enzyme biomarker improved emerging beyond baseline, 260-280 MET-min per MICT session. Feasibility was high (adherence 83.4%, completion 83.9%), and safety was relatively high.
CONCLUSION: Both HIIT and MICT effectively improve anthropometric, metabolic parameters, and liver function indicators in patients with MASLD, while demonstrating high feasibility and safety. Moderators' analyses identified key moderators and dose-response, informing evidence-based exercise prescription considerations for MASLD management.
REGISTERED: PROSPERO (CRD42025646755).