最大摄氧量与男性非酒精性脂肪性肝病患者肝脏脂肪含量相关  

VO_(2) max is correlated with liver steatosis in male nonalcoholic fatty liver patients

作　　者：刘晓慧[1] 勾钰淞 梁珊[1] 任弘[2] 李强 段威 张晶[1] LIU Xiao-hui;GOU Yu-song;LIANG Shan;REN Hong;LI Qiang;DUAN Wei;ZHANG Jing(Fatty Liver Disease Treatment Center,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China;Beijing Sport University,Beijing 100084,China;Beijing Physical Examination Center,Beijing 100036,China;Beijing Paopao-meimei Technology Co.,Ltd,Beijing 100144,China)

机构地区：[1]首都医科大学附属北京佑安医院脂肪性肝病诊疗中心,100069 [2]北京体育大学 [3]北京市体检中心 [4]北京跑跑美美科技有限公司

出　　处：《肝脏》2023年第3期355-359,共5页Chinese Hepatology

基　　金：首都医科大学附属北京佑安医院中青年人才孵育项目(YNKTQN2021015)。

摘　　要：目的探讨非酒精性脂肪性肝病(NAFLD)患者心肺适能水平与肝脏脂肪含量、炎症和肝纤维化的关系。方法入组62例NAFLD患者。采用最大摄氧量(maximal oxygen uptake,VO 2 max)来反映心肺适能,以受控衰减参数(controlled attenuated parameter,CAP)反映肝脏脂肪含量,同时检测生化学与人体成分等指标。按照年龄性别判断心肺适能等级,并分析VO 2 max与各项指标的相关性。结果本研究中男性占40例(64.5%),VO 2 max、体质量、CAP、ALT、尿酸、体脂率等均显著高于女性(P均<0.05)。VO 2 max分级为优秀/良好、一般/差和极差的人数,在男性NAFLD组分别为3例、14例和23例,女性分别为10例、11例和1例,两组存在显著性差异(P<0.001)。在男性患者中,轻中度和重度脂肪肝患者分别为10例和30例,重度脂肪肝患者BMI[(30.0±3.5)比(25.6±3.0)kg/m 2]、肝脏CAP值[(357.2±24.1)比(282.3±15.6)dB/m]、腰臀比[(0.98±0.03)比(0.93±0.03)]、体脂率[(29.7±4.3)比(23.9±4.2)%]等更高,而VO 2 max[(30.1±3.2)比(32.8±3.0)mL/(kg·min)]显著低于轻、中度肝脏脂肪变患者(P均<0.05)。相关性分析表明,男性NAFLD患者VO 2 max与肝脏CAP值、体脂率、内脏脂肪含量、内脏脂肪面积及BMI呈负相关,与四肢骨骼肌指数呈正相关(P均<0.05)。结论VO 2 max与肝脏脂肪变的严重程度密切相关。重度脂肪肝患者心肺功能和有氧运动能力低下,尤其男性脂肪肝患者更差。提示男性NAFLD患者运动干预应答不佳,临床治疗时需要根据耐受性制定个体化运动方案。Objective To investigate the level of cardiopulmonary fitness(CRF)in NAFLD patients and to evaluate the relationship of CRF with liver steatosis,inflammation and liver fibrosis.Methods Sixty-two patients were enrolled in this study.Maximal oxygen uptake(VO 2 max)level was determined to reflect CRF and controlled attenuated parameter(CAP)was tested to reflect liver fat content.Biochemical and body composition indexes were simutaneously detected.The CRF level was graded according to age and gender.The correlation between VO_(2) max and various fatty liver associated parameters were analyzed.Results Forty cases(64.5%)of the 62 patients were male,and their VO_(2) max,body weight,CAP,ALT,uric acid and body fat rate were significantly higher than those of female patients(all P<0.05).The levels of CRF were classified into 3 grades,i.e.,excellent/good,general/poor and very poor.There were 3 cases,14 cases and 23 cases in male patients,and 10 cases,11 cases and 1 case in female patients were classified into each of the 3 grades,respectively,with significant difference between the male and female patients(P<0.001).In male patients,there were 10 cases with mild to moderate fatty liver and 30 cases with severe fatty liver.The BMI[(30.0±3.5)vs.(25.6±3.0)kg/m 2],CAP value[(357.2±24.1)vs.(282.3±15.6)dB/m],weight hip ratio[(0.98±0.03)vs.(0.93±0.03)]and body fat rate[(29.7±4.3)vs.(23.9±4.2)%]were higher in patients with severe fatty liver,but their VO_(2) max[(30.1±3.2)vs.(32.8±3.0)mL/(kg·min)]was significantly lower than that in patients with mild to moderate fatty liver(both P<0.05).By correlation analysis it was shown that VO_(2) max was negatively correlated with CAP value,body fat rate,visceral fat content,visceral fat area and BMI in male patients,and positively correlated with appendicular skeletal muscle mass(both P<0.05).Conclusion VO_(2) max is closely associated with the severity of liver steatosis.The cardiopulmonary function and aerobic exercise capacity are low in NAFLD patients,especially in male patient

关 键 词：非酒精性脂肪性肝病 最大摄氧量 心肺适能 肝脏脂肪变 

分 类 号：R575.5[医药卫生—消化系统]