Understanding the Role of Exercise in Nonalcoholic Fatty Liver Disease: ERS-Linked Molecular Pathways

Table 2

The potential drugs combined with exercise to regulate ERS in NAFLD.

Drugs	Pharmacological role	Effects on NAFLD	Exercise effects on medication	Drug effects on ERS
Rutin	Cytoprotection and antioxidant	Abdominal fat ↓, glucose tolerance ↑, hepatic function ↑, inflammation ↓, ROS ↓	↑ [51]	↓ [51]
Resveratrol	Cytoprotection	Hepatic apoptosis ↓, liver ERS ↓, hepatic steatosis ↓	↑ [67]	↓ [68]
Vitamin D	Antioxidants	IR ↓, serum lipid level ↓, ALT ↓	↑ [64]	↓ [71]
Vitamin E	Antioxidants	Lipid peroxidation ↓, inflammation ↓, hepatic steatosis ↓, AST ↓, ALT ↓	↑ [72]	↓ [73]
Betaine	Antioxidants and insulin sensitizers	Adipocytokines ↑, IR ↓, adipose ERS ↓	↑ [74]	↓ [75]
Pentoxifylline	Cytoprotection (low ROS and inflammation)	ALT ↓, AST ↓, inflammation ↓	↑ [76]	↓ [77]
UDCA	Cytoprotection	No effective improvement	?	↓ [78, 79]
Silymarin	Cytoprotection and antioxidant	ALT ↓, high-density lipoprotein cholesterol ↑, oxidative stress ↓	?	↓ [80]
Statins	Reduce lipid level	Adipocytokines ↑, ALT, AST ↓, inflammation ↓, serum lipid level ↓	↑ [81]	↓ [82]
Ezetimibe	Reduce lipid level	Low-density lipoprotein cholesterol ↓, serum TG ↓, IR ↓	↑ [65, 83]	↓ [84]
Metformin	AMPK activator (promote fat consumption)	ALT ↓, inflammation ↓, hepatocellular injury ↓	↑ [85]	↓ [86, 87]
Omega-3 fatty acids	Improve metabolic profiles	Hepatic steatosis ↓, insulin sensitivity ↑	↑ [88, 89]	↓ [90, 91]
Incretin analogues	Modulate secretion of hormone	Glycaemic levels ↓, hepatic steatosis ↓, inflammation ↓, glycaemic levels ↓, fibrosis ↓	↑ [92, 93]	↓ [94, 95]
TZDs (pioglitazone)	Insulin sensitizers	ALT, AST↓, hepatic steatosis ↓, TG ↓, adipose IR ↓, inflammation ↓	↑ [96]	↓ [97, 98]
Sitagliptin and vildagliptin	DPP-4 inhibitors (suppress the degradation of glucagon-like peptide 1)	No effective improvement	?	↓ [99, 100]
Angiotensin receptor blockers	Modulate the renin-angiotensin-aldosterone system	ALT ↓, inflammation ↓	↑ [101]	↓ [102]
Probiotics and synbiotics	Improve inflammatory conditions of the gastrointestinal tract	Liver ROS ↓, inflammation ↓, ALT ↓	↑ [103]	↓ [104]
Orlistat	Augment weight loss and inhibit fat absorption	AST/ALT↓, hepatic steatosis ↓, weight ↓, ROS ↓	↑ [105, 106]	?