Title: Comparative Effects of Aerobic and Resistance Exercise on Bile Acid Profiles and Liver
Function in Patients with Non-Alcoholic Fatty Liver Disease
Version: 2 Date: 12 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The 8-week intervention period, while adequate for initial observations, may not be long enough
to capture the long-term effects of exercise on liver function and bile acid metabolism. A longer
follow-up would provide more insight into the sustainability of the benefits observed.
-While the exercise intensity for aerobic and resistance training is specified in terms of heart
rate percentage (50-70% of maximum heart rate), it would be helpful to describe how intensity
was monitored and whether it varied within the groups (e.g., considering variations in individual
fitness levels). This could affect the overall results and interpretation.
-While participants are selected based on strict criteria, the study does not mention how factors
like diet, sleep, and other lifestyle habits were controlled or monitored during the intervention.
These factors could influence the outcomes and confound the results, especially since diet and
exercise are often interconnected.
-While the study mentions the impact of aerobic exercise on bile acid metabolism, the discussion
could benefit from further exploration of other potential mechanisms of exercise-induced liver
improvement. For example, the role of exercise in reducing oxidative stress or inflammation,
both of which are central to NAFLD pathogenesis, could be addressed.
-The study suggests that exercise is beneficial for liver function but does not extensively explore
how exercise interacts with dietary habits in the context of NAFLD. Since diet plays a crucial
role in managing liver diseases, integrating a more comprehensive discussion of diet and exercise
synergy could provide deeper insights into optimal NAFLD management strategies.
-While UDCA is important, it might be premature to draw definitive conclusions about its role
in exercise-induced liver improvement based on this study alone. A more balanced view that
considers other bile acids and metabolites involved in liver function (e.g., those related to lipid
metabolism or inflammation) could provide a more nuanced understanding of the impact of
exercise on liver health.
-Although the study focuses on young individuals, the discussion could include a brief mention
of how these findings might be translated to older populations, who might have different
responses to exercise or NAFLD progression. Acknowledging this limitation would further
clarify the scope of the study’s implications.
Title: Comparative Effects of Aerobic and Resistance Exercise on Bile Acid Profiles and Liver
Function in Patients with Non-Alcoholic Fatty Liver Disease
Version: 2 Date: 12 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The 8-week intervention period, while adequate for initial observations, may not be long enough
to capture the long-term effects of exercise on liver function and bile acid metabolism. A longer
follow-up would provide more insight into the sustainability of the benefits observed.
-While the exercise intensity for aerobic and resistance training is specified in terms of heart
rate percentage (50-70% of maximum heart rate), it would be helpful to describe how intensity
was monitored and whether it varied within the groups (e.g., considering variations in individual
fitness levels). This could affect the overall results and interpretation.
-While participants are selected based on strict criteria, the study does not mention how factors
like diet, sleep, and other lifestyle habits were controlled or monitored during the intervention.
These factors could influence the outcomes and confound the results, especially since diet and
exercise are often interconnected.
-While the study mentions the impact of aerobic exercise on bile acid metabolism, the discussion
could benefit from further exploration of other potential mechanisms of exercise-induced liver
improvement. For example, the role of exercise in reducing oxidative stress or inflammation,
both of which are central to NAFLD pathogenesis, could be addressed.
-The study suggests that exercise is beneficial for liver function but does not extensively explore
how exercise interacts with dietary habits in the context of NAFLD. Since diet plays a crucial
role in managing liver diseases, integrating a more comprehensive discussion of diet and exercise
synergy could provide deeper insights into optimal NAFLD management strategies.
-While UDCA is important, it might be premature to draw definitive conclusions about its role
in exercise-induced liver improvement based on this study alone. A more balanced view that
considers other bile acids and metabolites involved in liver function (e.g., those related to lipid
metabolism or inflammation) could provide a more nuanced understanding of the impact of
exercise on liver health.
-Although the study focuses on young individuals, the discussion could include a brief mention
of how these findings might be translated to older populations, who might have different
responses to exercise or NAFLD progression. Acknowledging this limitation would further
clarify the scope of the study’s implications.
Please review this paper.
user
Title: Comparative Effects of Aerobic and Resistance Exercise on Bile Acid Profiles and Liver
Function in Patients with Non-Alcoholic Fatty Liver Disease
Version: 2 Date: 12 Feb 2025
Reviewer:  Anwar Ashraf Abouelnasr
Reviewer's report:
Dear Authors, please address the following points below
-The 8-week intervention period, while adequate for initial observations, may not be long enough
to capture the long-term effects of exercise on liver function and bile acid metabolism. A longer
follow-up would provide more insight into the sustainability of the benefits observed.
-While the exercise intensity for aerobic and resistance training is specified in terms of heart
rate percentage (50-70% of maximum heart rate), it would be helpful to describe how intensity
was monitored and whether it varied within the groups (e.g., considering variations in individual
fitness levels). This could affect the overall results and interpretation.
-While participants are selected based on strict criteria, the study does not mention how factors
like diet, sleep, and other lifestyle habits were controlled or monitored during the intervention.
These factors could influence the outcomes and confound the results, especially since diet and
exercise are often interconnected.
-While the study mentions the impact of aerobic exercise on bile acid metabolism, the discussion
could benefit from further exploration of other potential mechanisms of exercise-induced liver
improvement. For example, the role of exercise in reducing oxidative stress or inflammation,
both of which are central to NAFLD pathogenesis, could be addressed.
-The study suggests that exercise is beneficial for liver function but does not extensively explore
how exercise interacts with dietary habits in the context of NAFLD. Since diet plays a crucial
role in managing liver diseases, integrating a more comprehensive discussion of diet and exercise
synergy could provide deeper insights into optimal NAFLD management strategies.
-While UDCA is important, it might be premature to draw definitive conclusions about its role
in exercise-induced liver improvement based on this study alone. A more balanced view that
considers other bile acids and metabolites involved in liver function (e.g., those related to lipid
metabolism or inflammation) could provide a more nuanced understanding of the impact of
exercise on liver health.
-Although the study focuses on young individuals, the discussion could include a brief mention
of how these findings might be translated to older populations, who might have different
responses to exercise or NAFLD progression. Acknowledging this limitation would further
clarify the scope of the study’s implications.
assistant