Objective: The differential effects of physical activity (PA) types on nonalcoholic fatty liver disease (NAFLD) and their associations with NAFLD-related comorbidities, including atherosclerotic cardiovascular disease (ASCVD) has not been fully investigated.
Methods: This was a cross-sectional study using nationally representative samples of 66,021 participants from the Korean National Health and Nutrition Examination Surveys 2007–2020. Aerobic PA (A-PA) was defined as ≥ moderate-intensity 150 min/week or high-intensity 75 min/week of PA; Muscle strengthening PA (MS-PA) was defined as ≥ 2 days/week of muscle strength training. Individuals who conduct both A-PA and MS-PA were classified as multicomponent PA. The risk of ASCVD was estimated with using pooled equation score. A sensitivity analysis consisted of data from individuals who had leisure-time PA data.
Results: The individuals with NAFLD tended to less exercise than individuals without NAFLD. Multicomponent PA was associated with a lower NAFLD risk, compared with other groups (OR=0.82 for A-PA; OR=0.82 for MS-PA; OR=0.75 for multicomponent PA, all P<0.001). Multiple logistic models found that the risk of ASCVD was decreased in all PA groups in a dose-dependent manner, via the combination of A-PA and MS-PA in individuals both with and without NAFLD (OR=0.55 for multicomponent PA, OR=0.59 for MS-PA; OR=0.72 for A-PA in without NAFLD, OR=0.62 for multicomponent PA, OR=0.70 for MS-PA; OR=0.74 for A-PA in without NAFLD, all P<0.001). The multivariable models consistently found significant associations between leisure-time PA and ASCVD risk.
Conclusions: PA decreases the risks of NAFLD, and ASCVD regardless of its types. The risk reduction was greater in individuals who engaged in multicomponent PA.