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Different Exercise Modalities in the Treatment of NAFLD and Their Impact on Myokines

Not Applicable
Recruiting
Conditions
Nonalcoholic Fatty Liver Disease
Fatty Liver
NAFLD
Fatty Liver, Nonalcoholic
Interventions
Other: Exercise
Behavioral: Motivational Interviewing
Registration Number
NCT06257732
Lead Sponsor
Yeditepe University
Brief Summary

The goal of this 12-week clinical trial is to investigate the effectiveness of different exercise types in treating Non-Alcoholic Fatty Liver Disease (NAFLD) and to explore their impact on myokine levels associated with lipid metabolism. The main questions it aims to answer are:

1. How does the type and dose of exercise affect the treatment of NAFLD?

2. What is the influence of exercise interventions in NAFLD treatment on myokine levels related to lipid metabolism?

3. How does motivational interviewing contribute to lifestyle modification in the treatment of NAFLD?

Participants in this study will engage in assigned exercise routines randomly, including HIIT, resistance training, or FATmax exercises. Additionally, motivational interviewing techniques will be employed to assess their impact on lifestyle changes. Researchers will compare the outcomes among the different exercise groups, along with a control group receiving only standard care for NAFLD. This comparison aims to determine the respective effects of these interventions on both NAFLD and associated myokine levels.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
144
Inclusion Criteria
  • Have received a diagnosis of Non-Alcoholic Fatty Liver Disease (NAFLD)
  • Age between 25 and 50 years old
  • Use of smartphone
  • Fall into category A or B according to the American Heart Association Risk Assessment Criteria
Exclusion Criteria
  • Viral hepatitis
  • Excessive alcohol consumption (more than 30 grams per day for men and more than 20 grams per day for women)
  • Use of specific medications: amiodarone, corticosteroids, methotrexate, tamoxifen, synthetic estrogen, valproic acid, intravenous tetracycline, and highly active antiretroviral drugs
  • Presence of accompanying chronic diseases such as Wilson's disease, hemochromatosis, and celiac disease
  • Liver storage diseases
  • Cancer
  • Cirrhosis
  • Advanced changes in liver ultrasonography evaluations, such as fibrosis
  • Presence of other chronic diseases (kidney failure, heart failure, atherosclerotic heart disease, hypertension, arrhythmia disorders)
  • BMI greater than 40 kg/m²
  • History of surgery or trauma in the last 6 months
  • Orthopedic and/or neurological impairment
  • Health problems that may hinder participation in the exercise program
  • Regular and continuous participation in sports or exercise at least 3 times a week for the past 3 years
  • Family history of coronary artery disease (coronary artery disease before the age of 45 in male first-degree relatives and other male relatives, or before the age of 65 in female first-degree relatives and other female relatives)
  • Presence of specific symptoms during medical history or physical examination: chest pain radiating to the neck, jaw, or arm, shortness of breath during rest or physical activity, dizziness, fainting, orthopnea or paroxysmal nocturnal dyspnea, ankle edema, palpitations or tachycardia, intermittent claudication, heart murmur, unexplained excessive fatigue
  • Fall into category C or D according to the American Heart Association Risk Assessment Criteria

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
HIIT and Motivational Interviewing GroupExerciseIn addition to formulating a High-Intensity Interval Training (HIIT) exercise prescription for individuals with liver fat accumulation under standard care, motivational interviewing principles will be applied.
Resistance Exercise GroupExerciseIndividuals with liver fat accumulation under standard care will be provided with a resistance exercise prescription.
Resistance Exercise and Motivational Interviewing GroupMotivational InterviewingIn addition to formulating a resistance exercise prescription for individuals under standard care with liver fat accumulation, motivational interviewing principles will be applied.
Fatmax Exercise and Motivational Interviewing GroupExerciseIn addition to the prescription of Fatmax exercise for individuals with liver fat accumulation under standard care, motivational interviewing principles will be applied.
Resistance Exercise and Motivational Interviewing GroupExerciseIn addition to formulating a resistance exercise prescription for individuals under standard care with liver fat accumulation, motivational interviewing principles will be applied.
HIIT GroupExerciseIndividuals with liver fat accumulation under standard care will be provided with a High-Intensity Interval Training (HIIT) exercise prescription.
HIIT and Motivational Interviewing GroupMotivational InterviewingIn addition to formulating a High-Intensity Interval Training (HIIT) exercise prescription for individuals with liver fat accumulation under standard care, motivational interviewing principles will be applied.
Fatmax Exercise GroupExerciseIndividuals with liver fat accumulation under standard care will have their Fatmax values calculated and an exercise prescription will be designed accordingly.
Fatmax Exercise and Motivational Interviewing GroupMotivational InterviewingIn addition to the prescription of Fatmax exercise for individuals with liver fat accumulation under standard care, motivational interviewing principles will be applied.
Primary Outcome Measures
NameTimeMethod
Change in the liver steatosis grade12-week

