The impact of resistance training in patients diagnosed with metabolic dysfunction-associated steatotic liver disease: a systematic review

Resistance training, as a modality of physical exercise, has been recognized as a fundamental pillar in the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD). Current reviews, however, have not given due priority to the specific effects of this type of training on hepatic and clinical markers in individuals with MASLD. This study aimed to compile the available evidence on the impact of resistance training on hepatic and clinical parameters in individuals diagnosed with MASLD. To this end, a systematic search was conducted in the PubMed, Lilacs, Embase, Cochrane, SciELO, and Pedro databases, as well as a manual search, covering the period from January 2011 to December 2023. Randomized clinical trials that evaluated liver fat, insulin resistance, and liver enzymes in individuals with MASLD who were exclusively subjected to resistance training interventions were selected. This study is registered with International Prospective Register of Systematic Reviews (PROSPERO) (CRD4202236638) and the risk of bias in the eligible studies was assessed using ROB 2. Six studies were included, totaling 232 adult participants. Resistance training resulted in a significant reduction in liver fat (P < 0.001), liver enzymes (P < 0.05), and insulin resistance (P < 0.05) in individuals in the strength training group. Furthermore, greater adherence to resistance training (>90%) was observed compared to aerobic training. It is concluded that resistance training can be an easily accepted and consistent option for adults with MASLD, playing an important role in improving the clinical and hepatic markers of these individuals.