Regular Exercise Improves Insulin Sensitivity, Physical Activity, and Psychosocial Status in Patients with Chronic Liver Diseases

Limitations to physical activity lead to impairments of insulin sensitivity and deterioration of health related quality of life (HRQOL) in patients with chronic liver diseases (CLD). The effects of regular exercise on physical and psychosocial factors were prospectively evaluated in CLD. Five patients with various etiologies and stages were enrolled. Daily aerobic and resistance trainings were conducted for a course of five months with an oral intake of branched-chain amino acids (BCAA) starting one month prior to the exercise. Various biochemical, physical parameters, and profile of mood states (POMS) were measured before and after the course. Statistical significance was evaluated using a resampling method. No event was marked during the course to require additional treatments. A significant improvement in insulin sensitivity was observed as reductions of fasting blood glucose and serum insulin levels. Physical capability was significantly improved in both strength and endurance as increments of grasping and knee extension powers, and ventilatory threshold. The fatigue score was significantly reduced in accordance with a decreasing tendency of all other negative aspects in POMS. While significant decreases in serum concentrations of cholinesterase and prealbumin, platelet count, and bone mass were observed, serum concentrations of transferrin and BCAA as well as prothrombin activity showed increasing tendency. Regular exercise could be a promising alternative to improve insulin sensitivity and HRQOL in CLD, though medications and close evaluation should be conducted for possibilities of osteoporosis and hemorrhagic events