fa اثر هشت هفته تمرین تناوبی شدید و تمرین تداومی با شدت متوسط بر شاخص‌های غیرتهاجمی آسیب کبدی، ترکیب بدن و متابولیک در زنان میانسال مبتلا به MAFLD فیزیولوژی ورزشی sport physiology كاربردي Applicable <div style="text-align: justify;"><span style="font-size:14px;"><span style="font-family:IRANsans;"><span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span lang="AR-SA"><span b="" lotus="">مقدمه: کبد چرب مرتبط با اختلال متابولیک (</span></span><span dir="LTR"><span arial="">MAFLD</span></span><span lang="AR-SA"><span b="" lotus="">) شایع‌ترین بیماری مزمن کبدی است. تمرینات هوازی از رویکردهای غیردارویی مؤثر در مدیریت </span></span><span dir="LTR"><span arial="">MAFLD</span></span><span lang="AR-SA"><span b="" lotus=""> هستند، اما اثربخشی شدت‌های مختلف‌ آن نیازمند بررسی است. این مطالعه اثر هشت هفته تمرین تناوبی شدید (</span></span><span dir="LTR"><span arial="">HIIT</span></span><span lang="AR-SA"><span b="" lotus="">) و تمرین تداومی با شدت متوسط (</span></span><span dir="LTR"><span arial="">MICT</span></span><span lang="AR-SA"><span b="" lotus="">) را بر شاخص‌های غیرتهاجمی کبد، ترکیب بدن و متابولیک در زنان میانسال مبتلا به </span></span><span dir="LTR"><span arial="">MAFLD</span></span><span lang="AR-SA"><span b="" lotus=""> بررسی کرد.</span></span><span dir="LTR"><span style="font-family:"Arial",sans-serif"></span></span></span></span></span><br> <span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span lang="AR-SA"><span b="" lotus="">روش‌ها: در این کارآزمایی بالینی، </span></span><span lang="FA"><span b="" lotus="">۴۱</span></span><span lang="AR-SA"><span b="" lotus=""> زن مبتلا به </span></span><span dir="LTR"><span arial="">MAFLD</span></span><span lang="AR-SA"><span b="" lotus=""> (</span></span><span lang="AR-SA"><span b="" lotus="">6</span></span><span lang="AR-SA"><span b="" lotus="">.</span></span><span lang="AR-SA"><span b="" lotus="">16</span></span><span lang="AR-SA">&plusmn;</span><span lang="AR-SA"><span b="" lotus="">41</span></span><span lang="AR-SA"><span b="" lotus="">.</span></span><span lang="AR-SA"><span b="" lotus="">39</span></span><span lang="AR-SA"><span b="" lotus=""> سال؛ </span></span><span dir="LTR"><span arial="">&nbsp;kg/m</span></span>^{<span dir="LTR"><span b="" lotus="">2</span></span>}<span lang="AR-SA"><span b="" lotus="">3</span></span><span lang="AR-SA"><span b="" lotus="">.</span></span><span lang="AR-SA"><span b="" lotus="">36</span></span><span lang="AR-SA">&plusmn;</span><span lang="AR-SA"><span b="" lotus="">32</span></span><span lang="AR-SA"><span b="" lotus="">.</span></span><span lang="AR-SA"><span b="" lotus="">14</span></span> <span dir="LTR"><span arial="">BMI:</span></span><span lang="AR-SA"><span b="" lotus="">)،</span></span> <span lang="AR-SA"><span b="" lotus="">در سه گروه </span></span><span dir="LTR"><span arial="">HIIT</span></span><span lang="FA"><span b="" lotus="">، </span></span><span dir="LTR"><span arial="">MICT</span></span><span lang="FA"><span b="" lotus=""> و کنترل، </span></span><span lang="FA"><span b="" lotus="">8</span></span><span lang="AR-SA"><span b="" lotus=""> هفته</span></span><span lang="FA"><span b="" lotus=""> حضور یافتند</span></span><span lang="AR-SA"><span b="" lotus="">. </span></span><span dir="LTR"><span arial="">MICT</span></span><span lang="FA"><span b="" lotus=""> با </span></span><span lang="FA"><span b="" lotus="">60</span></span><span lang="FA"><span b="" lotus=""> تا </span></span><span lang="FA"><span b="" lotus="">70</span></span><span lang="FA"><span b="" lotus="">% ضربان قلب ذخیره برای</span></span><span lang="FA"><span b="" lotus="">30</span></span><span lang="FA"><span b="" lotus="">-</span></span><span lang="FA"><span