Study on the correlation between type 2 diabetes mellitus combined with non-alcoholic steatohepatitis and aerobic exercise performance
10.3760/cma.j.cn501113-20230517-00223
- VernacularTitle:2型糖尿病合并非酒精性脂肪性肝炎与有氧运动能力的相关性研究
- Author:
Jie ZHANG
1
;
Yang LI
;
Hongyan YU
;
Ying LI
;
Fengmei WANG
;
Fusheng DI
Author Information
1. 天津医科大学三中心临床学院 天津市重症疾病体外生命支持重点实验室 天津市人工细胞工程技术研究中心 天津市肝胆疾病研究所，天津 300170
- Keywords:
Type 2 diabetes;
Non-alcoholic fatty liver disease;
Non-alcoholic steatohepatitis;
Aerobic exercise capacity
- From:
Chinese Journal of Hepatology
2023;31(10):1068-1074
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the correlation between patients with type 2 diabetes mellitus combined with nonalcoholic steatohepatitis in order to provide theoretical support for the treatment of NAFLD through aerobic exercise performance.Methods:253 cases with T2DM combined with NAFLD were selected. 93 cases consented to undergo a liver biopsy. Among them, 74 cases with liver biopsy successfully passed the symptom-limited cardiopulmonary exercise test (CPET) and respiratory quotient (RQ)≥1.05. Patients were divided into two groups according to the NAFLD activity score (NAS) of the pathological biopsy: the non-NASH group (NAS < 4) and the NASH group (NAS≥4). The differences in general clinical and biochemical indicators and exercise parameters were compared between the two groups. The relevant factors that affect aerobic exercise performance in NAFLD patients were explored by correlation and regression analysis.Results:The peak oxygen uptake [VO2 @ peak, (17.82 ± 5.61) ml·kg -1·min -1 and (23.14 ± 5.86) ml·kg -1·min -1] and anaerobic threshold [VO2 @ AT, (11.47 ± 3.12) ml·kg -1·min -1 and (13.81 ± 3.53) ml·kg -1·min -1] were lower in the NASH group than those in the non-NASH group in T2DM patients, with P < 0.01, indicating a significant decrease in aerobic exercise performance in NASH patients compared to non-NASH patients. Correlation analysis showed that patients with T2DM combined with NAFLD VO2@peak was positively correlated with RQ, carbohydrate oxidation rate (%CHO), daily carbohydrate energy supply (CHO Kcal/d), high-density lipoprotein cholesterol (HDL-C), and maximal voluntary ventilation (MVV) ( r 0.360, 0.334, 0.341, 0.255, 0.294, P < 0.05 or P < 0.01, respectively) and negatively correlated with NAS score, fat attenuation, liver stiffness, fat oxidation rate (%FAT), daily fat energy supply (FAT Kcal/d), aspartate aminotransferase (AST), alanine aminotransferase (ALT), body mass, and body mass index (BMI) ( r -0.558, -0.411, -0.437, -0.340, -0.270, -0.288, -0.331, -0.295, -0.469, P < 0.05 or P < 0.01, respectively). VO2@AT were positively correlated with RQ, %CHO, total cholesterol (TC), and HDL-C ( r 0.351, 0.247, 0.303, 0.380, P < 0.05 or P < 0.01, respectively), while it was negatively correlated with NAS score, fat attenuation, liver stiffness, %FAT, FAT (Kcal/d), ferritin (Fer), ALT, AST, body weight, and BMI ( r -0.330, -0.384, -0.428, -0.270, -0.318, 0.320, -0.404, -0.416, -0.389, -0.520, P < 0.05 or P < 0.01, respectively). Stepwise multiple regression analyses revealed that BMI, RQ, and NAS scores were independent correlated factors of aerobic exercise performance. Conclusion:Hepatic inflammation and fibrosis affect the aerobic exercise performance of patients with T2DM combined with NAFLD.