Changes in the level of liver fat accumulation in radiological abdominal ultrasonography (USG) will be observed. The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

Secondary Outcome Measures
NameTimeMethod
ALT12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

LDL12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

CRP12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

Changes in body mass index12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

GGT12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

Free fatty acids12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

Changes in The 5 Times Sit-to-Stand Test results12-week

The 5 Times Sit-to-Stand Test will be administered as a balance test. Data collected at the beginning and end of the study will be compared.

Changes in Single Leg Standing Test results12-week

The Single Leg Standing Test will be administered as a balance test. Data collected at the beginning and end of the study will be compared.

Changes in the serum levels of myokines12-week

Serum samples will be obtained twice, at the beginning and end of the study. Musclin, myonectin, and myostatin levels will be measured using ELISA, while measurements of BAIBA will be conducted using Liquid Chromatography Spectrometry. Data collected at the beginning and end of the study will be compared.

AST12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

HDL12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

Total cholesterol12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

ESR12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

Changes in body weight12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

Changes in lean body mass12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

Changes in body fat percentage12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

Changes in peak oxygen consumption12-week

At the beginning, every 4 weeks, and at the end of the study, peak oxygen consumption measurement will be conducted through the cardiopulmonary exercise test. Data collected at the beginning and end of the study will be compared.

Changes in peak heart rate12-week

At the beginning, every 4 weeks, and at the end of the study, peak heart rate measurement will be conducted through the cardiopulmonary exercise test. Data collected at the beginning and end of the study will be compared.

Changes in Healthy Lifestyle Habits Scale II scores12-week

At the beginning and end of the study, a total of two administrations of the questionnaires will be conducted. Data collected at the beginning and end of the study will be compared.

Triglycerides12-week

The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

Changes in waist-to-hip ratio12-week

The waist and hip measurements will be taken twice with a tape measure. The results will be aggregated to arrive at one reported value as a waist-to-hip ratio. This is calculated as waist measurement divided by hip measurement (W⁄H). The difference between the values obtained at the beginning of the study and those measured after completing the program will be evaluated. Data collected at the beginning and end of the study will be compared.

Changes in muscle strength analysis results12-week

At the beginning and end of the study, the maximum isometric contraction strength of the hand and forearm muscles will be measured using a hand dynamometer. Data collected at the beginning and end of the study will be compared.

Changes in FATmax levels12-week

At the beginning and end of the study, participants' FATmax levels will be determined through the FATmax test. Data collected at the beginning and end of the study will be compared.

Changes in anaerobic threshold12-week

At the beginning, every 4 weeks, and at the end of the study, anaerobic threshold measurements will be conducted through the cardiopulmonary exercise test. Data collected at the beginning and end of the study will be compared.

Changes in basal metabolic rate12-week

Basal metabolic rate measurements will be conducted twice using an indirect calorimeter, once at the beginning and once at the end of the study. Data collected at the beginning and end of the study will be compared.

Changes in Short Form Survey (SF-36) scores12-week

At the beginning and end of the study, a total of two administrations of the questionnaires will be conducted. Data collected at the beginning and end of the study will be compared.

Changes in Beck Depression Scale scores12-week

At the beginning and end of the study, a total of two administrations of the questionnaires will be conducted. Data collected at the beginning and end of the study will be compared.

Changes in Pittsburgh Sleep Quality Index scores12-week

At the beginning and end of the study, a total of two administrations of the questionnaires will be conducted. Data collected at the beginning and end of the study will be compared.

Trial Locations

Locations (1)

Yeditepe University

🇹🇷

Istanbul, Ataşehir, Turkey

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