1. Serum Fibroblast Growth Factor 21 Is Markedly Decreased following Exercise Training in Patients with Biopsy-Proven Nonalcoholic Steatohepatitis
- Author
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Stine, Jonathan G, Welles, Jaclyn E, Keating, Shelley, Hussaini, Zeba, Soriano, Christopher, Heinle, J Wes, Geyer, Nathaniel, Chinchilli, Vernon M, Loomba, Rohit, and Kimball, Scot R
- Subjects
Biomedical and Clinical Sciences ,Health Sciences ,Clinical Sciences ,Sports Science and Exercise ,Clinical Trials and Supportive Activities ,Clinical Research ,Digestive Diseases ,Liver Disease ,Hepatitis ,Chronic Liver Disease and Cirrhosis ,Prevention ,Nutrition ,Good Health and Well Being ,Humans ,Non-alcoholic Fatty Liver Disease ,Fibroblast Growth Factors ,Liver ,Exercise ,Liver Cirrhosis ,Biopsy ,Biomarkers ,nonalcoholic fatty liver disease ,fatty liver ,physical activity ,cardiorespiratory fitness ,biomarker ,Food Sciences ,Nutrition and Dietetics ,Clinical sciences ,Nutrition and dietetics ,Public health - Abstract
Background and aimsExercise remains a key component of nonalcoholic fatty liver disease (NAFLD) treatment. However, mechanisms underpinning the improvements in NAFLD seen with exercise are unclear. Exercise improved liver fat and serum biomarkers of liver fibrosis in the NASHFit trial. We investigated exercise's mechanism of benefit by conducting a post hoc analysis of these data to determine the relationship between serum fibroblast growth factor (FGF) 21, which is implicated in NAFLD development, and exercise.MethodsIn the 20 wk NASHFit trial, patients with nonalcoholic steatohepatitis (NASH) were randomized to receive moderate-intensity aerobic exercise training or standard clinical care. Mediterranean-informed dietary counseling was provided to each group. Change in serum FGF21 was measured after an overnight fast.ResultsThere was a significant improvement in serum FGF21 with exercise training compared to standard clinical care (p = 0.037) with serum FGF21 reducing by 22% (-243.4 +/-349 ng/mL) with exercise vs. a 34% increase (+88.4 ng/mL +/-350.3 ng/mL) with standard clinical care. There was a large inverse association between change in serum FGF21 and change in cardiorespiratory fitness (VO2peak) (r = -0.62, 95% CI -0.88 to -0.05, p = 0.031), and on multivariable analysis, change in VO2peak remained independently associated with change in FGF21 (β = -44.5, 95% CI -83.8 to -5.11, p = 0.031).ConclusionsSerum FGF21 is markedly decreased in response to aerobic exercise training, offering a novel mechanism to explain the observed reduction in liver fat and improvement in serum biomarkers of liver fibrosis in patients with NASH who do exercise.
- Published
- 2023