CPET-based HIIT for MAFLD

Inclusion Criteria: Adults age 35\~65 years Nonalcoholic fatty liver diagnosed by abdominal ultrasonography In conjunction with at least one cardiometabolic risk factor: * Overweight or Obesity: ≥ 24kg/m2，or waist circumference ≥ 90 cm in men and \> 85 cm in women, or excessive body fat mass * Prediabetes or type 2 diabetes mellitus: HbA1c ≥ 5.7%, or fasting plasma glucose ≥ 6.1mmol/L, or 2-h plasma glucose during OGTT ≥ 7.8mmol/L * Plasma triglycerides ≥ 1.7 mmol/L (\>-150 mg/dl) or lipid-lowering treatment * HDL-cholesterol ≤ -1.0 mmol/L in men and ≤ -1.3 mmol/L in women or lipid-lowering treatment * Blood pressure ≥ 130/85 mmHg or treatment for hypertension Exclusion Criteria: * Contraindications for Cardiopulmonary Exercise Testing * The electrocardiogram (ECG) results during cardiopulmonary exercise testing (CPET) showed positive findings * Receiving GLP-1 receptor agonists, SGLT-2i, or taking \>2 antihypertensive/hypoglycemic/lipid-lowering/ antiarrhythmic drugs * Taking dietary supplements (e.g., fish oil products, over-the-counter diet pills, meal replacements) * Mental illness * Other liver diseases * Movement disorder related diseases and lower limb motor injury in the past 6 months * Pregnant, lactating or planning to become pregnant in the near future