Effect of high-intensity interval training in patients with chronic hepatitis B and hepatic steatosis: A randomised controlled trial

Sofie Jespersen; Asmita Fritt-Rasmussen; Cody Garett Durrer; Eva Fallentin; Ellen Sloth Andersen; Peter Thielsen; Thomas Bandholm; Sten Madsbad; Bente Klarlund Pedersen; Christian Ritz; Nina Weis; Rikke Krogh-Madsen

doi:10.1371/journal.pone.0351547

Effect of high-intensity interval training in patients with chronic hepatitis B and hepatic steatosis: A randomised controlled trial

Sofie Jespersen^*
, Asmita Fritt-Rasmussen
, Cody Garett Durrer
, Eva Fallentin
, Ellen Sloth Andersen
, Peter Thielsen
, Thomas Bandholm
, Sten Madsbad
, Bente Klarlund Pedersen
, Christian Ritz
, Nina Weis
, Rikke Krogh-Madsen

^*Kontaktforfatter

Rigshospitalet
Københavns Universitetshospital
Københavns Universitet

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

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Abstract

Background & aims

Having both chronic hepatitis B and hepatic steatosis increases the risk of liver-related morbidity and mortality. We aimed to investigate if high-intensity interval training could decrease the liver fat-fraction and improve liver status, body composition, lipid- and glucose metabolism, and blood pressure in patients with chronic hepatitis B and hepatic steatosis.

Methods

In a randomised, controlled trial, patients with chronic hepatitis B and hepatic steatosis were randomised 1:1 to high-intensity interval training over 12 weeks or no intervention. The primary outcome was reduction in liver fat-fraction (≥ 2.8%), assessed by magnetic resonance imaging. Secondary outcomes were body composition, indices of glucose metabolism, blood lipids, blood pressure, alanine aminotransferase, physical fitness assessed by maximal oxygen consumption (VO₂max), and self-assessed health. The trial was discontinued before reaching the planned sample size due to slow recruitment.

Results

Nineteen patients were included, and 14 completed the trial (seven per group). Changes in liver fat-fraction showed a between-group difference of −2.03% [95% CI: −5.5 to 1.4; p = 0.22]. Exercising patients improved VO₂max by 5.6 mL/kg/min [1.7 to 9.5; p < 0.05] and emotional well-being by 18.07 points [6.6 to 29.6; p < 0.05]. The exercise intervention did not affect total body fat −0.35% [−2.8 to 2.1] or lean body mass 0.6 kg [−0.7 to 1.9]. Changes in glucose tolerance, insulin secretion, Matsuda index −0.89 [−2.5 to 0.5; p = 0.18], cholesterol 0.29 mmol/L [−0.3 to 0.9; p = 0.32] and systolic blood pressure 6.36 mmHg [−6.4 to 19.1; p = 0.29] did not differ significantly between groups.

Conclusions

We did not observe a significant effect of high-intensity interval training on liver fat-fraction in patients with chronic hepatitis B and hepatic steatosis. Due to premature discontinuation and the resulting limited sample size, the study was underpowered, and the findings should be interpreted as exploratory. Nevertheless, the intervention improved physical fitness and emotional well-being.

Originalsprog	Engelsk
Artikelnummer	e0351547
Tidsskrift	PLOS ONE
Vol/bind	21
Udgave nummer	6
Antal sider	17
ISSN	1932-6203
DOI	https://doi.org/10.1371/journal.pone.0351547
Status	Udgivet - jun. 2026

Finansiering

The Center for Physical Activity Research is supported by TrygFonden (grants ID 101390 580 and ID 20045). The study was supported by the Department of Infectious Diseases, Copenhagen University Hospiutal, Hvidovre. Furthermore, this study was supported by the Beckett Foundation (ref. no: 22-2-9924) with a grant to SJ. The grant supporters had no role in the planning, execution, or data analysis of the study. We humbly thank all patients involved in the study for their time and participation. We thank Katja Kofoed and Emil Nelander Schmidt for project coordination and assistance in carrying out the study; we thank the students (Frederik Hammerich, Jon Dissing Sund, Mathilde Nicolaisen) for performing the exercise sessions and the staff at the Center for Physical Activity Research for their assistance in conducting the examinations of the patients. We thank the Department of Infectious Diseases staff at Copenhagen University Hospital, Hvidovre, for assisting with patient recruitment and transient elastography. We thank the Danish National Institute of Public Health, the University of Southern Denmark, and TrygFonden for lending us the activity trackers for this project. We thank the RAND as a part of the Medical Outcome Study for the use of the 36-item Health Survey.

