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The effect of a novel low-volume aerobic exercise intervention on liver fat in type 2 diabetes: a randomized controlled trial
Sabag A, Way KL, Sultana RN, Keating SE, Gerofi JA, Chuter VH, Byrne NM, Baker MK, George J, Caterson ID, Twigg SM, Johnson NA
Diabetes Care 2020 Oct;43(10):2371-2378
clinical trial
7/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: The aim of this study was to examine the effect of a novel low-volume high-intensity interval training (HIIT), moderate-intensity continuous training (MICT), or placebo (PLA) intervention on liver fat, glycemia, and cardiorespiratory fitness using a randomized placebo-controlled design. RESEARCH DESIGN AND METHODS: Thirty-five inactive adults (age 54.6 +/- 1.4 years, 54% male; BMI 35.9 +/- 0.9 kg/m2) with obesity and type 2 diabetes were randomized to 12 weeks of supervised MICT (n = 12) at 60% VO2peak for 45 min, 3 days/week; HIIT (n = 12) at 90% VO2peak for 4 min, 3 days/week; or PLA (n = 11). Liver fat percent was quantified through proton MRS. RESULTS: Liver fat reduced in MICT (-0.9 +/- 0.7%) and HIIT (-1.7 +/- 1.1%) but increased in PLA (1.2 +/- 0.5%) (p = 0.046). HbA1c improved in MICT (-0.3 +/- 0.3%) and HIIT (-0.3 +/- 0.3%) but not in PLA (0.5 +/- 0.2%) (p = 0.014). Cardiorespiratory fitness improved in MICT (2.3 +/- 1.2 mL/kg/min) and HIIT (1.1 +/- 0.5 mL/kg/min) but not in PLA (-1.5 +/- 0.9 mL/kg/min) (p = 0.006). CONCLUSIONS: MICT or a low-volume HIIT approach involving 12 min of weekly high-intensity aerobic exercise may improve liver fat, glycemia, and cardiorespiratory fitness in type 2 diabetes in the absence of weight loss. Further studies are required to elucidate the relationship between exercise-induced reductions in liver fat and improvements in glycemia.
Copyright American Diabetes Association. Reprinted with permission from The American Diabetes Association.

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