The Effects of Eight Weeks Aerobic Interval Exercise with Variable Volume on the Cardiovascular Risk Factors and Liver Enzymes of Women with Dyslipidemia

Document Type: Research Paper


1 Student of Exercise Physiology, Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran

2 Associate Professor of Exercise Physiology, Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran

3 Assistant Professor of Exercise Physiology, Faculty of Sport Sciences, Hakim Sabzevari University, Sabzevar, Iran.


Introduction: Metabolic dyslipidemia could lead to non-alcoholic fatty liver disease, and its secondary consequence is the development of metabolic syndrome and diabetes. The present study aimed to investigate the effects of eight weeks of aerobic interval exercise with variable volumes on the cardiovascular risk factors and liver enzymes of the women with dyslipidemia. Methods: This quasi-experimental study was conducted on 30 middle-aged women with high blood lipids. The patients were selected and divided into three groups of low-volume training (three sessions per week; n=10; LVT), high-volume training (four sessions per week; n=10; HVT), and control (n=10; C).The exercise program was implemented in eight weeks 3-4 sessions per week for 45-60 minutes with the intensity of 65-75% of the maximal heart rate. The inter-group and intra-group comparison were performed using student's t-test, and one-way analysis of variance (ANOVA) was used to assess the differences between the groups. Results: In the training groups, a significant reduction was observed in weight (LVT: 72.01 vs. 67.26, HVT: 72.80 vs. 68.06), body mass index (LVT: 28.19 vs. 26.31, HVT:27.85 vs. 26.04), body fat (LVT: 26.86 vs. 25.69, HVT:27.21 vs. 25.91), waist-to-hip ratio (LVT: 1.05 vs. 1.03, HVT:1.07 vs. 1.05), alanine transaminase(LVT: 46.60 vs. 39.60, HVT: 43.80 vs. 38.50), aspartate transaminase(LVT: 36.50 vs. 31.00, HVT: 33.50 vs. 29.40), and triglyceride (LVT: 171.80 vs. 163.60, HVT:176.90 vs. 161.40). However, the maximum oxygen uptake increased significantly after the intervention in both the training groups (LVT: 32.17 vs. 35.93, HVT:30.93 vs. 35.98). The levels of total cholesterol (211.20 vs. 204.90) and low-density lipoprotein cholesterol (134.13 vs. 126.68) significantly decreased only in the LVT group, while no such changes were observed in the HVT group. In addition, the systolic blood pressure (LVT: 135.40 vs. 128.60, HVT: 137.00 vs. 129.60) decreased significantly in both groups, while no significant change was observed in the diastolic blood pressure. Conclusion: According to the results, eight weeks of aerobic interval exercise could improve the cardiovascular risk factors, liver enzymes, and body composition of the women with dyslipidemia. Therefore, it is recommended that some cardiovascular risk factors and liver enzymes of women with dyslipidemia be used for the improvement of these patients.


1. Srikanth S, Deedwania P. Management of dyslipidemia in patients with hypertension, diabetes, and metabolic syndrome. Curr Hypertens Rep. 2016; 18(10): 76.

2. Georgiadis AN,Papavasiliou EC, Lourida ES, Alamanos Y, Kostara C, Tselepis AD, et al. Atherogenic lipid profile is a feature characteristic of patients with early rheumatoid arthritis: effect of early treatment–a prospective, controlled study. Arthritis Res Ther.  2006; 8(3): R82.

3. Kannel WB. Lipids, diabetes, and coronary heart disease: insights from the Framingham Study. Am Heart J. 1985; 110(5): 1100-7.

4. Legro RS, Kunselman AR, Dodson WC, Dunaif A. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab. 1999; 84(1): 165-9.

5. Onat A, Can G, Hergenç G, Yazici M, Karabulut A, Albayrak S. Serum apolipoprotein B predicts dyslipidemia, metabolic syndrome and, in women, hypertension and diabetes, independent of markers of central obesity and inflammation. Int J Obes. 2007; 31(7): 1119-25.

6. Gaggini M, Morelli M, Buzzigoli E, DeFronzo RA, Bugianesi E, Gastaldelli A. Non-alcoholic fatty liver disease (NAFLD) and its connection with insulin resistance, dyslipidemia, atherosclerosis and coronary heart disease. Nutrients. 2013; 5(5): 1544-60.

7. Wilmot KA, O'Flaherty M, Capewell S, Ford ES, Vaccarino V. Coronary heart disease mortality declines in the United States from 1979 through 2011: evidence for stagnation in young adults, especially women. Circulation. 2015; 132(11): 997-1002.

