Association of Physical Activity With Risk of Liver Fibrosis, Sarcopenia, and Cardiovascular Disease in Nonalcoholic Fatty Liver Disease

Ho Soo Chun; Minjong Lee; Hye Ah Lee; Seo Yeong Oh; Hyo Jeong Baek; Jae Won Moon; Yeon Jeong Kim; Jinha Lee; Hyoeun Kim; Hwi Young Kim; Kwon Yoo; Tae Hun Kim; Seung Up Kim

doi:10.1016/j.cgh.2021.12.043

Association of Physical Activity With Risk of Liver Fibrosis, Sarcopenia, and Cardiovascular Disease in Nonalcoholic Fatty Liver Disease

Ho Soo Chun, Minjong Lee, Hye Ah Lee, Seo Yeong Oh, Hyo Jeong Baek, Jae Won Moon, Yeon Jeong Kim, Jinha Lee, Hyoeun Kim, Hwi Young Kim, Kwon Yoo, Tae Hun Kim, Seung Up Kim

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

30 Scopus citations

Abstract

Background & Aims: International guidelines recommend physical activity for subjects with nonalcoholic fatty liver disease (NAFLD). This study investigated the association of physical activity with risk of liver fibrosis, sarcopenia, and cardiovascular disease (CVD) in NAFLD. Methods: In this multicenter, retrospective study, 11,690 NAFLD subjects who underwent a health screening program and were assessed for physical activity (metabolic equivalent task [MET]-min/week) between 2014 and 2020 were recruited. Liver fibrosis was assessed by using the fibrosis-4 index, NAFLD fibrosis score, and FibroScan-AST score, sarcopenia by using multi-frequency bioelectric impedance analysis, and CVD risk by using atherosclerotic CVD (ASCVD) risk score, and coronary artery calcium (CAC) score were calculated. Results: The prevalence of fibrosis, sarcopenia, high probability of ASCVD, and high CAC score significantly decreased with increasing quartiles of physical activity (all P for trend <.001). In a fully adjusted model, physical activity above 600 MET-min/week (≥third quartile) was independently associated with a reduced risk of fibrosis (adjusted odds ratio [aOR] = 0.59; 95% confidence interval [CI], 0.40–0.86), sarcopenia (aOR = 0.72; 95% CI, 0.58–0.88), high probability of ASCVD (aOR = 0.58; 95% CI, 0.46–0.73), and high CAC score (aOR = 0.32; 95% CI, 0.13–0.83; all P <.05). In addition, increasing amounts of physical activity were significantly associated with risk reduction between fibrosis, sarcopenia, and high probability of ASCVD (all P for trend <.001). In subjects with sarcopenic obesity or lean NAFLD, physical activity was also independently associated with reduced risk of fibrosis and high probability of ASCVD (all P <.05). Conclusions: Physical activity showed a protective effect against fibrosis, sarcopenia, and CVD in NAFLD.

Original language	English
Pages (from-to)	358-369.e12
Journal	Clinical Gastroenterology and Hepatology
Volume	21
Issue number	2
DOIs	https://doi.org/10.1016/j.cgh.2021.12.043
State	Published - Feb 2023

Bibliographical note

Funding Information:
Funding Supported by a grant from Basic Science Research Program through the National Research Foundation of Korea ( NRF ) funded by the Ministry of Education (grant number: 2017R1D1A1B03031499), and a grant and supported by the National Research Foundation of Korea ( NRF ) grant funded by the Korea government (Ministry of Science and ICT ) (grant number: 2020R1C1C1004112 and 2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Funding Information:
Conflicts of interest This author discloses the following: Seung Up Kim has served as an advisory committee member for Gilead Sciences, Bayer, Eisai, and Novo Nordisk; is a speaker for Gilead Sciences, GSK, Bayer, Eisai, AbbVie, EchoSens, MSD, Otsuka, and Bristol-Myers Squibb; and has also received a research grant from AbbVie and Bristol-Myers Squibb. The remaining authors disclose no conflicts.Funding Supported by a grant from Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (grant number: 2017R1D1A1B03031499), and a grant and supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Science and ICT) (grant number: 2020R1C1C1004112 and 2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Publisher Copyright:
© 2023 AGA Institute

