{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T21:03:32Z","timestamp":1790283812987,"version":"4.1.0"},"reference-count":43,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T00:00:00Z","timestamp":1697155200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Metabolites"],"abstract":"<jats:p>Non-alcoholic fatty liver disease (NAFLD) is a very common liver disease associated with obesity, unhealthy diet, and lack of physical exercise. Short-term aerobic or resistance exercise has been shown to result in reduced liver fat in patients with NAFLD; however, the impact of the combination of these types of exercise has received less attention. This study investigated the effect of a short-term (7 days) concurrent exercise training program performed daily on liver steatosis indices, as well as the glycemic and lipidemic profile of overweight\/obese sedentary volunteers. Twenty adult patients (age: 47.3 \u00b1 12.3 yrs, body mass index: 32.4 \u00b1 3.4 kg\/m2) with NAFLD, detected by ultrasound and hematological indices, participated in the study. Pre- and post-exercise intervention assessment included body weight (BW), waist circumference (WC), hip\/waist ratio (H\/W), Homeostasis Model Assessment Insulin Resistance (HOMA-IR), blood lipids, and steatosis indices. Fatty Liver Index, Lipid Accumulation Index, WC, H\/W, triglycerides, and total cholesterol were improved (p &lt; 0.05) post-exercise, while no differences (p &gt; 0.05) were observed in BW, HOMA-IR, HDL, LDL, Hepatic Steatosis Index, and Framingham Steatosis Index compared to pre-exercise values. It is concluded that a 7-day combined exercise program can have beneficial effects on hepatic steatosis and central adiposity indices, independently of weight loss, in patients with NAFLD.<\/jats:p>","DOI":"10.3390\/metabo13101074","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T01:03:12Z","timestamp":1697158992000},"page":"1074","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The Effects of a Short-Term Combined Exercise Program on Liver Steatosis Indices and the Lipidemic and Glycemic Profile in NAFLD Individuals: A Pilot Study"],"prefix":"10.3390","volume":"13","author":[{"given":"Dimitrios","family":"Voudouris","sequence":"first","affiliation":[{"name":"Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Horianopoulou","sequence":"additional","affiliation":[{"name":"Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoi","family":"Apostolopoulou","sequence":"additional","affiliation":[{"name":"Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costas","family":"Chryssanthopoulos","sequence":"additional","affiliation":[{"name":"Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2919-9960","authenticated-orcid":false,"given":"Mari","family":"Bardopoulou","sequence":"additional","affiliation":[{"name":"Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3458-4633","authenticated-orcid":false,"given":"Maria","family":"Maridaki","sequence":"additional","affiliation":[{"name":"Department of Physical Education and Sport Science, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 17237 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros","family":"Vassilakopoulos","sequence":"additional","affiliation":[{"name":"Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Koutsilieris","sequence":"additional","affiliation":[{"name":"Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0047-3003","authenticated-orcid":false,"given":"Anastassios","family":"Philippou","sequence":"additional","affiliation":[{"name":"Department of Physiology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3017","DOI":"10.1007\/s10620-013-2743-5","article-title":"Predictors of All-Cause Mortality and Liver-Related Mortality in Patients with Non-Alcoholic Fatty Liver Disease (NAFLD)","volume":"58","author":"Stepanova","year":"2013","journal-title":"Dig. Dis. Sci."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1993","DOI":"10.3748\/wjg.v26.i17.1993","article-title":"Metabolic inflammation as an instigator of fibrosis during non-alcoholic fatty liver disease","volume":"26","author":"Katsarou","year":"2020","journal-title":"World J. Gastroenterol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2011\/831536","article-title":"Mechanisms and Implications of Age-Related Changes in the Liver: Nonalcoholic Fatty Liver Disease in the Elderly","volume":"2011","author":"Gan","year":"2011","journal-title":"Curr. Gerontol. Geriatr. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2861","DOI":"10.1016\/j.dsx.2019.07.061","article-title":"The role of exercise in obesity","volume":"13","author":"Philippou","year":"2019","journal-title":"Diabetes Metab. Syndr. Clin. Res. Rev."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1016\/j.jhep.2011.06.010","article-title":"Lifestyle interventions for the treatment of non-alcoholic fatty liver disease in adults: A systematic review","volume":"56","author":"Thoma","year":"2012","journal-title":"J. Hepatol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Franco, I., Bianco, A., Mirizzi, A., Campanella, A., Bonfiglio, C., Sorino, P., Notarnicola, M., Tutino, V., Cozzolongo, R., and Giannuzzi, V. (2021). Physical Activity and Low Glycemic Index Mediterranean Diet: Main and Modification Effects on NAFLD Score. Results from a Randomized Clinical Trial. Nutrients, 13.","DOI":"10.3390\/nu13010066"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"54","DOI":"10.5223\/pghn.2021.24.1.54","article-title":"Changes in Liver Enzymes and Metabolic Profile in Adolescents with Fatty Liver following Exercise Interventions","volume":"24","author":"Iraji","year":"2021","journal-title":"Pediatr. Gastroenterol. Hepatol. Nutr."