Effect Of Combined Exercise On Carotid Intima-media Thickness In Patients Withnon-alcoholic Fatty Liver Disease

The prevalence of non-alcoholic fatty liver disease(NAFLD) in China has reached 29.2%, making it the second most prevalent liver disease. Recent research indicated that most NAFLD patients are more likely to die from cardiovascular disease(CVD) than from end-stage liver diseases. The progression of CVD in NAFLD patients can be assessed using carotid intima-media thickness (CIMT) through ultrasound. While exercise is established to support vascular health, but evidence on the impact of combined exercise interventions in NAFLD patients remains limited. PURPOSE: To investigate the effects of combined exercise with different intensities on CIMT in NAFLD patients. METHODS: NAFLD patients (n = 41) were randomized into three groups: Control (CON, n = 15), a moderate-intensity continuous training combined with resistance training group (MICT[30-minute 55-60%HRR] + RT, n = 13), a high-intensity interval training combined with resistance training group (HIIT [3 × 3-minute at 70-90%HHR, 2-minute at 40%HRR] + RT, n = 13). Participants performed a whole-body RT, which included 1 set of 10-12 repetitions of upper and lower limbs exercises. The 12-week intervention had 3 weekly exercise sessions. Ultrasound assessed innominate artery intima-media thickness(IAIMT) and bilateral common CIMT changes. Paired samples t-tests were conducted to assess within-group differences, while one-way analysis of covariance (ANCOVA) was used to evaluate between-group differences. RESULT: i) After 12-week intervention, both exercise groups significantly reduced INAIMT (HIIT+RT: 1.12 ± 0.25 mm vs 1.01 ± 0.25 mm, P = 0.002; MICT+RT: 1.22 ± 0.56 mm vs 1.12 ± 0.49 mm, P = 0.009); only HIIT+RT significantly improved common CIMT bilaterally (Right: 0.82 ± 0.26 mm vs 0.75 ± 0.26 mm, P = 0.001; Left: 0.88 ± 0.33 mm vs 0.79 ± 0.32 mm, P = 0.005). ii) Only the HIIT+RT significantly improved INAIMT compared to the CON (Δ = -0.12 ± 0.01 mm, P = 0.035); whereas the HIIT+RT and MICT+RT were significantly in improving right common IMT (Δ = -0.10 ± 0.08 mm, P < 0.001; Δ = -0.06 ± 0.02, P < 0.001) and left common IMT (Δ = -0.09 ± 0.14 mm, P = 0.001; Δ = -0.05 ± 0.15 mm, P < 0.05) compared to the CON. CONCLUSION: i) 12-week combined exercise significantly reduced CIMT in NAFLD patients. ii) HIIT+RT achieved similar CIMT improvements as MICT+RT but in a shorter duration. Supported by: Key Program of the National Social Science Foundation (19ZDA352)