Greater hepatic lipid saturation is associated with impaired glycaemic regulation in men with MASLD but is not altered by six weeks of exercise training

Aims To examine the impact of impaired glycaemic regulation and exercise training on hepatic lipid composition in men with metabolic dysfunction-associated steatotic liver disease (MASLD). 

Materials and methods In Part A (cross-sectional design), 40 men with MASLD (liver proton density fat fraction [PDFF]≥5.56%) were recruited to one-of-two groups: 1) normal glycaemic regulation (NGR; HbA1c<42 mmol∙mol-1 [<6.0%]; n=14); 2) impaired glycaemic regulation (IGR; HbA1c≥42 mmol∙mol-1 [≥6.0%]; n=26). In Part B (RCT design), the IGR group were randomised to one-of-two six-week interventions: 1) exercise training (EX; 70-75% max heart rate; four sessions/week; n=13); 2) non-exercise control (CON; n=13). Saturated (SI; primary outcome), unsaturated (UI), and polyunsaturated (PUI) hepatic lipid indices were determined using proton magnetic resonance spectroscopy. Additional secondary outcomes included liver PDFF, HbA1c, fasting plasma glucose (FPG), homeostatic model assessment of insulin resistance (HOMA-IR), V̇O2 peak, and plasma cytokeratin 18 (CK18) M65, among others. 

Conclusions IGR in MASLD is characterised by greater hepatic lipid saturation, however, this composition is not altered by six-weeks of moderate-intensity exercise training. ClinicalTrials.gov: NCT04004273