Acceleration training for managing nonalcoholic fatty liver disease: a pilot study

Figures & data

Figure 1 Illustration of the synchronous mode of vibration transmission in whole-body vibration exercise. Both legs extend and stretch at the same time, and a purely linear acceleration is directed to the trunk.

Table 1 Intervention outcomes for energy expenditure and intake, and anthropometry in obese patients with nonalcoholic fatty liver disease

Parameter	Baseline	After 12 weeks	Change	P-value
Energy expenditure and intake
Resting EE (kcal/day)	1,485 (1,317–1,726)	1,474 (1,329–1,709)	−11	0.96
npRQ	0.81 (0.75–0.91)	0.82 (0.78–0.86)	+0.01	0.73
TEE (kcal/day)	2,292 (1,825–2,645)	1,972 (1,862–2,513)	−320	0.11
TEI (kcal/day)	1,873 (1,512–2,760)	2,109 (1,458–2,880)	+236	0.21

Notes: Values are presented as the median (95% confidence interval). The comparison of within-group changes over time, from baseline to after 12 weeks, for all dependent variables was analyzed by Wilcoxon’s rank sum test.

Abbreviations: npRQ, nonprotein respiratory quotient; EE, energy expenditure; TEE, total daily energy expenditure; TEI, total daily energy intake.

Table 2 Intervention adherence outcomes for blood biochemistry in obese patients with nonalcoholic fatty liver disease

Parameter	Normal subjects	AT
	Pre	Pre	Post	Change	P-value
Anthropometry
Body weight (kg)	53.3 (47.6–63.8)	73.8 (66.8–96.6)††	73.5 (65.5–91.6)††	−0.3	<0.05
BMI (kg/m^2)	20.3 (19.0–21.8)	28.2 (25.5–33.2)††	28.0 (25.3–33.3)††	−0.2	<0.05
Body fat mass (kg)	11.0 (7.9–15.1)	28.9 (22.3–38.2)††	27.2 (18.4–37.8)††	−1.7	<0.05
Skeletal muscle (kg)	23.3 (19.1–28.1)	24.5 (21.1–30.0)	25.0 (21.4–29.2)	+0.5	0.68
Visceral fat area (cm^2)	42.5 (31.9–49.0)	132.0 (106.6–143.7)††	123.0 (106.2–146.4)††	−9.0	<0.05
Blood analysis
AST (U/L)	16.0 (15.0–19.0)	25.0 (19.0–41.0)††	21.0 (18.0–34.0)††	−11.7	0.29
ALT (U/L)	13.0 (11.0–17.0)	33.0 (20.0–53.0)††	22.5 (18.0–43.0)††	−15.7	<0.05
γ-GT (U/L)	15.0 (12.0–23.0)	28.0 (24.0–38.0)††	26.0 (19.0–37.0)††	−2.0	<0.05
Ferritin (ng/mL)	61.3 (20.8–125.0)	74.9 (26.8–123.0)†	60.8 (29.8–96.9)	−14.1	0.34
hs-CRP (mg/dL)	0.01 (0.01–0.02)	0.16 (0.05–0.28)†	0.06 (0.03–0.33)	−0.10	0.27
Platelet (10^4/μL)	23.3 (21.9–29.7)	24.8 (15.4–29.8)	25.4 (17.6–29.5)	+0.6	0.24
FFA (mEq/L)	0.45 (0.37–0.60)	0.61 (0.49–0.74)†	0.51 (0.41–0.56)	−0.10	<0.05
Triglycerides (mg/dL)	86.0 (42.0–100.0)	115.0 (85.0–164.0)†	110.0 (83.0–165.0)†	−5.0	0.76
Total cholesterol (mg/dL)	188.0 (166.0–195.0)	195.5 (178.0–223.0)	185.5 (165.0–210.0)	−10.0	<0.05
HDL-C (mg/dL)	60.0 (55.0–73.0)	51.8 (46.9–63.3)†	53.1 (47.3–59.3)†	+1.3	0.86
LDL-C (mg/dL)	106.0 (87.0–132.0)	110.0 (90.0–127.0)	102.0 (93.0–123.0)	−8.0	0.08
FPG (mg/dL)	77.0 (73.0–85.0)	94.5 (88.0–102.0)††	99.0 (89.0–107.0)††	+4.5	0.40
FPI (μU/mL)	4.6 (2.80–6.60)	8.3 (5.50–11.8)††	10.8 (4.30–12.6)††	+2.5	0.85
HbA1c (%)	4.8 (4.70–4.90)	5.2 (4.90–5.80)††	5.3 (4.90–5.50)††	+0.1	0.81
HOMA-IR	0.9 (0.53–1.25)	2.0 (1.20–3.26)††	2.3 (1.06–3.26)††	+0.3	0.75
Hyaluronan (ng/mL)	14.5 (10.1–20.7)	31.5 (10.0–43.0)	24.0 (10.0–48.0)	−7.5	0.46
Type IV collagen (ng/mL)	104.0 (90.0–117.0)	119.0 (99.0–142.0)†	123.1 (103.0–148.0)†	+4.1	0.60