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"120","DOI":"10.14218\/JCTH.2019.00012","article-title":"Effect of Exercise on NAFLD and Its Risk Factors: Comparison of Moderate versus Low Intensity Exercise","volume":"8","author":"Nath","year":"2020","journal-title":"J. Clin. Transl. Hepatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1249\/MSS.0000000000003199","article-title":"Physical Activity and Nonalcoholic Fatty Liver Disease: A Roundtable Statement from the American College of Sports Medicine","volume":"55","author":"Stine","year":"2023","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1053\/j.gastro.2015.04.005","article-title":"Weight Loss Through Lifestyle Modification Significantly Reduces Features of Nonalcoholic Steatohepatitis","volume":"149","author":"Friedman","year":"2015","journal-title":"Gastroenterology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1016\/j.jhep.2018.08.011","article-title":"Beneficial effects of lifestyle intervention in non-obese patients with non-alcoholic fatty liver disease","volume":"69","author":"Wong","year":"2018","journal-title":"J. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1738","DOI":"10.1002\/hep.25548","article-title":"Randomized trial of exercise effect on intrahepatic triglyceride content and lipid kinetics in nonalcoholic fatty liver disease","volume":"55","author":"Sullivan","year":"2012","journal-title":"Hepatology"},{"key":"ref_13","unstructured":"Philippou, A., Chryssanthopoulos, C., Maridaki, M., Dimitriadis, G., and Koutsilieris, M. (2019). Cardiorespiratory Fitness in Cardiometabolic Diseases, Springer."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1002\/hep.23276","article-title":"Randomized controlled trial testing the effects of weight loss on nonalcoholic steatohepatitis","volume":"51","author":"Promrat","year":"2010","journal-title":"Hepatology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1137","DOI":"10.4254\/wjh.v8.i27.1137","article-title":"Independent effects of diet and exercise training on fat oxidation in non-alcoholic fatty liver disease","volume":"8","author":"Croci","year":"2016","journal-title":"World J. Hepatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"4219","DOI":"10.1210\/jc.2016-2353","article-title":"Exercise Training Reduces Liver Fat and Increases Rates of VLDL Clearance but Not VLDL Production in NAFLD","volume":"101","author":"Cuthbertson","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Babu, A.F., Csader, S., Lok, J., G\u00f3mez-Gallego, C., Hanhineva, K., El-Nezami, H., and Schwab, U. (2021). Positive Effects of Exercise Intervention without Weight Loss and Dietary Changes in NAFLD-Related Clinical Parameters: A Systematic Review and Meta-Analysis. Nutrients, 13.","DOI":"10.3390\/nu13093135"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1152\/japplphysiol.00127.2012","article-title":"Short-term exercise reduces markers of hepatocyte apoptosis in nonalcoholic fatty liver disease","volume":"113","author":"Fealy","year":"2012","journal-title":"J. Appl. Physiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"E1181","DOI":"10.1210\/jc.2013-1229","article-title":"Improved Hepatic Lipid Composition Following Short-Term Exercise in Nonalcoholic Fatty Liver Disease","volume":"98","author":"Haus","year":"2013","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"988","DOI":"10.1152\/japplphysiol.00237.2013","article-title":"Fetuin-A is linked to improved glucose tolerance after short-term exercise training in nonalcoholic fatty liver disease","volume":"115","author":"Malin","year":"2013","journal-title":"J. Appl. Physiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1152\/japplphysiol.00693.2015","article-title":"Short-term aerobic exercise training improves gut peptide regulation in nonalcoholic fatty liver disease","volume":"120","author":"Kullman","year":"2016","journal-title":"J. Appl. Physiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1080\/07303084.1993.10606684","article-title":"Strength Testing\u2014Predicting a One-Rep Max from Reps-to-Fatigue","volume":"64","author":"Brzycki","year":"2013","journal-title":"J. Phys. Educ. Recreat. Dance"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis model assessment: Insulin resistance and \u03b2-cell function from fasting plasma glucose and insulin concentrations in man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.dld.2009.08.002","article-title":"Hepatic steatosis index: A simple screening tool reflecting nonalcoholic fatty liver disease","volume":"42","author":"Lee","year":"2010","journal-title":"Dig. Liver Dis."