Keywords

Cardiovascular Disease
Liver Fibrosis
Nonalcoholic Fatty Liver Disease
Physical Activity
Sarcopenia

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10.1016/j.cgh.2021.12.043

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Chun, H. S., Lee, M., Lee, H. A., Oh, S. Y., Baek, H. J., Moon, J. W., Kim, Y. J., Lee, J., Kim, H., Kim, H. Y., Yoo, K., Kim, T. H., & Kim, S. U. (2023). Association of Physical Activity With Risk of Liver Fibrosis, Sarcopenia, and Cardiovascular Disease in Nonalcoholic Fatty Liver Disease. Clinical Gastroenterology and Hepatology, 21(2), 358-369.e12. https://doi.org/10.1016/j.cgh.2021.12.043

@article{5e6c995c323d4464b7651af1e80e685c,

title = "Association of Physical Activity With Risk of Liver Fibrosis, Sarcopenia, and Cardiovascular Disease in Nonalcoholic Fatty Liver Disease",

abstract = "Background & Aims: International guidelines recommend physical activity for subjects with nonalcoholic fatty liver disease (NAFLD). This study investigated the association of physical activity with risk of liver fibrosis, sarcopenia, and cardiovascular disease (CVD) in NAFLD. Methods: In this multicenter, retrospective study, 11,690 NAFLD subjects who underwent a health screening program and were assessed for physical activity (metabolic equivalent task [MET]-min/week) between 2014 and 2020 were recruited. Liver fibrosis was assessed by using the fibrosis-4 index, NAFLD fibrosis score, and FibroScan-AST score, sarcopenia by using multi-frequency bioelectric impedance analysis, and CVD risk by using atherosclerotic CVD (ASCVD) risk score, and coronary artery calcium (CAC) score were calculated. Results: The prevalence of fibrosis, sarcopenia, high probability of ASCVD, and high CAC score significantly decreased with increasing quartiles of physical activity (all P for trend <.001). In a fully adjusted model, physical activity above 600 MET-min/week (≥third quartile) was independently associated with a reduced risk of fibrosis (adjusted odds ratio [aOR] = 0.59; 95% confidence interval [CI], 0.40–0.86), sarcopenia (aOR = 0.72; 95% CI, 0.58–0.88), high probability of ASCVD (aOR = 0.58; 95% CI, 0.46–0.73), and high CAC score (aOR = 0.32; 95% CI, 0.13–0.83; all P <.05). In addition, increasing amounts of physical activity were significantly associated with risk reduction between fibrosis, sarcopenia, and high probability of ASCVD (all P for trend <.001). In subjects with sarcopenic obesity or lean NAFLD, physical activity was also independently associated with reduced risk of fibrosis and high probability of ASCVD (all P <.05). Conclusions: Physical activity showed a protective effect against fibrosis, sarcopenia, and CVD in NAFLD.",

keywords = "Cardiovascular Disease, Liver Fibrosis, Nonalcoholic Fatty Liver Disease, Physical Activity, Sarcopenia",

author = "Chun, {Ho Soo} and Minjong Lee and Lee, {Hye Ah} and Oh, {Seo Yeong} and Baek, {Hyo Jeong} and Moon, {Jae Won} and Kim, {Yeon Jeong} and Jinha Lee and Hyoeun Kim and Kim, {Hwi Young} and Kwon Yoo and Kim, {Tae Hun} and Kim, {Seung Up}",

