Effects of an 8-week elastic band resistance training program on hepatic steatosis, insulin resistance, and circulating irisin in postmenopausal women with MASLD: A randomized controlled trial

Objectives: To evaluate the effects of an 8-week elastic band resistance training program (EBRT) on hepatic steatosis, liver stiffness, liver enzymes, metabolic outcomes, body mass index, and circulating irisin in postmenopausal women with metabolic dysfunction-associated steatotic liver disease (MASLD). Design: A randomized controlled trial. Methods: Fifty-two postmenopausal women with MASLD were EBRT (n = 26) or a control group (n = 26) for eight weeks. Controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) were assessed using transient elastography. Liver enzymes, glycemic indices, BMI, and circulating irisin were measured at baseline and post-intervention. Dietary intake and daily step counts were monitored throughout the study. Group × time effects were analyzed using linear mixed-effects models. Results: All participants completed follow-up. A significant group × time interaction was observed for CAP (β = − 36.77 dB/m, 95% CI − 50.90 to − 22.64; p < 0.001). Significant interactions also favored EBRT for LSM (β = − 1.51 kPa), ALT (β = − 11.49 U/L), GGT (β = − 11.18 U/L), fasting insulin (β = − 3.32 μU/mL), BMI (β = − 0.73 kg/m2), and circulating irisin (β = 3.73 ng/mL; all p ≤ 0.006). Interactions for AST, fasting glucose, and HOMA-IR were not significant. Conclusions: Eight weeks of supervised EBRT reduced hepatic steatosis and was associated with favorable changes in selected hepatic, metabolic, anthropometric, and myokine outcomes. EBRT may be a feasible low-impact exercise strategy for postmenopausal women with MASLD; however, secondary outcomes should be interpreted cautiously because no multiplicity adjustment was applied.