SynthesisFrontiers in physiology2026
Exercise training improves hepatic enzymes, body mass index, and cardiorespiratory fitness in adults with metabolic dysfunction-associated steatotic liver disease: a systematic review and meta-analysis.
Synthesis in Frontiers in physiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Exercise is recommended for metabolic dysfunction-associated steatotic liver disease (MASLD). Recent reviews have addressed specific exercise modalities or selected outcome domains, but an updated integrated appraisal of hepatic, metabolic, and cardiorespiratory responses across randomized trials remains needed. Method: We conducted a PRISMA 2020-compliant systematic review and meta-analysis of randomized controlled trials in adults with MASLD or legacy diagnoses of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis. PubMed, Embase, CENTRAL, Scopus, Web of Science, and SPORTDiscus were searched from inception to June 2026. Post-intervention mean differences (MDs) or standardized mean differences (SMDs) with 95% confidence intervals (CIs) were pooled. Risk of bias was assessed using RoB 2 and certainty using GRADE. Results: Twenty-five trials were included. Exercise reduced alanine aminotransferase (ALT; MD -7.33 U/L, 95% CI -10.71 to -3.95), aspartate aminotransferase (AST; MD -5.52 U/L, 95% CI -10.24 to -0.79), and BMI (random-effects MD -1.54 kg/m², 95% CI -2.28 to -0.80), and improved VO Conclusion: Exercise training improves hepatic enzymes, BMI, and cardiorespiratory fitness in adults with MASLD/NAFLD, whereas evidence for liver fat and glycemic outcomes remains less certain. PROSPERO: CRD420261416397. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420261416397.
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