ReviewJournal of sport and health science2026
Dose‒response relationship between exercise and hepatic steatosis: A systematic review with Bayesian network meta-analysis of randomized controlled trials.
Review in Journal of sport and health science, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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8 authors.
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Abstract
backgroundCurrent guidelines offer unclear recommendations on exercise types and doses for metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to: (a) identify the most effective exercise type; (b) model the dose‒response relationship between exercise and hepatic steatosis; (c) determine the minimum clinically significant dose.
methodsWe searched PubMed, Web of Science, Embase, the Cochrane Library, CINAHL, Scopus, Rehabilitation & Sports Medicine Source, clinicaltrials.gov, China Knowledge Network Infrastructure (CNKI), Wanfang, VIP, and Sinomed databases from establishment to May 27, 2025 for randomized controlled trials on exercise interventions in MASLD. Network meta-analysis and dose‒response network meta-analysis were used.
resultsAmong 24 studies (961 participants), combined aerobic‒resistance exercise showed the highest surface under the cumulative ranking curve (0.81). A non-linear dose‒response revealed benefits plateauing at 630 metabolic equivalents (METs)-min/week (mean = -0.68, 95%CI: -0.95 to -0.40) and peaking at 850 MET-min/week (mean = -0.72, 95%CI: -0.97 to -0.49). Optimal doses were 640 MET-min/week for combined aerobic‒resistance exercise, 880 for high-intensity circuit training, and 590 for moderate-intensity continuous training. High-intensity interval training showed progressive benefits, while resistance exercise required exceeding 640 MET-min/week. The minimum clinically significant dose was 460 MET-min/week, but combined aerobic‒resistance exercise achieved this at only 130 MET-min/week.
conclusionA non-linear curve underscores key dose thresholds for efficacy and safety: 460 (minimum), 630 (cost-effective), and 850 MET-min/week (plateau). These equate to moderate-intensity exercise (4.5 METs) for 20, 30, or, 40 min 5 times/week, or vigorous-intensity exercise (7.5 METs) for 30 min 2, 3, or 4 times/week. Combined aerobic‒resistance exercise offered both efficacy and dose advantages.
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