美国伊利诺伊大学芝加哥分校Krista A. Varady团队近期取得重要工作进展，他们报道了隔日禁食结合有氧运动对非酒精性脂肪肝的影响。相关研究成果2022年12月21日在线发表于《细胞—代谢》杂志上。

据介绍，目前迫切需要创新的非药物性生活方式策略来治疗非酒精性脂肪性肝病（NAFLD）。

研究人员比较了隔日禁食（ADF）联合运动与单独禁食或单独运动对肝内甘油三酯（IHTG）含量的影响。患有肥胖和NAFLD的成年人（n = 80, 81%为女性，年龄:23-65岁）被随机分为4组中的1组，为期3个月：ADF（600 kcal/2500 kJ的“禁食日”与自由摄入的“盛宴日”交替进行）和中等强度的有氧运动（每周5次，每次60分钟）；单独使用ADF；单独锻炼；或者无干预对照组。到第3个月，与运动组（−1.30%；95%可信区间，−3.80%至1.20%；p=0.02）和对照组（−0.17%；95%可信区间；−2.17%至1.83%；p<0.01）相比，联合组的IHTG含量显著降低（−5.48%；95%可信区间：−7.77%至−3.18%），但与ADF组（−2.25%；95%可信区间：−4.46%至−0.04%；p=0.05）相比无显著差异。

与对照组相比，联合组患者体重、脂肪量、腰围、谷丙转氨酶（ALT）水平显著降低，胰岛素敏感性显著升高。各组间瘦体重、天冬氨酸转氨酶（AST）、HbA1c、血压、血脂、肝纤维化评分和肝因子（胎球蛋白A、FGF-21和硒蛋白P）无显著差异。

总之，间歇性禁食与运动相结合可有效减少NAFLD患者的肝脏脂肪变性，但与单独禁食相比，可能没有额外的益处。

附：英文原文

Title: Effect of alternate day fasting combined with aerobic exercise on non-alcoholic fatty liver disease: A randomized controlled trial

Author: Mark Ezpeleta, Kelsey Gabel, Sofia Cienfuegos, Faiza Kalam, Shuhao Lin, Vasiliki Pavlou, Zhenyuan Song, Jacob M. Haus, Sean Koppe, Shaina J. Alexandria, Lisa Tussing-Humphreys, Krista A. Varady

Issue&Volume: 2022-12-21

Abstract: Innovative non-pharmacological lifestyle strategies to treat non-alcoholic fatty liverdisease (NAFLD) are critically needed. This study compared the effects of alternateday fasting (ADF) combined with exercise to fasting alone, or exercise alone, on intrahepatictriglyceride (IHTG) content. Adults with obesity and NAFLD (n = 80, 81% female, age:23–65 years) were randomized to 1 of 4 groups for 3 months: combination of ADF (600 kcal/2,500 kJ“fast day” alternated with an ad libitum intake “feast day”) and moderate-intensity aerobic exercise (5 session per week,60 min/session); ADF alone; exercise alone; or a no-intervention control group. Bymonth 3, IHTG content was significantly reduced in the combination group (5.48%;95% CI, 7.77% to 3.18%), compared with the exercise group (1.30%; 95% CI, 3.80%to 1.20%; p = 0.02) and the control group (0.17%; 95% CI, 2.17% to 1.83%; p < 0.01)but was not significantly different versus the ADF group (2.25%; 95% CI, 4.46% to0.04%; p = 0.05). Body weight, fat mass, waist circumference, and alanine transaminase(ALT) levels significantly decreased, while insulin sensitivity significantly increasedin the combination group compared with the control group. Lean mass, aspartate transaminase(AST), HbA1c, blood pressure, plasma lipids, liver fibrosis score, and hepatokines(fetuin-A, FGF-21, and selenoprotein P) did not differ between groups. Combining intermittentfasting with exercise is effective for reducing hepatic steatosis in patients withNAFLD but may offer no additional benefit versus fasting alone.

DOI: 10.1016/j.cmet.2022.12.001

Source: https://www.cell.com/cell-metabolism/fulltext/S1550-4131(22)00538-1