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We aimed to examine changes in surrogate measures of liver histological response with exercise training.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a post hoc pooled analysis of three randomised controlled trials (duration: 12\u201320\u2009weeks) comparing aerobic exercise interventions with controls. The primary outcome measure was a \u226530% relative reduction in (MRI\u2010measured) liver fat, as a surrogate measure of liver histological response (the threshold necessary for fibrosis improvement). Secondary outcome measures were changes in other biomarkers of liver fibrosis, anthropometry, body composition and aerobic fitness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eighty\u2010eight adults (exercise: 54, control: 34; male: 67%) were included with mean (SD) age 51 (11) years and body mass index 33.3 (5.2) kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      . Following the intervention, exercise had ~5\u2010fold (OR [95%CI]: 4.86 [1.72, 13.8],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.002) greater odds of \u226530% relative reduction in MRI\u2010measured liver fat compared with control. This paralleled the improvements in anthropometry (waist and hip circumference reduction), body composition (body fat, visceral and subcutaneous adipose tissue) and aerobic fitness (V\u0307O\n                      <jats:sub>2<\/jats:sub>\n                      peak, ventilatory threshold and exercise capacity). Importantly, these effects were independent of clinically significant body weight loss (&lt;3% body weight).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Exercise training led to clinically meaningful improvements in surrogate serum\u2010 and imaging\u2010based measures of liver histological change, without clinically meaningful body weight reduction. These data reinforce the weight\u2010neutral benefit of exercise training and suggest that aerobic training may improve liver fibrosis in patients with MASLD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.15947","type":"journal-article","created":{"date-parts":[[2024,6,7]],"date-time":"2024-06-07T09:38:06Z","timestamp":1717753086000},"page":"2368-2381","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Exercise improves surrogate measures of liver histological response in metabolic dysfunction\u2010associated steatotic liver disease"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6128-0822","authenticated-orcid":false,"given":"Daniel J.","family":"Cuthbertson","sequence":"first","affiliation":[{"name":"Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences University of Liverpool  Liverpool UK"},{"name":"Liverpool University Hospitals NHS Foundation Trust  Liverpool UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5357-2721","authenticated-orcid":false,"given":"Shelley E.","family":"Keating","sequence":"additional","affiliation":[{"name":"School of Human Movement and Nutrition Sciences The University of Queensland  St Lucia Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5932-4793","authenticated-orcid":false,"given":"Christopher J. 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