Abstract
Our study investigated the relationship between metabolic flexibility (MetF) and hepatic fat content (HFC) in individuals with non-alcoholic fatty liver disease (NAFLD). Men and women who met the diagnostic criteria for NAFLD were recruited. MetF was evaluated by the change of respiratory exchange ratio (ΔRER) from resting to exercise. Body composition, hepatic fat content (HFC), and clinical blood metabolic profiles were assessed. The study included 30 subjects (16 males). Subjects were classified into HMF (higher MetF) group and LMF (lower MetF) group based on the median ΔRER of 0.12. Subjects in the LMF group demonstrated significantly higher waist circumference(p=0.048), waist to hip ratio(p=0.043), HFC (p<0.001), visceral fat(p=0.039), and android fat to gynoid fat ratio(p=0.027). The LMF group exhibited higher levels of triglycerides (p=0.040), total cholesterol(p=0.001), low-density lipoprotein cholesterol(p<0.001), and liver enzyme compared to HMF group. The AUC of glucose (p=0.030), free fat acids(p=0.024), and triglyceride (p=0.033) in LMF group were greater than those in HMF group, respectively. Metabolic flexibility reflects metabolic health in NAFLD, with lower MetF associated with higher abdominal fat and worse metabolic profiles. Enhancing fat oxidation at rest and carbohydrate oxidation during exercise may reduce HFC. High-intensity exercise is recommended to improve metabolic outcomes in NAFLD patients.