8. Ahmed A, Wong RJ, Harrison SA. Nonalcoholic fatty liver disease review: diagnosis, treatment, and outcomes. Clin Gastroenterol Hepatol. 2015; 13(12): 2062-70.

9. Manimmanakorn A, Hamlin MJ, Ross JJ, Taylor R, Manimmanakorn N. Effects of low-load resistance training combined with blood flow restriction or hypoxia on muscle function and performance in netball athletes. J Sci Med Sport. 2013; 16(4): 337-342.

10. Davoodi M, Moosavi H, Nikbakht M. The effect of eight weeks selected aerobic exercise on liver parenchyma and liver enzymes (AST, ALT) of fat liver patients. Journal of Shahrekord Uuniversity of Medical Sciences. 2012; 14(1): 84-90. (Persian)

11. Shamsoddini A, Sobhani V, Ghamar Chehreh MH, Alavian SM, Zaree A. Effect of aerobic and resistance exercise training on liver enzymes and hepatic fat in Iranian men with nonalcoholic fatty liver disease. Hepat mon. 2015; 15(10): e31434.

12. Fathei M, Khairabadi S, Ramezani F, Hejazi K. The effects of eight weeks aerobic training, green tea supplementation and compound of them on serum liver enzymes and apolipoproteins in inactive overweight women. Medical journal of mashhad university of medical sciences. 2016; 59(2): 114-23.

13. Omagari K, Kadokawa Y, Masuda J, Egawa I, Sawa T, Hazama H, et al. Fatty liver in non-alcoholic non-overweight Japanese adults: incidence and clinical characteristics. J Gastroenterol Hepatol. 2002; 17(10): 1098-105.

14. De Piano A, do Prado WL, Caranti DA, Siqueira KO, Stella SG, Lofrano-Prado MC, et al. Metabolic and nutritional profile of obese adolescents with nonalcoholic fatty liver disease. J Pediatr Gastroenterol Nutr. 2007; 44(4): 446-52.

15. Valizadeh A, Yousefi Bilehsavar O, Abdi H, Jahanshahi Z, Madadi B. The Effect of acute exercise on changes Liver enzymes (ALT، ALP، AST) in Non-athletes middle-aged women with hypertension. Int J Adv Biotechnol Res. 2016; 7(3): 365-71.

16. Khaoshbaten M, Gholami N, Sokhtehzari S, Monazami AH, Rostami Nejad M. The effect of an aerobic exercise on serum level of liver enzymes and liver echogenicity in patients with non alcoholic fatty liver disease. Gastroenterol Hepatol Bed Bench. 2013; 6(Suppl 1): S112-6.

17. Valizadeh R. Nikbakht M, Davodi M, Khodadoost M. The effect of eight weeks elected aerobic exercise on the levels of (AST, ALT) enzymes of men patients with have fat liver. Procedia Soc Behav Sci. 2011; 15: 3362-5.

18. Yao J, Meng M, Yang S, Li F, Anderson RM, Liu C, et al. Effect of aerobic and resistance exercise on liver enzyme and blood lipids in Chinese patients with nonalcoholic fatty liver disease: a randomized controlled trial. Int J Clin Exp Med. 2018; 11(5): 4867-74.

19. Zeinvand lorestani A, Mirnasouri R, Rahmati M. The effect of eight weeks of aerobic training on the levels of enzymes associated with non-alcoholic fatty liver in obese children. Yafte. 2018; 20(2): 53-61. (Persian)

20. Park JH. Kim HJ, Han A, Kang DM, Park S. Effects of aerobic exercise training on the risk factors for liver diseases in elderly women with obesity and impaired fasting glucose: A pilot study. J Exerc Nutrition Biochem. 2019; 23(1): 21-7.

21. Braith RW, Graves JE, Pollock ML, Leggett SL, Carpenter DM, Colvin AB. Comparison of 2 vs 3 days/week of variable resistance training during 10-and 18-week programs. Int J Sports Med. 1989; 10(6): 450-4.

22. Balducci S, Cardelli P, Pugliese L, D'Errico V, Haxhi J, Alessi E, et al. Volume-dependent effect of supervised exercise training on fatty liver and visceral adiposity index in subjects with type 2 diabetes The Italian Diabetes Exercise Study (IDES). Diabetes Res Clin Pract. 2015; 109(2): 355-63.

23. Haghighi AH, Gelardi N, Hamedinia MR. The Effect of an Aerobic Exercise Program with Two Different Volumes on Some Risk Factors of Cardiovascular Diseases in Mentally Retarded Girls. Journal of Sport Biosciences. 2015; 7(2): 241-59.

