RT Journal Article SR Electronic T1 Effect of low-volume exercise on hepatic steatosis in adults with obesity plus normal glucose, prediabetes or type 2 diabetes: a randomised controlled trial JF BMJ Open Sport & Exercise Medicine JO BMJ OPEN SP EX MED FD BMJ Publishing Group Ltd SP e001878 DO 10.1136/bmjsem-2023-001878 VO 10 IS 4 A1 Baker, Callum A1 Hocking, Samantha L A1 Wang, Xiaoyu A1 Gerofi, James A1 Colagiuri, Stephen A1 Sabag, Angelo A1 Molyneaux, Lynda A1 Xu, Yu A1 Li, Mian A1 Bi, Yufang A1 Min, Danqing A1 Johnson, Nathan A A1 Twigg, Stephen M YR 2024 UL http://bmjopensem.bmj.com/content/10/4/e001878.abstract AB Objectives This study aimed to evaluate the effects of a novel, low-volume combined high-intensity interval training (HIIT) and progressive resistance training (PRT) in overweight/obese adults.Methods This randomised control trial compared the effect of regular supervised HIIT combined with PRT (Exercise) with an unsupervised stretching intervention (Control), in previously inactive adults with either normal glucose (NG), pre-diabetes or type 2 diabetes (T2DM) with body mass index of >25 kg/m2. Participants were randomly allocated (1:1) to receive low-volume exercise or control by an online randomisation tool. The primary outcome was the difference in change of hepatic steatosis between Exercise and Control. A prespecified sensitivity analysis was undertaken for weight stable participants (<5% change in bodyweight from baseline). Secondary outcomes were change in hepatic steatosis within the glucose groups, glycaemic control, cardiorespiratory fitness, muscle strength and body composition.Results Between June 2018 and May 2021, 162 participants were randomly assigned (NG: 76, pre-diabetes: 60, T2DM: 26) and 144 were included in the final analysis. Mean absolute change in hepatic steatosis was −1.4% (4.9) in Exercise (n=73) and −0.1% (7.2) in Control (n=71)(p=0.25). By preplanned sensitivity analysis, the mean change in hepatic steatosis with Exercise (n=70) was −1.5% (5) compared with 0.7% (4.6) with Control (n=61) (p=0.017). Subgroup analysis within the glucose groups showed that exercise reduced hepatic steatosis in those with pre-diabetes but not NG or T2DM (pre-diabetes: −1.2% (4.4) in Exercise and 1.75% (5.7) in Control, p=0.019).Conclusion These findings show that low-volume HIIT with PRT yields improvements in muscle strength and cardiorespiratory fitness and may have a small effect on hepatic steatosis.Trial registration number The trial was prospectively registered with the ANZCTR (ACTRN12617000552381).Data are available upon reasonable request.