Abstract: Objective To investigate the alteraions in clinical characteristics and serum metabolites in patients with non-alcoholic fatty liver disease (NAFLD) following a four-week aerobic exercise intervention. Methods 20 patients with NAFLD, diagnosed at the Department of Gastroenterology at Putuo District Central Hospital, Shanghai, from June 2021 to June 2022, underwent an aerobic exercise regimen. We collected baseline patients data, liver function tests, and blood lipid profiles. Concurrently, serum sample metabolites were measured, and the metabolic differences pre-and post-intervention were analyzed. Results In patients with NAFLD, significant reductions were observed post-intervention: body weight decreased from 72.21 ± 7.44 kg to 70.63 ± 7.25 kg; BMI dropped from 25.39 ± 1.32 kg/m² to 24.83 ± 1.39 kg/m²; and waist circumference from 96.52 ± 6.61 cm to 93.76 ± 6.23 cm (P<0.05); Post-intervention, liver enzymes showed marked improvements with ALT, AST, AKP, GGT, and CHE levels at [21.00 (17.00, 25.00) U/L, 13.00 (9.00, 19.50) U/L, 68.32 ± 24.14 U/L, 18.00 (14.50, 35.50) U/L, 6466.92 ± 1402.02 U/L] respectively, all significantly lower than pre-intervention values (P<0.05). Additionally, significant decreases were noted in TG and LDL levels[1.14 (1.05, 1.48) mmol/L, 2.48 ± 0.57 mmol/L] respectively(P<0.05). Serum metabolomics analysis identified 31 potential differential metabolites, predominantly lipids and amino acids. Conclusion Aerobic exercise intervention has been shown to effectively reduce body weight, improve blood biochemical indices, and enhance lipid and amino acid metabolism in patients with NAFLD. These improvements can significantly decelerate the progress of NAFLD. This underscores the clinical importance of devising tailored exercise therapy plans for NAFLD patients.

Key words: Aerobic exercise, Non-alcoholic fatty liver, Serum metabolomics