24. Swain DP, Abernathy KS, Smith CS, Lee SJ, Bunn SA. Target heart rates for the development of cardiorespiratory fitness. Med Sci Sports Exerc. 1994; 26(1): 112-6.

25. Mottillo EP, Shen XJ, Granneman JG. Role of hormone-sensitive lipase in β-adrenergic remodeling of white adipose tissue. Am J Physiol Endocrinol  Metab. 2007; 293(5): E1188-97.

26. DeLany JP, Kelley DE, Hames KC, Jakicic JM, Goodpaster BH. Effect of physical activity on weight loss, energy expenditure, and energy intake during diet induced weight loss. Obesity (Silver Spring). 2014; 22(2): 363-70.

27. Blundell JE, Finlayson G, Gibbons C, Caudwell P, Hopkins M. The biology of appetite control: do resting metabolic rate and fat-free mass drive energy intake? Physiol Behav. 2015; 152(Pt B): 473-8.

28. McLaughlin T, Lamendola C, Coghlan N, Liu TC, Lerner K, Sherman A, et al. Subcutaneous adipose cell size and distribution: relationship to insulin resistance and body fat. Obesity (Silver Spring). 2014; 22(3): 673-80.

29. Hsieh CJ, Wang PW, Chen TY. The relationship between regional abdominal fat distribution and both insulin resistance and subclinical chronic inflammation in non-diabetic adults. Diabetol Metab Syndr. 2014; 6(1): 49.

30. Yari Z, Rahimlu M, Poustchi H, Ebrahimi Daryani N, Hekmatdoost A. Effect of Faxseed Supplementation on Liver enzymes, Hepatic Fibrosis and Steatosis in Nonalcoholic Fatty Liver Disease: A Randomized-controlled Clinical Trial. Iranian Journal of Nutrition Sciences & Food Technology. 2016. 10(4): 1-12.

31. Baldi JC, Wilson GA, Wilson LC, Wilkins GT, Lamberts RR. The type 2 diabetic heart: its role in exercise intolerance and the challenge to find effective exercise interventions. Sports Med. 2016; 46(11): 1605-17.

32. Henriksen EJ. Invited review: Effects of acute exercise and exercise training on insulin resistance. J Appl Physiol (1985). 2002; 93(2): 788-96.

33. Borghouts LB, Keizer HA. Exercise and insulin sensitivity: a review. Int J Sports Med. 2000; 21(1): 1-12.

34. Sullivan S, Kirk EP, Mittendorfer B, Patterson BW, Klein S. Randomized trial of exercise effect on intrahepatic triglyceride content and lipid kinetics in nonalcoholic fatty liver disease. Hepatology. 2012; 55(6): 1738-45.

35. Angulo P. Nonalcoholic fatty liver disease. N Engl J Med. 2002; 346(16): 1221-31.

36. Arkan MC, Hevener AL, Greten FR, Maeda S, Li ZW, Long JM, et al. IKK-β links inflammation to obesity-induced insulin resistance. Nat Med. 2005; 11(2): 191-8.

37. Recasens M, Ricart W, Fernández-Real JM. Obesity and inflammation. Rev Med Univ Navarra. 2004; 48(2): 49-54.

38. McManaman JL, Bales ES, Orlicky DJ, Jackman M, MacLean PS, Cain S, et al. Perilipin-2-null mice are protected against diet-induced obesity, adipose inflammation, and fatty liver disease. J Lipid Res. 2013; 54(5): 1346-59.

39. Plotnikoff RC, Courneya KS, Trinh L, Karunamuni N, Sigal RJ. Aerobic physical activity and resistance training: an application of the theory of planned behavior among adults with type 2 diabetes in a random, national sample of Canadians. Int J Behav Nutr Phys Act. 2008; 5(1): 61.

40. Durstine JL. Action plan for high cholesterol. Human Kinetics; 2006.

41. Takahashi S. Triglyceride rich lipoprotein-LPL-VLDL receptor and Lp (a)-VLDL receptor pathways for macrophage foam cell formation. J Atheroscler Thromb. 2017; 24(6):  552-9.

42. Ahn N, Kim K. High-density lipoprotein cholesterol (HDL-C) in cardiovascular disease: effect of exercise training. Integr Med Res. 2016; 5(3): 212-5.

43. Mittendorfer B, Yoshino M, Patterson BW, Klein S. VLDL triglyceride kinetics in lean, overweight, and obese men and women. J Clin Endocrinol Metab. 2016; 101(11): 4151-60.

44. Despres JP,Moorjani S, Tremblay A, Poehlman ET, Lupien PJ, Nadeau A, et al. Heredity and changes in plasma lipids and lipoproteins after short-term exercise training in men. Arteriosclerosis. 1988; 8(4): 402-9.