Physical activity is inversely associated with hepatic fibro-inflammation: A population-based cohort study using UK Biobank data

Aron P Sherry; Scott A Willis; Thomas Yates; William Johnson; Cameron Razieh; Jack A Sargeant; Sundus Malaikah; David J Stensel; Guruprasad P Aithal; James A King

doi:10.1016/j.jhepr.2022.100622

Physical activity is inversely associated with hepatic fibro-inflammation: A population-based cohort study using UK Biobank data

JHEP Rep. 2022 Nov 2;5(1):100622. doi: 10.1016/j.jhepr.2022.100622. eCollection 2023 Jan.

Authors

Aron P Sherry^{1

2}, Scott A Willis^{1

2}, Thomas Yates^{2

3}, William Johnson^{1

2}, Cameron Razieh^{2

3

4}, Jack A Sargeant^{2

3}, Sundus Malaikah^{1

2}, David J Stensel^{1

2

5}, Guruprasad P Aithal^{6

7}, James A King^{1

2}

Affiliations

¹ National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, UK.
² NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and University of Leicester, UK.
³ Diabetes Research Centre, University of Leicester, UK.
⁴ Office for National Statistics, Newport, UK.
⁵ Faculty of Sport Sciences, Waseda University, Tokorozawa, Japan.
⁶ Nottingham Digestive Diseases Centre, School of Medicine, University of Nottingham, UK.
⁷ NIHR Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and the University of Nottingham, UK.

Abstract

Background & aims: Physical activity (PA) is recommended in the management of non-alcoholic fatty liver disease (NAFLD) given its beneficial effects on liver fat and cardiometabolic risk. Using data from the UK Biobank population-cohort, this study examined associations between habitual PA and hepatic fibro-inflammation.

Methods: A total of 840 men and women aged 55-70 years were included in this cross-sectional study. Hepatic fibro-inflammation (iron-corrected T1 [cT1]) and liver fat were measured using MRI, whilst body fat was measured using dual-energy X-ray absorptiometry. PA was measured using accelerometry. Generalised linear models examined associations between PA (light [LPA], moderate [MPA], vigorous [VPA], moderate-to-vigorous [MVPA] and mean acceleration) and hepatic cT1. Models were fitted for the whole sample and separately for upper and lower median groups for body and liver fat. Models were adjusted for sociodemographic and lifestyle variables.

Results: In the full sample, LPA (-0.08 ms [-0.12 to -0.03]), MPA, (-0.13 ms [-0.21 to -0.05]), VPA (-1.16 ms [-1.81 to -0.51]), MVPA (-0.14 ms [-0.21 to -0.06]) and mean acceleration (-0.67 ms [-1.05 to-0.28]) were inversely associated with hepatic cT1. With the sample split by median liver or body fat, only VPA was inversely associated with hepatic cT1 in the upper median groups for body (-2.68 ms [-4.24 to -1.13]) and liver fat (-2.33 [-3.73 to -0.93]). PA was unrelated to hepatic cT1 in the lower median groups.

Conclusions: Within a population-based cohort, device-measured PA is inversely associated with hepatic fibro-inflammation. This relationship is strongest with VPA and is greater in people with higher levels of body and liver fat.

Lay summary: This study has shown that people who regularly perform greater amounts of physical activity have a reduced level of inflammation and fibrosis in their liver. This beneficial relationship is particularly strong when more intense physical activity is undertaken (i.e., vigorous-intensity), and is most visible in individuals with higher levels of liver fat and body fat.

Keywords: DXA, dual-energy X-ray absorptiometry; Exercise; LPA, light physical activity; Liver fat; MPA, moderate physical activity; MVPA, moderate-to-vigorous physical activity; NAFLD, non-alcoholic fatty liver disease; NASH, non-alcoholic steatohepatitis; Non-alcoholic steatohepatitis; Obesity; PA, physical activity; PDFF, proton density fat fraction; VPA, vigorous physical activity; cT1, iron-corrected T1; ms, milliseconds.

Abstract

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