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Bedogni, G., Kahn, H.S., Bellentani, S., and Tiribelli, C. (2010). A simple index of lipid overaccumulation is a good marker of liver steatosis. BMC Gastroenterol., 10.","DOI":"10.1186\/1471-230X-10-98"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1016\/j.cgh.2016.03.034","article-title":"Development and Validation of the Framingham Steatosis Index to Identify Persons with Hepatic Steatosis","volume":"14","author":"Long","year":"2016","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Kahn, H.S. (2005). The \u201clipid accumulation product\u201d performs better than the body mass index for recognizing cardiovascular risk: A population-based comparison. BMC Cardiovasc. Disord., 5.","DOI":"10.1186\/1471-2261-5-26"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1002\/hep.21178","article-title":"Development of a simple noninvasive index to predict significant fibrosis in patients with HIV\/HCV coinfection","volume":"43","author":"Sterling","year":"2006","journal-title":"Hepatology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1002\/hep.21496","article-title":"The NAFLD fibrosis score: A noninvasive system that identifies liver fibrosis in patients with NAFLD","volume":"45","author":"Angulo","year":"2007","journal-title":"Hepatology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1111\/j.1572-0241.1999.01006.x","article-title":"The Ratio of Aspartate Aminotransferase to Alanine Aminotransferase: Potential Value in Differentiating Nonalcoholic Steatohepatitis from Alcoholic Liver Disease","volume":"94","author":"Sorbi","year":"1999","journal-title":"Am. J. Gastroenterol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1002\/hep.24356","article-title":"Fatty liver index and mortality: The cremona study in the 15th year of follow-up","volume":"54","author":"Calori","year":"2011","journal-title":"Hepatology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1053\/j.gastro.2015.04.043","article-title":"Liver Fibrosis, but No Other Histologic Features, Is Associated with Long-term Outcomes of Patients with Nonalcoholic Fatty Liver Disease","volume":"149","author":"Angulo","year":"2015","journal-title":"Gastroenterology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"89","DOI":"10.3727\/105221617X15124844266408","article-title":"The Effects of Physical Exercise on Fatty Liver Disease","volume":"18","author":"Sud","year":"2018","journal-title":"Gene Expr."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1080\/17461391.2019.1571114","article-title":"Mechanisms of beneficial effects of exercise training on non-alcoholic fatty liver disease (NAFLD): Roles of oxidative stress and inflammation","volume":"19","author":"Farzanegi","year":"2019","journal-title":"Eur. J. Sport Sci."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Gidaro, A., Manetti, R., Delitala, A.P., Salvi, E., Bergamaschini, L., Vidili, G., and Castelli, R. (2012). Prothrombotic and Inflammatory Markers in Elderly Patients with Non-Alcoholic Hepatic Liver Disease before and after Weight Loss: A Pilot Study. J. Clin. Med., 10.","DOI":"10.3390\/jcm10214906"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1281","DOI":"10.1042\/bst0311281","article-title":"Insulin signalling, exercise and cellular integrity","volume":"31","author":"Kirwan","year":"2003","journal-title":"Biochem. Soc. Trans."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1113\/jphysiol.1995.sp020553","article-title":"Eccentric exercise decreases glucose transporter GLUT4 protein in human skeletal muscle","volume":"482","author":"Asp","year":"1995","journal-title":"J. Physiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"E849","DOI":"10.1152\/ajpendo.1999.276.5.E849","article-title":"TNF-\u03b1 impairs insulin signaling and insulin stimulation of glucose uptake in C2C12 muscle cells","volume":"276","author":"Claffey","year":"1999","journal-title":"Am. J. Physiol -Endocrinol. Metab."},{"key":"ref_39","first-page":"565","article-title":"Pathophysiology of Exercise-Induced Muscle Damage and Its Structural, Functional, Metabolic, and Clinical Consequences","volume":"69","author":"Vodopivc","year":"2020","journal-title":"Physiol. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"305","DOI":"10.3390\/physiologia3020022","article-title":"The Involvement of Lipid Mediators in the Mechanisms of Exercise-Induced Muscle Damage","volume":"3","author":"Gakis","year":"2023","journal-title":"Physiologia"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"2857","DOI":"10.1519\/JSC.0b013e3181e840f3","article-title":"The Mechanisms of Muscle Hypertrophy and Their Application to Resistance Training","volume":"24","author":"Schoenfeld","year":"2010","journal-title":"J. Strength Cond. Res."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/S0304-4165(00)00045-3","article-title":"Regulation of protein synthesis in lactating rat mammary tissue by cell volume","volume":"1475","author":"Grant","year":"2000","journal-title":"Biochim. Biophys. Acta BBA-Gen. Subj."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1006\/bbrc.1996.5959","article-title":"Mammary Protein Synthesis Is Acutely Regulated by the Cellular Hydration State","volume":"230","author":"Millar","year":"1997","journal-title":"Biochem. Biophys. Res. Commun."}],"container-title":["Metabolites"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-1989\/13\/10\/1074\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:06:03Z","timestamp":1760130363000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-1989\/13\/10\/1074"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,13]]},"references-count":43,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2023,10]]}},"alternative-id":["metabo13101074"],"URL":"https:\/\/doi.org\/10.3390\/metabo13101074","relation":{},"ISSN":["2218-1989"],"issn-type":[{"value":"2218-1989","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,13]]}}}