Physical exercise acutely increases liver stiffness in humans

AlphaZance

Background: Liver stiffness (LS) as measured by transient elastography is now widely used to non-invasively assess the degree of fibrosis in chronic liver disease. However, several other conditions also increase LS values irrespective of fibrosis such as cholestasis, congestion, inflammation, or an increase of arterial pressure.

Aims: To learn more about LS during exercise in humans, a condition known to increase arterial pressure and cardiac output.

Methods: 12 volunteers (all male, age 23 – 48 years) with normal laboratory testing and normal abdominal ultrasound underwent an exercise electrocardiogram for 10 minutes at 100 Watts and 10 minutes at 200 Watts. Blood pressure was measured every 2 minutes using an inflatable (Riva-Rocci) cuff placed around the upper arm. LS was measured by transient elastography (Fibroscan) using the M (depth 25 – 65 mm, frequency 3.5 MHz) probe (Echosens). TE was performed on the right lobe of the liver in intercostal position. Before every set of LS measurements under exercise, the position of the liver was reevaluated by ultrasound in order to minimize measurement errors.

Results: Mean basal LS in all volunteers with valid measurements in a sitting position (n = 11) was 4.4 ± 1.8 kPA which did not significantly differ from baseline LS in a lying position (4.1 ± 1.0 kPa). Ten minutes exercise at 100 W increased systolic pressure from 106 ± 8 to 135 ± 16 mmHg while heart rate increased from 79 ± 14 to 116 ± 20 bpm. Notably, LS increased significantly to 5.7 ± 1.4 kPa (p < 0.05). Further increase of exercise to 200 W led to an increase of LS to 6.7 ± 2.1 kPa as well as systolic pressure and heart rate (146 ± 16 mmHg and 148 ± 18 beats per minutes). After a recovery phase, blood pressure and heart rate returned to baseline values and LS also normalized (4.7 ± 0.9 kPa). This increase in LS correlated highly significantly with systolic pressure (r = 0.527) and heart rate (r = 0.495). Importantly, 36% of healthy volunteers surpassed the cut-off value for F2 fibrosis of 7.5 kPa during exercise.

Conclusion: Elevated cardiac output and arterial pressure during physical exercise suffice to increase LS in healthy volunteers.
https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0036-1587303

AlphaZance

Results from ergo-log on post-workout recovery:
https://cse.google.com/cse?cx=partner-pub-7117181179885591:4103325817&ie=UTF-8&q=post+workout&sa=Search&ref=www.google.com/#gsc.tab=0&gsc.q=post workout OR recovery

Prior carb-loading probably helps as well.

JulofEnoch

@AlphaCog

Hmm, quite interesting, thanks for sharing.

AlphaZance

Point Shear Wave Elastography and the Effect of Physical Exercise, Alcohol Consumption, and Respiration in Healthy Adults

We found that LSM (liver stiffness measurement) increased significantly following physical exercise, observing clinically significant differences (≥1 kPa) in 1 in 5 subjects.

Our study thus supports previous findings, strengthening the hypothesis that physical strain prior to LSM results in significantly higher LSM values and should be avoided prior to measurement. To our knowledge, only one other study has previously investigated the impact of exercise on LSM 8 , but includes only 7 participants. The study found a significant LSM increase 0 and 5 min after activity, while it returned close to baseline values after 10 min.

Pulse increase during physical strain has been linked to increased blood flow through the liver, further suggesting that blood redistribution may increase LSM. In line with this, we observed that the increase in exercise-induced LSM was restricted to subjects with a pulse increase >40 bpm, whereas individuals with a low pulse increase (≤40 bpm) did not show signs of increasing LSM after activity, suggesting that only strenuous exercise inducing a high heart rate affects LSM values. Hence, 10 min of rest prior to LSM may be superfluous in most subjects if strenuous exercise is avoided. The low number of individuals (n=9) and short observation time following exercise preclude definitive conclusions, and further studies are warranted to strengthen recommendations regarding rest prior to LSM. Gender differences found in our study, i. e., significant LSM increase observed in males and not in females, also warrant further study to allow conclusions.
https://pmc.ncbi.nlm.nih.gov/articles/PMC7723471/