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

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13 Citations (Scopus)


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 languageEnglish
Pages (from-to)358-369.e12
JournalClinical Gastroenterology and Hepatology
Issue number2
Publication statusPublished - 2023 Feb

Bibliographical note

Publisher Copyright:
© 2023 AGA Institute

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology


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