Notes: Values are presented as the median (95% confidence interval). The comparison of within-group changes over time, from baseline to after 12 weeks, for all dependent variables was analyzed by Wilcoxon’s rank sum test.

† P<0.05,

†† P<0.01, significant difference between groups (normal group versus acceleration training group pre and post).

Abbreviations: AT, acceleration training; BMI, body mass index; AST, aspartate aminotransferase; ALT, alanine aminotransferase; γ-GT, gamma glutamyl transpeptidase; hs-CRP, high-sensitivity C-reactive protein; FFA, free fatty acids; HDL-C, high density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol; FPG, fasting plasma glucose; FPI, fasting plasma insulin; HbA_1c, glycated hemoglobin; HOMA-IR, insulin resistance by homeostasis model assessment.

Figure 2 Effects of AT on muscle strength (A), cross-sectional area (B), fat deposition (C) in the femoral muscle (quadriceps), intrahepatocellular lipids measured by magnetic resonance spectroscopy (D), intrahepatocellular lipids measured by Fibroscan 502 (E), and liver stiffness (F) in obese patients with nonalcoholic fatty liver disease.

Notes: *P<0.05, significant difference versus baseline and week 12. ^†P 0.05, ^††P<0.01, significant difference between groups (normal group versus AT group pre and post). The lower edge, midline, and upper edge of each box represent the 25th percentile, median, and 75th percentile scores, respectively. The line from each box extends to the minimum and maximum score.
Abbreviations: AT, acceleration training; IMCL, intramyocellular lipids; EMCL, extramyocellular lipids; IHL, intrahepatic lipids.

Figure 3 Effects of AT on serum levels of leptin, adiponectin, TNF-α, IL-6 (A), and hs-CRP and TBARS (B) in obese patients with nonalcoholic fatty liver disease.

Notes: *P<0.05, significant difference between the baseline and week 12. ^†P<0.05, ^††P<0.01, significant difference between groups (normal subject group versus AT group pre and post). The lower edge, midline, and upper edge of each box represent the 25th percentile, median, and 75th percentile scores, respectively. The line from each box extends to the minimum and maximum score.
Abbreviations: AT, acceleration training; TNF-α, tumor necrosis factor-alpha; IL-6, interleukin-6; hsCRP, high-sensitivity C-reactive protein; TBARS, thiobarbituric acid reactive substances.

Figure 4 Changes in SF-36 scores prior to and after acceleration training in obese patients with nonalcoholic fatty liver disease.

Notes: *P<0.05, significant difference between baseline and week 12.
Abbreviations: BP, bodily pain; GH, general health perception; SF-36, Short Form Health Survey; ER, emotional role; MH, mental health; PF, physical functioning; PR, physical role; SF, social functioning; VT, vitality.

Figure S1 The acceleration training program conducted in this study.