Journal Article Ahead of print 3 citations
PubMed: 42297097 DOI: 10.1016/j.metabol.2026.156677
High-intensity interval training and moderate-intensity continuous training are effective, feasible, and safe for patients with metabolic dysfunction-associated steatotic liver disease (MASLD): A systematic review and meta-analysis.
Metabolism
Authors: Bo Wang, Xinyu Zeng, Hengzhi Deng, Bopeng Qiu, Kai Xu, Meiling Tao, Yilin Zhang, Huakun Zheng, Qingshuo Xu, Shuo Li, Yuming Zhong, Xing Zhang, Hansen Li, Henghao Yan, Jian Song, Zengyu Zhang, Zhide Liang, Qiyu Sun, Bitai Wu, Xinuan Zhang, Alexios Batrakoulis, Dejan Reljic, Mingyue Yin
Affiliations
- Physical Education College, Jilin University, Changchun, China.
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China.
- Faculty of Sports and Exercise Science, University of Malaya, Kuala Lumpur, Malaysia.
- School of Strength and Conditioning, Beijing Sport University, Beijing, 100084, China; Division of Sports Science & Physical Education, Tsinghua University, Beijing, 100084, China.
- Tianjin University of Sport, School of Sports Training, China.
- School of Exercise and Health Science, Shanghai University of Sport, Shanghai, China.
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.
- School of Physical Education, Sichuan Agricultural University, Ya'an, China.
- Institute of Sports Science, School of Physical Education, Southwest University, Chongqing, China.
- School of Physical Education, Shanghai Normal University, Shanghai, China.
- Jinshan Hospital Affiliated to Fudan University, Shanghai, China.
- School of Health Sciences and Sports, Macau Polytechnic University, Macau.
- New Energy and Environment College, Jilin University, Changchun, China.
- School of Physical Education, Changsha University of Science and Technology, Changsha, Hunan, China.
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu City, Sichuan Province, China.
- Department of Life Sciences, European University Cyprus, Nicosia, Cyprus; Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece.
- Hector-Center for Nutrition, Exercise and Sports, Department of Medicine 1 - Gastroenterology, Pneumology and Endocrinology, University Hospital Erlangen, Germany.
- School of Athletic Performance, Shanghai University of Sport, Shanghai, China; School of Coaching, Shanghai University of Sport, Shanghai, China.
Abstract
PURPOSE
This meta-analysis evaluated the efficacy and feasibility of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and identified key moderators.
METHODS
Controlled trials were systematically searched (PubMed, Web of Science, CNKI; initially in Feb 2025 and updated Jan 2026). Random-effects meta-analyses used SMDs; risk of bias, methodological quality, and evidence certainty were systematically assessed.
RESULTS
Thirty-seven trials (1546 participants, 51% female, moderate quality) showed HIIT significantly improved 12 outcomes vs. controls, including body composition (g - 0.94 to -0.52), cardiometabolic parameters (-1.56 to 1.34), and liver markers (-1.06 to -0.50), while MICT benefited 18 outcomes, including body composition (-0.84 to -0.60), cardiometabolic parameters (-1.42 to 1.79), and liver markers (-0.72 to -0.67). HIIT was superior for total cholesterol reduction (g - 0.44, p < 0.05). Subgroup analyses identified significant moderation by obesity status, training frequency, exercise modality, and progression. Meta-regression revealed MICT effects moderated by age, BMI, and prescription parameters (e.g., session duration, weekly time, program length), with significant associations for body fat, lipids, and glycemic control changes. Exploratory nonlinear meta-regression showed distinct dose-response patterns for liver enzyme biomarker improved emerging beyond baseline, 260-280 MET-min per MICT session. Feasibility was high (adherence 83.4%, completion 83.9%), and safety was relatively high.
CONCLUSION
Both HIIT and MICT effectively improve anthropometric, metabolic parameters, and liver function indicators in patients with MASLD, while demonstrating high feasibility and safety. Moderators' analyses identified key moderators and dose-response, informing evidence-based exercise prescription considerations for MASLD management.
REGISTERED
PROSPERO (CRD42025646755).
MeSH
Liver Diseases, Exercise, Safety, Body Composition, Prescriptions, Liver, High-Intensity Interval Training