Effects of lifestyle intervention on adults with metabolic associated fatty liver disease: A systematic review and meta-analysis

Xiao-Ni Chai; Bing-Qian Zhou; Ni Ning; Ting Pan; Fan Xu; Si-Han He; Ni-Ni Chen; Mei Sun

doi:10.3389/fendo.2023.1081096

Effects of lifestyle intervention on adults with metabolic associated fatty liver disease: A systematic review and meta-analysis

Front Endocrinol (Lausanne). 2023 Feb 16:14:1081096. doi: 10.3389/fendo.2023.1081096. eCollection 2023.

Authors

Xiao-Ni Chai¹, Bing-Qian Zhou¹, Ni Ning¹, Ting Pan¹, Fan Xu¹, Si-Han He², Ni-Ni Chen³, Mei Sun^{1

4}

Affiliations

¹ Xiangya Nursing School, Central South University, Changsha, China.
² School of Nursing, Hunan Traditional Chinese Medical College, Zhuzhou, China.
³ Department of Health Management, The Third Xiangya Hospital, Central South University, Changsha, China.
⁴ School of Nursing, Changsha Medical University, Changsha, China.

Abstract

Introduction: This systematic review and meta-analysis evaluates the overall effects of lifestyle interventions upon hepatic fat content and metabolism-related indicators among adults with metabolic associated fatty liver disease.

Methods: It was registered under PROSPERO (CRD42021251527). We searched PubMed, EMBASE, MEDLINE, Cochrane, CINAHL, Scopus, CNKI, Wan-fang, VIP, and CBM from the inception of each database to May 2021 for RCT studies of lifestyle interventions on hepatic fat content and metabolism-related indicators. We used Review Manager 5.3 for meta-analysis and used text and detailed tabular summaries when heterogeneity existed.

Results: Thirty-four RCT studies with 2652 participants were included. All participants were obesity, 8% of whom also had diabetes, and none was lean or normal weight. Through subgroup analysis, we found low carbohydrate diet, aerobic training and resistance training significantly improved the level of HFC, TG, HDL, HbA1c, and HOMA-IR. Moreover, low carbohydrate diet is more effective in improving HFC than low fat diet and resistance training is better than aerobic training in reduction in HFC and TG (SMD, -0.25, 95% CI, -0.45 to -0.06; SMD, 0.24, 95% CI, 0.03 to 0.44, respectively).

Discussion: Overall, this is the first review that systematically synthesizes studies focused on the effects of various lifestyle on adults with MAFLD. The data generated in this systematic review were more applicable to obesity MAFLD rather than lean or normal weight MAFLD.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier (CRD42021251527).

Keywords: MAFLD; diet; exercise; lifestyle; meta-analysis; systematic review.

Publication types

Meta-Analysis
Systematic Review
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Databases, Factual
Diet, Carbohydrate-Restricted
Humans
Life Style
Non-alcoholic Fatty Liver Disease*
Obesity

Grants and funding

This work was supported by the Hunan Provincial Innovation Foundation for Postgraduate (CX20210348), the Fundamental Research Funds for the Central Universities of Central South University (No. 2021zzts1008), the Fundamental Research Funds for the Central Universities of Central South University (No. 2021zzts1016). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript