Long-term effects of aerobic plus resistance training on the adipokines and neuropeptides in nonalcoholic fatty liver disease obese adolescents

Eur J Gastroenterol Hepatol. 2012 Nov;24(11):1313-24. doi: 10.1097/MEG.0b013e32835793ac.


Objective: To compare the effects of aerobic training (AT) with aerobic plus resistance training (AT+RT) in nonalcoholic fatty liver disease (NAFLD) obese adolescents.

Design: Long-term interdisciplinary weight-loss therapy (1 year of clinical, nutritional, psychological, and exercise-related intervention).

Participants: Fifty-eight postpubertal obese adolescents were randomized to AT or AT+RT according to NAFLD diagnosis. Adipokine and neuropeptide concentrations were measured by enzyme-linked immunosorbent assay, visceral fat by ultrasound, and body composition by plethysmography.

Results: The NAFLD group that followed the AT+RT protocol presented lower insulin, homeostasis model assessment-insulin resistance (HOMA-IR), and alanine transaminase (ALT) values after intervention compared with AT. It was verified that there was a higher magnitude of change in the subcutaneous fat, glycemia, total cholesterol (TC), low-density lipoprotein-cholesterol, ALT, and adiponectin in response to AT+RT than in the control group (AT). All patients who underwent the AT+RT exhibited significantly higher adiponectin, leptin, and Δadiponectin and lower melanin-concentrating hormone (MCH) concentrations after therapy compared with the AT group. In the simple linear regression analysis, changes in glycemia, insulin, and HOMA-IR were independent predictors of significant improvement in adiponectin concentration. Indeed, ΔAST (aspartate transaminase) and ΔGGT (γ-glutamyl transpeptidase) were independent predictors of ΔALT, while Δfat mass and ΔAgRP (agouti-related protein) were independent predictors of ΔMCH. Although the number of patients was limited, we showed for the first time the positive effects of AT+RT protocol in a long-term interdisciplinary therapy to improve inflammatory biomarkers and to reduce orexigenic neuropeptide concentrations in NAFLD obese adolescents.

Conclusion: The long-term interdisciplinary therapy with AT+RT protocol was more effective in significantly improving noninvasive biomarkers of NAFLD that are associated with the highest risk of disease progression in the pediatric population.

Trial registration: ClinicalTrials.gov NCT01358773.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipokines / blood*
  • Adiponectin / blood
  • Adiposity
  • Adolescent
  • Biomarkers / blood
  • Blood Glucose / metabolism
  • Body Mass Index
  • Brazil
  • Enzyme-Linked Immunosorbent Assay
  • Exercise*
  • Fatty Liver / blood
  • Fatty Liver / diagnosis
  • Fatty Liver / physiopathology
  • Fatty Liver / therapy*
  • Female
  • Humans
  • Hypothalamic Hormones / blood
  • Inflammation Mediators / blood
  • Insulin / blood
  • Intra-Abdominal Fat / diagnostic imaging
  • Intra-Abdominal Fat / physiopathology
  • Leptin / blood
  • Linear Models
  • Lipids / blood
  • Male
  • Melanins / blood
  • Neuropeptides / blood*
  • Non-alcoholic Fatty Liver Disease
  • Obesity / blood
  • Obesity / diagnosis
  • Obesity / physiopathology
  • Obesity / therapy*
  • Pituitary Hormones / blood
  • Plethysmography
  • Resistance Training*
  • Time Factors
  • Treatment Outcome
  • Ultrasonography
  • Weight Loss
  • Young Adult


  • ADIPOQ protein, human
  • Adipokines
  • Adiponectin
  • Biomarkers
  • Blood Glucose
  • Hypothalamic Hormones
  • Inflammation Mediators
  • Insulin
  • Leptin
  • Lipids
  • Melanins
  • Neuropeptides
  • Pituitary Hormones
  • melanin-concentrating hormone

Associated data

  • ClinicalTrials.gov/NCT01358773