b="" lotus="">45</span></span><span lang="FA"><span b="" lotus=""> دقیقه و </span></span><span dir="LTR"><span arial="">HIIT</span></span><span lang="FA"><span b="" lotus=""> با </span></span><span lang="FA"><span b="" lotus="">50</span></span><span lang="FA"><span b="" lotus=""> تا </span></span><span lang="FA"><span b="" lotus="">100</span></span><span lang="FA"><span b="" lotus="">-</span></span><span lang="FA"><span b="" lotus="">110</span></span><span lang="FA"><span b="" lotus="">% بیشنه سرعت هوازی در </span></span><span lang="FA"><span b="" lotus="">4</span></span><span lang="FA"><span b="" lotus=""> تا </span></span><span lang="FA"><span b="" lotus="">6</span></span><span lang="FA"><span b="" lotus=""> تناوب </span></span><span lang="FA"><span b="" lotus="">30</span></span><span lang="FA"><span b="" lotus=""> ثانیه‌ای اجرا شد. </span></span><span lang="AR-SA"><span b="" lotus="">شاخص‌های ترکیب بدن (وزن</span></span><span lang="FA"><span b="" lotus="">، </span></span><span dir="LTR"><span arial="">BMI</span></span><span lang="FA"><span b="" lotus="">، </span></span><span dir="LTR"><span arial="">BAI</span></span><span lang="FA"><span b="" lotus="">، و </span></span><span dir="LTR"><span arial="">ABSI</span></span><span lang="AR-SA"><span b="" lotus="">)، استئاتوز (</span></span><span dir="LTR"><span arial="">HSI</span></span><span lang="FA"><span b="" lotus="">، </span></span><span dir="LTR"><span arial="">FSI</span></span><span lang="FA"><span b="" lotus="">، و </span></span><span dir="LTR"><span arial="">LFS</span></span><span lang="AR-SA"><span b="" lotus="">)، فیبروز (</span></span><span dir="LTR"><span arial="">NFS</span></span><span lang="AR-SA"><span b="" lotus="">، </span></span><span dir="LTR"><span arial="">NRS</span></span><span lang="FA"><span b="" lotus="">، </span></span><span dir="LTR"><span arial="">FIB-4</span></span><span lang="FA"><span b="" lotus="">، </span></span><span dir="LTR"><span arial="">FIB-5</span></span><span lang="FA"><span b="" lotus=""> و </span></span><span dir="LTR"><span arial="">APRI</span></span><span lang="AR-SA"><span b="" lotus="">) و متابولیک (</span></span><span dir="LTR"><span arial="">LAP</span></span><span lang="FA"><span b="" lotus=""> و </span></span><span dir="LTR"><span arial="">CMI</span></span><span lang="AR-SA"><span b="" lotus="">) پیش و پس از مداخله اندازه‌گیری شدند. تحلیل آماری با آزمون</span></span><span dir="LTR"><span arial=""> t </span></span><span lang="AR-SA"><span b="" lotus="">&nbsp;زوجی، </span></span><span dir="LTR"><span arial="">&nbsp;ANOVA-one way</span></span><span lang="AR-SA"><span b="" lotus="">و </span></span><span dir="LTR"><span arial="">GLMRM</span></span><span b="" lotus=""> در سطح معناداری </span><span lang="FA"><span b="" lotus="">0</span></span><span lang="FA"><span b="" lotus="">.</span></span><span lang="FA"><span b="" lotus="">05</span></span><span lang="FA"><span b="" lotus="">></span></span><span dir="LTR"><span arial="">p</span></span> <span lang="AR-SA"><span b="" lotus="">انجام گرفت</span></span><span dir="LTR"><span arial="">.</span></span><span lang="AR-SA"><span style="font-family:"B Lotus""></span></span></span></span></span><br> <span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span lang="AR-SA"><span b="" lotus="">یافته‌ها: هر دو برنامه تمرینی موجب کاهش وزن، </span></span><span dir="LTR"><span arial="">BMI</span></span><span lang="AR-SA"><span b="" lotus="">، </span></span><span dir="LTR"><span arial="">BAI</span></span> <span lang="AR-SA"><span b="" lotus="">و</span></span><span dir="LTR"><span arial=""> LFS</span></span><span lang="AR-SA"><span b="" lotus="">شدند (</span></span><span lang="FA"><span b="" lotus="">0</span></span><span lang="FA"><span b="" lotus="">.