Table 2.

Characteristics of randomized clinical trials on subjects with MASLD: aerobic vs. resistance exercise

Author (year)	Country/ethnicity	Subjects	Intervention	Assessment methodology	Case number	Intervention period	Parameters	Liver outcomes	Remark
Slentz et al. (2011)53	United States	Overweight	Aerobic exercise vs. resistance exercise	Computed tomography	144	16 weeks	Liver fat, visceral fat, liver enzyme, and HOMA-IR	Both aerobic and resistance exercise reduced liver fat score; greater score reduction with aerobic training
Lee et al. (2012)48	United States	Obese adolescents	Aerobic exercise vs. resistance exercise vs. control	MR spectroscopy	45	12 weeks	Liver fat, insulin sensitivity, and glucose	Both aerobic and resistance exercise trainings reduced liver fat score; resistance training improved insulin sensitivity
Bacchi et al. (2013)49	Italy	T2DM and MASLD	Aerobic exercise vs. resistance exercise	HMR spectrospopy	31	16 weeks	Liver fat, insulin sensitivity, and subcutaneous adipose tissue	10% reduction of hepatic fat in aerobic exercise; 12% reduction of hepatic fat in resistance exercise
Shamsoddini et al. (2015)52	Iran	MASLD	Aerobic vs. resistance exercise vs. control	Ultrasonography	30	8 weeks	Liver fat, liver enzymes, insulin sensitivity, and anthropometry	Equally effective for reducing liver fat
Jia et al. (2018)34	China	MASLD	Aerobic vs. resistance exercise vs. control	Ultrasonography, hepatic attenuation ratio	474	24 weeks	Liver fat, liver enzyme, body composition, and NFS score	Effective for reducing liver fat in both exercise groups; higher reduction in the resistance group	Diet control
Lee et al. (2019)35	United States	Overweight/obesity	Aerobic exercise vs. resistance exercise vs. combined exercise	MR spectroscopy	118	24 weeks	Liver fat, insulin, and glucose	Liver fat was reduced in the aerobic exercise group (–0.6%) and combined (–0.6%) exercise group, but not in the resistance exercise group (–0.3%)
Charatcharoenwitthaya et al. (2021)36	Thailand	MASLD	Moderate intensity aerobic vs. resistance exercise	Transient elastography	35	12 weeks	Liver fat, body composition, cardiorespiratory fitness, and glucose tolerance	Equally effective for reducing liver fat	Diet control

MASLD, metabolic dysfunction-associated steatotic liver disease; HOMA-IR, homeostasis model assessment of insulin resistance; MR, magnetic resonance; T2DM, type 2 diabetes mellitus; HMR, Hongmeiren; NFS, NAFLD (nonalcoholic fatty liver disease) fibrosis score.