Effect of different exercise interventions on patients with metabolic dysfunction-associated fatty liver disease： A systematic review and network Meta-analysis

Guodong MA; Zhuojing SUN; Song HU; Zijun YE; Mingchen MA; Fei CUI; Jiaju ZHU

doi:10.12449/JCH260213

Volume 42 Issue 2

Feb. 2026

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Article Navigation > Journal of Clinical Hepatology > 2026 > 42(2): 326-344

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Effect of different exercise interventions on patients with metabolic dysfunction-associated fatty liver disease： A systematic review and network Meta-analysis

DOI: 10.12449/JCH260213

Guodong MA¹,
Zhuojing SUN^{1
,
,
,},
Song HU²,
Zijun YE³,
Mingchen MA¹,
Fei CUI¹,
Jiaju ZHU^{4
,
,
,}

1.
Jilin Sport University，Changchun 130022，China
2.
Department of Sports Rehabilitation，Pukyong National University，Busan 612022，Republic of Korea
3.
School of Life and Health Sciences，The Chinese University of Hong Kong，Hong Kong 999077，China
4.
School of Physical Education，Northeast Normal University，Changchun 130024，China

Research funding:

Social Science Foundation of Jilin Province (2019B122);

Graduate Student Research and Innovation Fund of Jilin Sport University (YC2024022)

More Information

Corresponding author: SUN Zhuojing， 202301033@jlsu.edu.cn （ORCID： 0009-0004-1749-0082）; ZHU Jiaju， zhujj@nenu.edu.cn （ORCID： 0009-0005-9000-7920）
Received Date: 2025-09-08
Accepted Date: 2025-10-31
Published Date: 2026-02-25

Abstract

Abstract

Objective To investigate the effect of different exercise interventions on metabolism and liver parameters in patients with metabolic dysfunction-associated fatty liver disease （MAFLD）， and to provide evidence-based recommendations for clinical exercise rehabilitation. Methods This study was conducted according to the PRISMA guidelines， and the protocol was registered on the PROSPERO platform， with a registration number of CRD42025641717. PubMed， Web of Science， Scopus， Wiley Online Library， CNKI， Wanfang Data， and VIP were searched for related articles published up to September 2024. The Cochrane tool for assessing risk of bias was used to assess the quality of articles， and Stata MP 17.0 was used to perform the network meta-analysis. Results A total of 57 articles were included， involving 2 648 patients. The results showed that aerobic exercise combined with resistance exercise had the best effect in improving body mass index （mean difference ［WMD］=-0.97， 95% confidence interval ［CI］： -1.66 to -0.28］， P<0.05， surface under the cumulative ranking curve ［SUCRA］=85.4） and triglycerides （WMD=-29.6， 95%CI： -46.66 to 12.54， P<0.05， SUCRA=87.3）； resistance exercise was the optimal intervention method for improving total cholesterol （WMD=-15.99， 95%CI： -24.19 to -7.79， P<0.05， SUCRA=79.9） and glutamine transaminase （WMD=-8.08， 95%CI： -12.13 to -4.02， P<0.05， SUCRA=87.3）； low-intensity aerobic exercise had the best effect in improving aspartate aminotransferase （WMD=-4.3， 95%CI： -8.45 to -0.15， P<0.05， SUCRA=73.5）， gamma-glutamyl transpeptidase （GGT）（WMD=-3.26， 95%CI： -7.79 to 1.27， P>0.05， SUCRA=82.3）， and glycated hemoglobin （HbA1c）（WMD=-0.6， 95%CI： -2.02 to 0.82， P>0.05， SUCRA=78.8）； moderate-intensity aerobic exercise was the optimal intervention modality to improve Homeostasis Model Assessment of Insulin Resistance （WMD=-0.92， 95%CI： -1.51 to -0.33， P<0.05， SUCRA=69.4）. It should be noted that there were no significant differences in HbA1c and GGT across different exercise interventions （all P>0.05）， suggesting that there was currently no sufficient statistical evidence to support that exercise could improve these two indicators. Conclusion Based on the comprehensive league table and cumulative probability ranking， aerobic exercise combined with resistance exercise， resistance exercise， and low- and moderate-intensity aerobic exercise may be the best exercise modality for improving key indicators in MAFLD patients， and targeted exercise modalities should be selected for intervention against different indicators； however， due to limitations of the original studies， further studies are needed for validation and exploration.
- Metabolic Dysfunction-Associated Fatty Liver Disease,
- Exercise Therapy,
- Network Meta-Analysis

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References(86)

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Effect of different exercise interventions on patients with metabolic dysfunction-associated fatty liver disease： A systematic review and network Meta-analysis

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Effect of different exercise interventions on patients with metabolic dysfunction-associated fatty liver disease： A systematic review and network Meta-analysis

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