</span></span><span lang="FA"><span b="" lotus="">05</span></span><span lang="FA"><span b="" lotus="">></span></span><span dir="LTR"><span arial="">p</span></span><span lang="AR-SA"><span b="" lotus="">). </span></span><span dir="LTR"><span arial="">ABSI</span></span><span lang="FA"><span b="" lotus=""> در کنترل افزایش داشت (</span></span><span dir="LTR"><span arial="">0.05</span></span> <span dir="LTR"><span arial="">p<</span></span><span lang="FA"><span b="" lotus="">).</span></span> <span dir="LTR"><span arial="">HSI</span></span> <span lang="AR-SA"><span b="" lotus="">در</span></span><span dir="LTR"><span arial=""> HIIT </span></span><span lang="AR-SA"><span b="" lotus="">و</span></span><span dir="LTR"><span arial="">FSI</span></span><span b="" lotus=""> در</span><span dir="LTR"><span arial=""> MICT </span></span><span lang="AR-SA"><span b="" lotus="">کاهش یافت (</span></span><span lang="FA"><span b="" lotus="">0</span></span><span lang="FA"><span b="" lotus="">.</span></span><span lang="FA"><span b="" lotus="">05</span></span><span lang="FA"><span b="" lotus="">></span></span><span dir="LTR"><span arial="">p</span></span><span lang="AR-SA"><span b="" lotus="">). در شاخص‌های فیبروز تنها</span></span> <span dir="LTR"><span arial="">FIB-5</span></span> <span lang="AR-SA"><span b="" lotus="">در</span></span><span dir="LTR"><span arial=""> MICT </span></span><span lang="AR-SA"><span b="" lotus="">نسبت به</span></span><span dir="LTR"><span arial=""> HIIT </span></span><span lang="AR-SA"><span b="" lotus="">و </span></span><span dir="LTR"><span arial="">NRS </span></span><span lang="AR-SA"><span b="" lotus="">&nbsp;در</span></span><span dir="LTR"><span arial=""> MICT</span></span> &nbsp;<span lang="AR-SA"><span b="" lotus="">(</span></span><span lang="FA"><span b="" lotus="">0</span></span><span lang="FA"><span b="" lotus="">.</span></span><span lang="FA"><span b="" lotus="">05</span></span><span lang="FA"><span b="" lotus="">></span></span><span dir="LTR"><span arial="">p</span></span><span lang="AR-SA"><span b="" lotus="">) کاهش داشت.</span></span><span dir="LTR"><span arial="">LAP </span></span><span lang="AR-SA"><span b="" lotus="">&nbsp;در هر دو گروه تمرینی نسبت به کنترل و</span></span><span dir="LTR"><span arial="">CMI </span></span><span lang="AR-SA"><span b="" lotus="">&nbsp;در</span></span><span dir="LTR"><span arial=""> MICT </span></span><span lang="AR-SA"><span b="" lotus="">کاهش یافت (</span></span><span lang="FA"><span b="" lotus="">0</span></span><span lang="FA"><span b="" lotus="">.</span></span><span lang="FA"><span b="" lotus="">05</span></span><span lang="FA"><span b="" lotus="">></span></span><span dir="LTR"><span arial="">p</span></span><span lang="AR-SA"><span b="" lotus="">). </span></span></span></span></span><br> <span style="line-height:normal"><span style="direction:rtl"><span style="unicode-bidi:embed"><span lang="AR-SA"><span b="" lotus="">نتیجه‌گیری: </span></span><span lang="FA"><span b="" lotus="">با وجود برتری </span></span><span dir="LTR"><span arial="">MICT</span></span><span lang="FA"><span b="" lotus=""> در برخی شاخص‌ها، </span></span><span dir="LTR"><span arial="">HIIT</span></span><span lang="FA"><span b="" lotus=""> با صرف زمان کمتر اثرات مشابهی ایجاد کرد و می‌تواند گزینه‌ای کارآمد در مدیریت بالینی </span></span><span dir="LTR"><span arial="">MAFLD</span></span><span b="" lotus=""> باشد.