# The Impact of Low-Volume High-Intensity Interval Training (LV-HIIT) on Fatty Liver Index (FLI) and Estimated Glomerular Filtration Rate (eGFR) in Patients with Type 2 Diabetes Mellitus (T2DM) PMID: 39136513 Journal: Current Diabetes Reviews Published: 2025 Authors: Raesi R, Kalbasi S, Gaeini AA, Ghasem Kashani MH, Tajik K ## Question What is the effect of a 4-week low-volume high-intensity interval training program on fatty liver index and estimated glomerular filtration rate in patients with type 2 diabetes? ## Summary In 80 sedentary adults with type 2 diabetes, a 4-week treadmill low-volume HIIT program was associated with reduced fatty liver index and increased estimated glomerular filtration rate compared with baseline, while the no-intervention control group did not improve eGFR. The intervention also improved several cardiometabolic markers, but the study was short and limited to one clinic population. ## Population - Eighty sedentary adults aged 40-65 years with type 2 diabetes for at least one year and HbA1c 6.4%-10%, randomized to LV-HIIT or no-intervention control. - Sample size: 80 - Age: Age range 40-65 years; LV-HIIT 51.55 +/- 5.93 years and control 54.40 +/- 7.88 years. - Sex: Overall 34 male (42.5%) and 46 female (57.5%); LV-HIIT 15 male/25 female; control 19 male/21 female. - Fitness level: Sedentary; no regular exercise in previous 6 months. - Health status: Type 2 diabetes; excluded respiratory, inflammatory, cardiovascular, renal, other chronic diseases, functional limitations, smoking, and heavy drinking. ## Methodology - Randomized controlled trial with two parallel groups: LV-HIIT and no-intervention control. - 4 weeks. - Diabetes and Metabolic Diseases Clinic of Loghman Hakim Hospital, Tehran, Iran; treadmill exercise intervention. - Randomized and controlled study design. ## Protocol - LV-HIIT. - Modality: Treadmill interval exercise. - Work intervals: Four 1-min intervals at 70% HRmax. - Recovery: Three 4-min intervals at 60% HRmax between work intervals. - Sets or repetitions: 4 work intervals. - Intensity: 70% HRmax work intervals; 60% HRmax recovery intervals. - Session duration: At least 21 min plus unreported warm-up duration. - Frequency: 3 sessions/week. - Program length: 4 weeks. - Control. - Modality: No exercise intervention. - Program length: 4 weeks. ## Outcomes ### Fatty liver index Status: improved FLI decreased within the LV-HIIT group from baseline to follow-up; post-intervention between-group FLI difference was not significant. LV-HIIT 62.0 (30.0, 82.0) to 53.0 (22.5, 72.0), p<0.001 within group; post-intervention between-group p=0.623. ### Estimated glomerular filtration rate Status: improved eGFR increased within the LV-HIIT group and was higher than control post-intervention. LV-HIIT 71.0 (61.4, 76.7) to 73.6 (69.1, 76.1), p<0.001 within group; post-intervention between-group p=0.021. ### Glycemic control Status: improved LV-HIIT reduced fasting blood sugar and HbA1c within group; post-intervention FBS was lower than control, while HbA1c between-group difference was not significant. FBS 129.0 to 121.0, p<0.001 within LV-HIIT and post-intervention between-group p=0.014; HbA1c 7.0 to 6.5, p<0.001 within LV-HIIT and post-intervention between-group p=0.320. ### Liver enzymes Status: improved ALT and GGT decreased within LV-HIIT and were lower than control post-intervention; AST did not significantly change. ALT p<0.001 within LV-HIIT and p=0.041 between groups post-intervention; GGT p=0.012 within LV-HIIT and p=0.025 between groups; AST p=0.209 within LV-HIIT. ### Anthropometrics and lipids Status: improved LV-HIIT reduced weight, BMI, waist circumference, LDL, triglycerides, and total cholesterol within group. Weight, BMI, waist circumference, triglycerides, and total cholesterol p<0.001 within LV-HIIT; LDL p=0.001 within LV-HIIT. ### Control group outcomes Status: mixed Control group showed a significant reduction in fasting blood sugar and a significant worsening-direction change in FLI, with no significant eGFR change. Control FBS p=0.002 within group; control FLI 51.0 to 52.5, p=0.001; control eGFR p=0.133. ## Practical Insights - A short, 3-times-weekly interval program with 1-minute work bouts and longer low-intensity intervals may improve some surrogate metabolic, liver, and kidney markers in sedentary type 2 diabetes patients. - The protocol is only partly translatable because warm-up duration, achieved intensity, adherence, and adverse events were not reported. - For consumer use, claims should specify calculated FLI and estimated GFR rather than direct liver fat or kidney disease outcomes. ## Limitations - Generalizability limited to patients referred to one diabetes clinic in Tehran, Iran. - No albuminuria marker of kidney disease. - Physical activity effects on muscle metabolism and creatinine production were not investigated. - Short 4-week study period. - Small sample size. - Adherence, dropout, achieved intensity, and adverse events were not reported. - Warm-up duration was not reported. ## Safety And Adherence - Participants completed health and sports history questionnaire and physician examination before randomization. - The study excluded people with functional limitations, respiratory, inflammatory, cardiovascular, renal, and other chronic diseases, smoking, or heavy drinking. - No adverse events, injuries, or dropout data were reported in the extracted article text. ## Original Sources - [PubMed](https://pubmed.ncbi.nlm.nih.gov/39136513/) (pubmed) - [DOI](https://doi.org/10.2174/0115733998320832240805113238) (doi) - [PMC full text](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12606594/) (full text) ## Agent Guidance Preserve the paper-level scope of this note. Do not generalize beyond the population, protocol, measured outcomes, and limitations above.