Dokumenter og links

10.1371/journal.pone.0351547Licens: CC BY

Open Access VersionForlagets udgivne version, 1,44 MBLicens: CC BY

SDU link

Tjek adgangen til materialet i Syddansk Universitetsbiblioteks søgemaskine

Citationsformater

Jespersen, S., Fritt-Rasmussen, A., Durrer, C. G., Fallentin, E., Andersen, E. S., Thielsen, P., Bandholm, T., Madsbad, S., Pedersen, B. K., Ritz, C., Weis, N., & Krogh-Madsen, R. (2026). Effect of high-intensity interval training in patients with chronic hepatitis B and hepatic steatosis: A randomised controlled trial. PLOS ONE, 21(6), Artikel e0351547. https://doi.org/10.1371/journal.pone.0351547

@article{9f1c093f533149a9ba8a2d5885a29f6f,

title = "Effect of high-intensity interval training in patients with chronic hepatitis B and hepatic steatosis: A randomised controlled trial",

abstract = "Background \& aims Having both chronic hepatitis B and hepatic steatosis increases the risk of liver-related morbidity and mortality. We aimed to investigate if high-intensity interval training could decrease the liver fat-fraction and improve liver status, body composition, lipid- and glucose metabolism, and blood pressure in patients with chronic hepatitis B and hepatic steatosis. Methods In a randomised, controlled trial, patients with chronic hepatitis B and hepatic steatosis were randomised 1:1 to high-intensity interval training over 12 weeks or no intervention. The primary outcome was reduction in liver fat-fraction (≥ 2.8\%), assessed by magnetic resonance imaging. Secondary outcomes were body composition, indices of glucose metabolism, blood lipids, blood pressure, alanine aminotransferase, physical fitness assessed by maximal oxygen consumption (VO2max), and self-assessed health. The trial was discontinued before reaching the planned sample size due to slow recruitment. Results Nineteen patients were included, and 14 completed the trial (seven per group). Changes in liver fat-fraction showed a between-group difference of −2.03\% [95\% CI: −5.5 to 1.4; p = 0.22]. Exercising patients improved VO2max by 5.6 mL/kg/min [1.7 to 9.5; p < 0.05] and emotional well-being by 18.07 points [6.6 to 29.6; p < 0.05]. The exercise intervention did not affect total body fat −0.35\% [−2.8 to 2.1] or lean body mass 0.6 kg [−0.7 to 1.9]. Changes in glucose tolerance, insulin secretion, Matsuda index −0.89 [−2.5 to 0.5; p = 0.18], cholesterol 0.29 mmol/L [−0.3 to 0.9; p = 0.32] and systolic blood pressure 6.36 mmHg [−6.4 to 19.1; p = 0.29] did not differ significantly between groups. Conclusions We did not observe a significant effect of high-intensity interval training on liver fat-fraction in patients with chronic hepatitis B and hepatic steatosis. Due to premature discontinuation and the resulting limited sample size, the study was underpowered, and the findings should be interpreted as exploratory. Nevertheless, the intervention improved physical fitness and emotional well-being.",

author = "Sofie Jespersen and Asmita Fritt-Rasmussen and Durrer, \{Cody Garett\} and Eva Fallentin and Andersen, \{Ellen Sloth\} and Peter Thielsen and Thomas Bandholm and Sten Madsbad and Pedersen, \{Bente Klarlund\} and Christian Ritz and Nina Weis and Rikke Krogh-Madsen",

year = "2026",

month = jun,

doi = "10.1371/journal.pone.0351547",

language = "English",

volume = "21",

journal = "PLOS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "6",

}

Jespersen, S, Fritt-Rasmussen, A, Durrer, CG, Fallentin, E, Andersen, ES, Thielsen, P, Bandholm, T, Madsbad, S, Pedersen, BK, Ritz, C, Weis, N & Krogh-Madsen, R 2026, 'Effect of high-intensity interval training in patients with chronic hepatitis B and hepatic steatosis: A randomised controlled trial', PLOS ONE, bind 21, nr. 6, e0351547. https://doi.org/10.1371/journal.pone.0351547

TY - JOUR

T1 - Effect of high-intensity interval training in patients with chronic hepatitis B and hepatic steatosis