</span></span></span></span></span></span></div> <span style="font-size:12pt"><span new="" roman="" style="font-family:" times=""><strong><span style="font-size:13.0pt"><span arial="" style="font-family:"><span style="font-weight:normal">Abstract</span></span></span></strong><strong><span style="font-size:13.0pt"><span arial="" style="font-family:"><span style="font-weight:normal"></span></span></span></strong></span></span><br> <span style="font-size:12pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:13.0pt"><span arial="" style="font-family:"><span style="font-weight:normal">Background: Metabolic dysfunction-associated fatty liver disease (MAFLD) is the most prevalent chronic liver disorder. Aerobic exercise is a key non-pharmacological strategy for MAFLD management, yet the impact of different training intensities remains unclear. This study investigated the effects of eight weeks of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on non-invasive liver indices, body composition, and metabolic markers in middle-aged women with MAFLD.</span></span></span></strong></span></span></span><br> <span style="font-size:12pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:13.0pt"><span arial="" style="font-family:"><span style="font-weight:normal">Methods: In this clinical trial, 41 women with MAFLD (41.39 &plusmn; 6.16 years; BMI: 32.14 &plusmn; 3.36 kg/m&sup2;) were randomly assigned to HIIT, MICT, or control groups. MICT involved 30&ndash;45 minutes at 60&ndash;70% heart rate reserve, while HIIT included 4&ndash;6 bouts of 30 seconds at 50&ndash;100&ndash;110% of maximal aerobic speed. Body composition (weight, BMI, BAI, ABSI), steatosis (HSI, FSI, LFS), fibrosis (NFS, NRS, FIB-4, FIB-5, APRI), and metabolic indices (LAP, CMI) were measured before and after the intervention. Statistical analyses included paired t-tests, one-way ANOVA, and GLMRM (p < 0.05).</span></span></span></strong></span></span></span><br> <span style="font-size:12pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:13.0pt"><span arial="" style="font-family:"><span style="font-weight:normal">Results: Both HIIT and MICT significantly reduced weight, BMI, BAI, and LFS. ABSI increased in control. HSI decreased following HIIT, while FSI decreased after MICT. Among fibrosis indices, only FIB-5 showed a significant reduction in MICT compared to HIIT, and NRS decreased in MICT compared to control. LAP decreased in both training groups relative to control, whereas CMI decreased only in MICT.</span></span></span></strong></span></span></span><br> <span style="font-size:12pt"><span style="line-height:normal"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:13.0pt"><span arial="" style="font-family:"><span style="font-weight:normal">Conclusion: Although MICT demonstrated superiority in certain parameters, HIIT elicited comparable effects in a shorter duration and may represent an efficient strategy for the clinical management of MAFLD.</span></span></span></strong></span></span></span><br> &nbsp; شاخص‌های غیرتهاجمی کبدی, ترکیب بدن, استئاتوز, فیبروز, متابولیسم, روش‌های تشخیصی Liver Function Tests, body composition, steatosis, fibrosis, metabolism, Diagnostic Techniques. 0 0 http://jsmt.khu.ac.ir/browse.php?a_code=A-10-2545-1&slc_lang=fa&sid=1 Sepideh Jafariyan سپیده جعفریان sjafariyan91@gmail.com 10031947532846006050 10031947532846006050 No - Razi University of Kermanshah دانشگاه رازی کرمانشاه Amirabbas Monazzami امیرعباس منظمی monazzami.amirabbas@gmail.com 10031947532846006051 10031947532846006051 Yes - Razi University of Kermanshah دانشگاه رازی کرمانشاه Tuoraj Ahmadijouybari تورج احمدی جویباری dr.ahmadi_jouybari@yahoo.com 10031947532846006052 10031947532846006052 No Kermanshah University of Medical Sciences دانشگاه علوم پزشکی کرمانشاه Kheirollah Yari Khalilani خیراله یاری خلیلانی khirollah.yari@yahoo.com 10031947532846006053 10031947532846006053 No Kermanshah University of Medical Sciences دانشگاه علوم پزشکی کرمانشاه