Exercise and Metabolic Disease Intervention: Medical Basis for Aerobic Exercise in the Treatment of Fatty Liver, Blood Glucose Monitoring, and Risk Assessment

Fatty liver disease is a pathological condition caused by various factors that impair liver fat metabolism, leading to excessive fat accumulation in the liver. It is classified into alcoholic fatty liver and non-alcoholic fatty liver disease based on etiology. Current research suggests that obesity-related fatty liver is caused by an imbalance in the synthesis of triglycerides and the secretion of very low-density lipoprotein (VLDL) by hepatocytes. The more severe the obesity and the longer the duration of obesity, the more severe the fatty liver. Obese patients have increased fat mass, and under the action of hormone-sensitive lipase, increased fat mobilization produces a large amount of fatty acids released into the bloodstream, leading to increased triglyceride synthesis in the liver.

Fatty liver caused by obesity does not result in severe damage to liver cells, and it can be reversibly restored through appropriate exercise combined with dietary control. Studies have confirmed that exercise does not increase the liver's ability to break down fat, but aerobic exercise primarily utilizes the aerobic oxidation of fat for energy. Moderate-intensity aerobic exercise increases fat mobilization, consuming excess body fat and reducing free fatty acids in the blood. Furthermore, aerobic exercise causes the continuous release of fatty acids deposited in the liver into the bloodstream as an energy source, reducing fat within liver cells and thus alleviating fatty liver.

Existing studies have found that obese patients who lose weight through effective exercise, even if their obesity level does not fully return to normal, can completely cure fatty liver disease. Long-term aerobic exercise also increases resting metabolism in obese patients, leading to increased energy expenditure, lower blood triglycerides, and reduced body fat. Moderate-intensity aerobic exercise has a positive effect on alleviating hyperlipidemia and improving the severity of fatty liver disease. Simultaneously, it can improve insulin resistance, reduce the conversion of glycogen and fat, and promote the oxidative breakdown of fat.

Glycated hemoglobin (HbA1c) is the component formed by the non-enzymatic binding of hemoglobin and glucose. It is the gold standard for diabetes screening, diagnosis, and glycemic control. The formation of HbA1c is irreversible, and its level represents the average blood glucose level over 120 days. Laboratory tests for diabetes include glucose level testing, insulin testing, HbA1c testing, and related antibody testing. Blood glucose measurements only represent immediate levels and indicate the condition at the time of testing; they cannot be used as an indicator of the degree of disease control.

Glycated hemoglobin (HbA1c) reflects the average blood glucose level over the past 120 days. These three indicators show when blood glucose levels differ. In early-stage diabetes, both fasting and postprandial blood glucose are abnormal, but a diagnosis cannot be made due to the presence of the "three highs and one low" symptoms (polyuria, polydipsia, polyphagia, and weight loss). In such cases, HbA1c testing can help clarify the diagnosis. High levels require timely assessment of the patient's diet, exercise, and medication, and increased testing frequency. It can also serve as a predictor of cardiovascular disease; higher concentrations are associated with a greater risk of macrovascular disease and mortality in diabetic patients.

Numerous studies have confirmed a close relationship between obesity and the occurrence and development of certain organic diseases. Obese individuals must undergo a physical examination and health check before participating in exercise to understand their physical condition and fitness level, ensuring safety. The physical examination includes a diagnosis of the degree of obesity. Exercise for weight loss is specifically for obese individuals, requiring a clear diagnosis of the degree of obesity. Commonly used indicators include: height, weight, body mass index (BMI), circumference, waist-to-hip ratio, and body fat percentage.

Physical fitness tests include heart rate, blood pressure, resting electrocardiogram (ECG), lung capacity, and strength assessment. Routine blood tests should be performed in the morning on an empty stomach, including: complete blood count (CBC), fasting blood glucose, blood insulin, triglycerides, cholesterol, and high/low density lipoproteins (HDL/LDL). Specialized examinations include liver ultrasound to diagnose fatty liver and echocardiography to detect changes in cardiac structure. Health checkups are used to screen for chronic diseases, determine the impact of disease severity on exercise and diet, and adjust treatment plans accordingly.

Exercise stress testing can assess a patient's cardiopulmonary function during exercise. Cardiopulmonary function during exercise is a good indicator of how well the heart pumps blood to various tissues and organs during exercise. Through this test, the overall function of organ systems under exercise conditions can be comprehensively evaluated, cardiopulmonary reserve and exercise endurance can be quantitatively assessed, cardiovascular diseases can be ruled out, and the safety of weight loss through exercise can be ensured. Therefore, obese patients with chronic diseases must undergo a physical examination, health check, and exercise stress testing before participating in physical fitness activities.