High-intensity interval training (HIIT), as an individualized exercise training mode based on cardiopulmonary exercise testing (CPET), is characterized by high-intensity training sessions interspersed with short rest periods. The findings from recent trials suggest that in the management of metabolic dysfunction-associated fatty liver disease (MAFLD), compared with traditional aerobic exercise modes such as moderate-intensity continuous training, HIIT may achieve similar or even better effects in reducing liver fat content, increasing peak oxygen uptake, improving insulin resistance, and lowering blood pressure, despite requiring less time commitment and lower energy expenditure. However, there is currently no consensus regarding the formulation of HIIT exercise protocols. Based on the lower limits of the current mainstream HIIT intensity, sets, and interval time parameters, this study aims to assess the effectiveness, safety, and feasibility of the current exercise prescription in improving MAFLD.
54 Participants aged 35-65 years with MAFLD will be randomized 1:1 to intervention or control. The intervention group will undertake home-based HIIT four times weekly for 8 weeks. Each session comprises 8 cycles with 30-second bouts at 80% peak VO₂ followed by 60-second recoveries at 50% peak VO₂. The control group do not take any types of exercise interventions. Standard care would be provided for both groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
54
Exercise sessions were conducted as telemedically supervised, home-based HIIT performed on electric resistance bikes, with protocols individually tailored. Each HIIT session comprised 8 cycles of alternating 30-second high-intensity intervals (HIT at 80% peakVO₂) and 60-second low-intensity recovery intervals (LIT at 50% peakVO₂). Warm-up and cool-down phases were performed with the bike's resistance set to 0 watts (unloaded pedaling). The total intervention duration was 8 weeks. Received health lifestyle education based on the Prevention and Treatment Guidelines for Metabolic (Non-Alcoholic) Fatty Liver Disease (2024 Edition) and the Dietary Guidelines for Adults with Hyperlipidemia (2023 Edition).Wear smart bracelets 24/7 to monitor daily activity levels, with participants prohibited from engaging in any other systematic exercise training during the intervention period.
The control group will not receive any exercise intervention, and they will be instructed to not take any structured exercise regimens.Received health lifestyle education based on the Prevention and Treatment Guidelines for Metabolic (Non-Alcoholic) Fatty Liver Disease (2024 Edition) and the Dietary Guidelines for Adults with Hyperlipidemia (2023 Edition).Wear smart bracelets 24/7 to monitor daily activity levels, with participants prohibited from engaging in any other systematic exercise training during the intervention period.
Beijing Ditan Hospital, Capital Medical University
Beijing, China
Beijing Friendship Hospital, Capital Medical University
Beijing, China
Beijing Youan Hospital, Capital Medical University
Beijing, China
Peking University Third Hospital
Beijing, China
The Fifth Medical Center, Chinese PLA General Hospital
Beijing, China
Liver fat content (%)
Liver fat content will be measured using MRI-PDFF.
Time frame: Baseline (week 0) , after complete post-training (week 8).
LSM (kPa)
Liver fibrosis will be measured using MRE.
Time frame: Baseline (week 0) , after complete post-training (week 8).
Blood specimen
Lab tests include red blood cell count.
Time frame: Baseline (week 0) , after complete mid-training (week 4), after complete post-training (week 8).
Blood specimen
Lab tests include hematocrit.
Time frame: Baseline (week 0) , after complete mid-training (week 4), after complete post-training (week 8).
Blood specimen
Lab tests include hemoglobin count.
Time frame: Baseline (week 0) , after complete mid-training (week 4), after complete post-training (week 8).
Blood specimen
Lab tests include testosterone.
Time frame: Baseline (week 0) , after complete mid-training (week 4), after complete post-training (week 8).
Blood specimen
Lab tests include cortisol.
Time frame: Baseline (week 0) , after complete mid-training (week 4), after complete post-training (week 8).
Blood specimen
Lab tests include creatine kinase.
Time frame: Baseline (week 0) , after complete mid-training (week 4), after complete post-training (week 8).
Blood specimen
Lab tests include blood urea.
Time frame: Baseline (week 0) , after complete mid-training (week 4), after complete post-training (week 8).
Blood specimen
Lab tests include alanine aminotransferase.
Time frame: Baseline (week 0) , after complete mid-training (week 4), after complete post-training (week 8).
Blood specimen
Lab tests include aspartate aminotransferase.
Time frame: Baseline (week 0) , after complete mid-training (week 4), after complete post-training (week 8).
Blood specimen
Lab tests include lactic acid
Time frame: After first time and complete of mid-training (week 4), after first time and complete of post-training (week 8).
Exercise Feasibility
The implementation status of the home-based exercise prescription, including training frequency per week, average pedal frequency of the high-intensity exercise on the resistance bike, and average pedal frequency of the low-intensity exercise on the resistance bike
Time frame: Every week after complete training from week 1 to week 8.
LSM (kPa)
Liver fibrosis will be measured using Fibrotouch@.
Time frame: Baseline (week 0) , after complete post-training (week 8).
Peak VO2
Peak VO2 is assessed through CPET, using a maximal graded treadmill test based on the Chinese expert consensus on the standardized clinical application of CPET.
Time frame: Baseline (week 0) , after complete post-training (week 8).
BMI
Weight (kg) is measured with digital weighing scale. Height (cm) is measured with a portable stadiometer. BMI is calculated as weight in kilograms divided by the square of height in meters
Time frame: Baseline (week 0) , after complete post-training (week 8).
Brog score
The Borg Subjective Fatigue Scale (Borg) would be tested after each session
Time frame: After complete mid-training (week 4) , after complete post-training (week 8).
Exercise Feasibility
The proportion of subjects leaving group during the preparation period and early termination of the trial
Time frame: From baseline (week 0) to after complete post-training (week 8).
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