T2 - A randomised controlled trial

AU - Jespersen, Sofie

AU - Fritt-Rasmussen, Asmita

AU - Durrer, Cody Garett

AU - Fallentin, Eva

AU - Andersen, Ellen Sloth

AU - Thielsen, Peter

AU - Bandholm, Thomas

AU - Madsbad, Sten

AU - Pedersen, Bente Klarlund

AU - Ritz, Christian

AU - Weis, Nina

AU - Krogh-Madsen, Rikke

PY - 2026/6

Y1 - 2026/6

N2 - Background & aims Having both chronic hepatitis B and hepatic steatosis increases the risk of liver-related morbidity and mortality. We aimed to investigate if high-intensity interval training could decrease the liver fat-fraction and improve liver status, body composition, lipid- and glucose metabolism, and blood pressure in patients with chronic hepatitis B and hepatic steatosis. Methods In a randomised, controlled trial, patients with chronic hepatitis B and hepatic steatosis were randomised 1:1 to high-intensity interval training over 12 weeks or no intervention. The primary outcome was reduction in liver fat-fraction (≥ 2.8%), assessed by magnetic resonance imaging. Secondary outcomes were body composition, indices of glucose metabolism, blood lipids, blood pressure, alanine aminotransferase, physical fitness assessed by maximal oxygen consumption (VO2max), and self-assessed health. The trial was discontinued before reaching the planned sample size due to slow recruitment. Results Nineteen patients were included, and 14 completed the trial (seven per group). Changes in liver fat-fraction showed a between-group difference of −2.03% [95% CI: −5.5 to 1.4; p = 0.22]. Exercising patients improved VO2max by 5.6 mL/kg/min [1.7 to 9.5; p < 0.05] and emotional well-being by 18.07 points [6.6 to 29.6; p < 0.05]. The exercise intervention did not affect total body fat −0.35% [−2.8 to 2.1] or lean body mass 0.6 kg [−0.7 to 1.9]. Changes in glucose tolerance, insulin secretion, Matsuda index −0.89 [−2.5 to 0.5; p = 0.18], cholesterol 0.29 mmol/L [−0.3 to 0.9; p = 0.32] and systolic blood pressure 6.36 mmHg [−6.4 to 19.1; p = 0.29] did not differ significantly between groups. Conclusions We did not observe a significant effect of high-intensity interval training on liver fat-fraction in patients with chronic hepatitis B and hepatic steatosis. Due to premature discontinuation and the resulting limited sample size, the study was underpowered, and the findings should be interpreted as exploratory. Nevertheless, the intervention improved physical fitness and emotional well-being.

AB - Background & aims Having both chronic hepatitis B and hepatic steatosis increases the risk of liver-related morbidity and mortality. We aimed to investigate if high-intensity interval training could decrease the liver fat-fraction and improve liver status, body composition, lipid- and glucose metabolism, and blood pressure in patients with chronic hepatitis B and hepatic steatosis. Methods In a randomised, controlled trial, patients with chronic hepatitis B and hepatic steatosis were randomised 1:1 to high-intensity interval training over 12 weeks or no intervention. The primary outcome was reduction in liver fat-fraction (≥ 2.8%), assessed by magnetic resonance imaging. Secondary outcomes were body composition, indices of glucose metabolism, blood lipids, blood pressure, alanine aminotransferase, physical fitness assessed by maximal oxygen consumption (VO2max), and self-assessed health. The trial was discontinued before reaching the planned sample size due to slow recruitment. Results Nineteen patients were included, and 14 completed the trial (seven per group). Changes in liver fat-fraction showed a between-group difference of −2.03% [95% CI: −5.5 to 1.4; p = 0.22]. Exercising patients improved VO2max by 5.6 mL/kg/min [1.7 to 9.5; p < 0.05] and emotional well-being by 18.07 points [6.6 to 29.6; p < 0.05]. The exercise intervention did not affect total body fat −0.35% [−2.8 to 2.1] or lean body mass 0.6 kg [−0.7 to 1.9]. Changes in glucose tolerance, insulin secretion, Matsuda index −0.89 [−2.5 to 0.5; p = 0.18], cholesterol 0.29 mmol/L [−0.3 to 0.9; p = 0.32] and systolic blood pressure 6.36 mmHg [−6.4 to 19.1; p = 0.29] did not differ significantly between groups. Conclusions We did not observe a significant effect of high-intensity interval training on liver fat-fraction in patients with chronic hepatitis B and hepatic steatosis. Due to premature discontinuation and the resulting limited sample size, the study was underpowered, and the findings should be interpreted as exploratory. Nevertheless, the intervention improved physical fitness and emotional well-being.

U2 - 10.1371/journal.pone.0351547

DO - 10.1371/journal.pone.0351547

M3 - Journal article

C2 - 42335161

AN - SCOPUS:105042855254

SN - 1932-6203

VL - 21

JO - PLOS ONE

JF - PLOS ONE

IS - 6

M1 - e0351547

ER -

Effect of high-intensity interval training in patients with chronic hepatitis B and hepatic steatosis: A randomised controlled trial

Abstract

Finansiering

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Fingeraftryk

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