note = "Funding Information: Funding Supported by a grant from Basic Science Research Program through the National Research Foundation of Korea ( NRF ) funded by the Ministry of Education (grant number: 2017R1D1A1B03031499), and a grant and supported by the National Research Foundation of Korea ( NRF ) grant funded by the Korea government (Ministry of Science and ICT ) (grant number: 2020R1C1C1004112 and 2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: Conflicts of interest This author discloses the following: Seung Up Kim has served as an advisory committee member for Gilead Sciences, Bayer, Eisai, and Novo Nordisk; is a speaker for Gilead Sciences, GSK, Bayer, Eisai, AbbVie, EchoSens, MSD, Otsuka, and Bristol-Myers Squibb; and has also received a research grant from AbbVie and Bristol-Myers Squibb. The remaining authors disclose no conflicts.Funding Supported by a grant from Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (grant number: 2017R1D1A1B03031499), and a grant and supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Science and ICT) (grant number: 2020R1C1C1004112 and 2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: {\textcopyright} 2023 AGA Institute",

year = "2023",

month = feb,

doi = "10.1016/j.cgh.2021.12.043",

language = "English",

volume = "21",

pages = "358--369.e12",

journal = "Clinical Gastroenterology and Hepatology",

issn = "1542-3565",

publisher = "W.B. Saunders Ltd",

number = "2",

}

Chun, HS, Lee, M, Lee, HA, Oh, SY, Baek, HJ, Moon, JW, Kim, YJ, Lee, J, Kim, H, Kim, HY, Yoo, K, Kim, TH & Kim, SU 2023, 'Association of Physical Activity With Risk of Liver Fibrosis, Sarcopenia, and Cardiovascular Disease in Nonalcoholic Fatty Liver Disease', Clinical Gastroenterology and Hepatology, vol. 21, no. 2, pp. 358-369.e12. https://doi.org/10.1016/j.cgh.2021.12.043

TY - JOUR

T1 - Association of Physical Activity With Risk of Liver Fibrosis, Sarcopenia, and Cardiovascular Disease in Nonalcoholic Fatty Liver Disease

AU - Chun, Ho Soo

AU - Lee, Minjong

AU - Lee, Hye Ah

AU - Oh, Seo Yeong

AU - Baek, Hyo Jeong

AU - Moon, Jae Won

AU - Kim, Yeon Jeong

AU - Lee, Jinha

AU - Kim, Hyoeun

AU - Kim, Hwi Young

AU - Yoo, Kwon

AU - Kim, Tae Hun

AU - Kim, Seung Up

N1 - Funding Information: Funding Supported by a grant from Basic Science Research Program through the National Research Foundation of Korea ( NRF ) funded by the Ministry of Education (grant number: 2017R1D1A1B03031499), and a grant and supported by the National Research Foundation of Korea ( NRF ) grant funded by the Korea government (Ministry of Science and ICT ) (grant number: 2020R1C1C1004112 and 2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Funding Information: Conflicts of interest This author discloses the following: Seung Up Kim has served as an advisory committee member for Gilead Sciences, Bayer, Eisai, and Novo Nordisk; is a speaker for Gilead Sciences, GSK, Bayer, Eisai, AbbVie, EchoSens, MSD, Otsuka, and Bristol-Myers Squibb; and has also received a research grant from AbbVie and Bristol-Myers Squibb. The remaining authors disclose no conflicts.Funding Supported by a grant from Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (grant number: 2017R1D1A1B03031499), and a grant and supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (Ministry of Science and ICT) (grant number: 2020R1C1C1004112 and 2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Publisher Copyright: © 2023 AGA Institute

