JGH:体力活动强度可以增强心肺健康并改善非酒精性脂肪肝疾病

2022-01-18 MedSci原创 MedSci原创

非酒精性脂肪性肝炎(NASH)又称代谢性脂肪性肝炎,是病理变化与酒精性肝炎相似但无过量饮酒史的临床综合征,好发于中年特别是超重肥胖个体。

非酒精性脂肪肝(NAFLD)是指肝脏的脂肪浸润达到肝脏重量的5%以上,影响着大约25%的欧洲成年人。非酒精性脂肪肝是一种渐进性疾病,可能导致肝脏纤维化和肝硬化。流行病学和临床研究发现,非酒精性脂肪肝与一系列心血管疾病的发展有关,包括左心室功能障碍、动脉粥样硬化、肝硬化等。非酒精性脂肪肝的长期治疗指南侧重于减肥和饮食控制,但缺乏有关其他积极的生活方式的推荐。即使是相对轻微的减肥就可以显著减少肝脏脂肪,改善心脏代谢风险状况因素,并提高长期的健康结果。因此,高水平的体力活动和心肺健康可以预防非酒精性脂肪肝。本项研究旨在探究不同的体育活动强度和心肺健康是否是非酒精性脂肪肝的独立预测因素。

研究人员为了完成本项课题,纳入了之前没有肝功能障碍诊断的健康成年人。根据脂肪肝指数评分估计非酒精性脂肪肝的患病率。研究人员通过患者的自我报告将患者分为低、中等和剧烈的身体活动组。参与者完成了增量跑步机测试以估计心肺健康的评估,随后将数据分为五分位数组(Q1 [最不适合] 到 Q5 [最适合])进行统计学评估。

 

 

研究结果发现在7111名成年人样本中,非酒精性脂肪肝的患病率在男性成年人中为 28.3%,在女性成年人中为 6.5%。逻辑回归显示,如果维持 > 60 分钟/周的剧烈体育活动,非酒精性脂肪肝的相对几率可以降低42%([OR] = 0.58,95% [CI]:0.49-0.68)。在 Q1 和 Q4 之间,心肺健康与非酒精性脂肪肝疾病之间存在负剂量反应关联。与第一分位数相比,第二分位数患者的非酒精性脂肪肝的几率降低了 39%(OR = 0.61,95%[CI]:0.51-0.73),而在第五分位数则降低了 51%(OR = 0.49,95%[CI]:0.41-0.60)。适度的体育活动并没有降低非酒精性肝病的几率。

图:不同体力活动强度与非酒精性脂肪肝的相关性

本项研究证实每周进行> 60 分钟剧烈体育活动的成年人中,非酒精性脂肪肝的患病率最低。然而,心肺健康与非酒精性脂肪肝之间存在更强的剂量反应关系。改善心肺健康作为治疗和预防非酒精性脂肪肝的潜在治疗目标值得进一步研究。

原始出处:

Catherine J. Kerr. Et al. The associations between physical activity intensity, cardiorespiratory fitness, and non-alcoholic fatty liver disease. Journal of Gastroenterology and Hepatology.2022.

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    2022-09-07 aids222
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