Effects of Different Types of Exercise on Liver Function in Type 2 Diabetes in Mice (Review)

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder that affects multiple organ systems. The liver serves as a central regulator of carbohydrate and lipid homeostasis and represents a major target of diabetic complications. Regular physical activity is acknowledged as an effective non-pharmacological intervention for improving metabolic control in diabetes. The purpose of this review was a comparative analysis of the effects of different exercise modalities on liver-related biomarkers in animals with T2DM. Materials and methods. A network meta-analysis of 38 randomized controlled trials with a total of 601 animals involved was conducted. The following databases were searched: Web of Science, PubMed, Scopus, CNKI and EBSCO. Six categories of exercise interventions were analysed: aerobic training, resistance training, swimming, high-intensity interval training, moderate-intensity continuous training, and voluntary wheel running. The initial assessment criteria included alanine aminotransferase (ALT), aspartate aminotransferase (AST), hepatic triglyceride, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels as well as phosphoenolpyruvate carboxykinase (PEPCK) enzymatic activity. Results. High-intensity interval training showed the greatest effectiveness in reducing ALT and hepatic triglyceride levels as well as increasing HDL concentrations in mice with T2DM. Resistance training was most effective in lowering AST and LDL as well as in PEPCK activity. Swimming and moderate-intensity continuous training had a positive, albeit less pronounced, influence on certain biomarkers. The findings indicate that high-intensity interval training and resistance training can be more effective strategies for modulating hepatic metabolism in mice with T2DM. These results underscore the potential of physical exercise as a safe and accessible adjunct to the management of diabetes-induced liver dysfunction. However, additional clinical studies in human populations are needed to substantiate these effects.