PY - 2023/2

Y1 - 2023/2

N2 - Background & Aims: International guidelines recommend physical activity for subjects with nonalcoholic fatty liver disease (NAFLD). This study investigated the association of physical activity with risk of liver fibrosis, sarcopenia, and cardiovascular disease (CVD) in NAFLD. Methods: In this multicenter, retrospective study, 11,690 NAFLD subjects who underwent a health screening program and were assessed for physical activity (metabolic equivalent task [MET]-min/week) between 2014 and 2020 were recruited. Liver fibrosis was assessed by using the fibrosis-4 index, NAFLD fibrosis score, and FibroScan-AST score, sarcopenia by using multi-frequency bioelectric impedance analysis, and CVD risk by using atherosclerotic CVD (ASCVD) risk score, and coronary artery calcium (CAC) score were calculated. Results: The prevalence of fibrosis, sarcopenia, high probability of ASCVD, and high CAC score significantly decreased with increasing quartiles of physical activity (all P for trend <.001). In a fully adjusted model, physical activity above 600 MET-min/week (≥third quartile) was independently associated with a reduced risk of fibrosis (adjusted odds ratio [aOR] = 0.59; 95% confidence interval [CI], 0.40–0.86), sarcopenia (aOR = 0.72; 95% CI, 0.58–0.88), high probability of ASCVD (aOR = 0.58; 95% CI, 0.46–0.73), and high CAC score (aOR = 0.32; 95% CI, 0.13–0.83; all P <.05). In addition, increasing amounts of physical activity were significantly associated with risk reduction between fibrosis, sarcopenia, and high probability of ASCVD (all P for trend <.001). In subjects with sarcopenic obesity or lean NAFLD, physical activity was also independently associated with reduced risk of fibrosis and high probability of ASCVD (all P <.05). Conclusions: Physical activity showed a protective effect against fibrosis, sarcopenia, and CVD in NAFLD.

AB - Background & Aims: International guidelines recommend physical activity for subjects with nonalcoholic fatty liver disease (NAFLD). This study investigated the association of physical activity with risk of liver fibrosis, sarcopenia, and cardiovascular disease (CVD) in NAFLD. Methods: In this multicenter, retrospective study, 11,690 NAFLD subjects who underwent a health screening program and were assessed for physical activity (metabolic equivalent task [MET]-min/week) between 2014 and 2020 were recruited. Liver fibrosis was assessed by using the fibrosis-4 index, NAFLD fibrosis score, and FibroScan-AST score, sarcopenia by using multi-frequency bioelectric impedance analysis, and CVD risk by using atherosclerotic CVD (ASCVD) risk score, and coronary artery calcium (CAC) score were calculated. Results: The prevalence of fibrosis, sarcopenia, high probability of ASCVD, and high CAC score significantly decreased with increasing quartiles of physical activity (all P for trend <.001). In a fully adjusted model, physical activity above 600 MET-min/week (≥third quartile) was independently associated with a reduced risk of fibrosis (adjusted odds ratio [aOR] = 0.59; 95% confidence interval [CI], 0.40–0.86), sarcopenia (aOR = 0.72; 95% CI, 0.58–0.88), high probability of ASCVD (aOR = 0.58; 95% CI, 0.46–0.73), and high CAC score (aOR = 0.32; 95% CI, 0.13–0.83; all P <.05). In addition, increasing amounts of physical activity were significantly associated with risk reduction between fibrosis, sarcopenia, and high probability of ASCVD (all P for trend <.001). In subjects with sarcopenic obesity or lean NAFLD, physical activity was also independently associated with reduced risk of fibrosis and high probability of ASCVD (all P <.05). Conclusions: Physical activity showed a protective effect against fibrosis, sarcopenia, and CVD in NAFLD.

KW - Cardiovascular Disease

KW - Liver Fibrosis

KW - Nonalcoholic Fatty Liver Disease

KW - Physical Activity

KW - Sarcopenia

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U2 - 10.1016/j.cgh.2021.12.043

DO - 10.1016/j.cgh.2021.12.043

M3 - Article

C2 - 34998993

AN - SCOPUS:85125737359

SN - 1542-3565

VL - 21

SP - 358-369.e12

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

IS - 2

ER -

Association of Physical Activity With Risk of Liver Fibrosis, Sarcopenia, and Cardiovascular Disease in Nonalcoholic Fatty Liver Disease

Abstract

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Keywords

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