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Whether exercise training improves liver fibrosis without body weight loss remains controversial. We further investigated this relationship using serum biomarkers of liver fibroinflammation in a post hoc analysis of an exercise trial where patients did not lose significant body weight.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In the NASHFit trial, patients with metabolic dysfunction\u2010associated steatohepatitis were randomized to receive either moderate\u2010intensity aerobic exercise training or standard clinical care for 20\u2009weeks. Mediterranean\u2010informed dietary counselling was provided to each group. Change in serum biomarkers was measured and compared between the two groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Exercise training led to improvement in serum biomarkers of liver fibroinflammation, including (1) \u226517\u2009IU\/L reduction in alanine aminotransferase (ALT) in 53% of individuals in the exercise training group compared to 13% in the standard clinical care group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; mean reduction 24% vs. 10% respectively) and (2) improvement in CK18 (\u221261 vs. +71\u2009ng\/mL,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.040). ALT improvement \u226517\u2009IU\/L was correlated with \u226530% relative reduction in magnetic resonance imaging\u2010measured liver fat and PNPLA3 genotype.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Exercise training improves multiple serum biomarkers of liver fibroinflammation at clinically significant thresholds of response without body weight loss. This study provides further evidence that exercise training should be viewed as a weight\u2010neutral intervention for which response to intervention can be readily monitored with widely available non\u2010invasive biomarkers that can be applied at the population level.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.15769","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T08:59:19Z","timestamp":1701161959000},"page":"532-540","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Exercise training improves serum biomarkers of liver fibroinflammation in patients with metabolic dysfunction\u2010associated steatohepatitis"],"prefix":"10.1111","volume":"44","author":[{"given":"Sara J.","family":"Harris","sequence":"first","affiliation":[{"name":"College of Medicine, The Pennsylvania State University  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nataliya","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Penn State Health\u2010Milton S. Hershey Medical Center  Hershey Pennsylvania USA"},{"name":"Fatty Liver Program Penn State Health\u2010Milton S. Hershey Medical Center  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Breianna","family":"Hummer","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Penn State Health\u2010Milton S. Hershey Medical Center  Hershey Pennsylvania USA"},{"name":"Fatty Liver Program Penn State Health\u2010Milton S. Hershey Medical Center  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian R.","family":"Schreibman","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Penn State Health\u2010Milton S. Hershey Medical Center  Hershey Pennsylvania USA"},{"name":"Fatty Liver Program Penn State Health\u2010Milton S. 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Hershey Medical Center  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0965-3123","authenticated-orcid":false,"given":"Nathaniel R.","family":"Geyer","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences The Pennsylvania State University\u2010College of Medicine  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vernon M.","family":"Chinchilli","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences The Pennsylvania State University\u2010College of Medicine  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Sciamanna","sequence":"additional","affiliation":[{"name":"College of Medicine, The Pennsylvania State University  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Loomba","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine University of California San Diego  San Diego California USA"},{"name":"NAFLD Research Center University of California San Diego  San Diego California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3352-6928","authenticated-orcid":false,"given":"Jonathan G.","family":"Stine","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine Penn State Health\u2010Milton S. 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