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Factors independently associated with cardiorespiratory fitness in patients with non-alcoholic fatty liver disease

Factors independently associated with cardiorespiratory fitness in patients with non-alcoholic fatty liver disease
Factors independently associated with cardiorespiratory fitness in patients with non-alcoholic fatty liver disease

Low cardiorespiratory fitness (CRF) is associated with non-alcoholic fatty liver disease (NAFLD) and low CRF is an important risk factor for cardiovascular disease. The factors that influence CRF in NAFLD are poorly understood and it has been suggested that reduced hepatic mitochondrial function (HMF) may be linked to low CRF. Therefore, our aim was to determine the factors associated with CRF in NAFLD.

METHODS: Ninety-seven patients with NAFLD were studied. CRF was assessed by treadmill testing and expressed as maximal O 2 consumption (VO 2 peak) per lean body mass. HMF was assessed by the 13 C-ketoisocaproate breath test. Multivariable linear regression modelling was undertaken to test the independence of associations with CRF.

RESULTS: Mean (SD) age was 51 (13) years and 61% were men. With CRF as the outcome, age (B coefficient -0.3, 95%CI -0.4, -0.2, P < .0001), total body fat mass (B coefficient -0.2, 95%CI -0.3, -0.05, P = .01), type 2 diabetes mellitus (T2DM) (B coefficient -3.6, 95%CI -1.1, -6.1, P = .005), smoking status (B coefficient -5.7, 95%CI -1.9, -9.5, P = .004), serum γ-glutamyl transferase (GGT) (B coefficient -0.04, 95%CI -0.05, -0.02, P < .0001), HMF (B coefficient -0.5, 95%CI -0.8, -0.1, P = .01) and diastolic function (B coefficient 0.1, 95%CI 0.05, 0.13, P < .0001) were independently associated with CRF. This model explained 60% of the total variance in CRF (R 2 = 0.6, P < .0001); and this model with GGT alone explained 24% of the variance in CRF.

CONCLUSIONS: In patients with NAFLD, HMF is independently associated with CRF and a model with GGT alone explained most of the variance in CRF.

cardiorespiratory fitness, cardiovascular disease, hepatic mitochondrial function, non-alcoholic fatty liver disease, serum γ-glutamyl transferase, type 2 diabetes
1478-3223
2998-3007
Afolabi, Paul
757e7f01-664c-493e-bc51-c6a2c933dc22
Scorletti, Eleonora
42bb0659-ac67-4a73-bf36-a881fe6c1563
Calder, Philip
1797e54f-378e-4dcb-80a4-3e30018f07a6
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c
Afolabi, Paul
757e7f01-664c-493e-bc51-c6a2c933dc22
Scorletti, Eleonora
42bb0659-ac67-4a73-bf36-a881fe6c1563
Calder, Philip
1797e54f-378e-4dcb-80a4-3e30018f07a6
Byrne, Christopher
1370b997-cead-4229-83a7-53301ed2a43c

Afolabi, Paul, Scorletti, Eleonora, Calder, Philip and Byrne, Christopher (2020) Factors independently associated with cardiorespiratory fitness in patients with non-alcoholic fatty liver disease. Liver International, 40 (12), 2998-3007. (doi:10.1111/liv.14618).

Record type: Article

Abstract

Low cardiorespiratory fitness (CRF) is associated with non-alcoholic fatty liver disease (NAFLD) and low CRF is an important risk factor for cardiovascular disease. The factors that influence CRF in NAFLD are poorly understood and it has been suggested that reduced hepatic mitochondrial function (HMF) may be linked to low CRF. Therefore, our aim was to determine the factors associated with CRF in NAFLD.

METHODS: Ninety-seven patients with NAFLD were studied. CRF was assessed by treadmill testing and expressed as maximal O 2 consumption (VO 2 peak) per lean body mass. HMF was assessed by the 13 C-ketoisocaproate breath test. Multivariable linear regression modelling was undertaken to test the independence of associations with CRF.

RESULTS: Mean (SD) age was 51 (13) years and 61% were men. With CRF as the outcome, age (B coefficient -0.3, 95%CI -0.4, -0.2, P < .0001), total body fat mass (B coefficient -0.2, 95%CI -0.3, -0.05, P = .01), type 2 diabetes mellitus (T2DM) (B coefficient -3.6, 95%CI -1.1, -6.1, P = .005), smoking status (B coefficient -5.7, 95%CI -1.9, -9.5, P = .004), serum γ-glutamyl transferase (GGT) (B coefficient -0.04, 95%CI -0.05, -0.02, P < .0001), HMF (B coefficient -0.5, 95%CI -0.8, -0.1, P = .01) and diastolic function (B coefficient 0.1, 95%CI 0.05, 0.13, P < .0001) were independently associated with CRF. This model explained 60% of the total variance in CRF (R 2 = 0.6, P < .0001); and this model with GGT alone explained 24% of the variance in CRF.

CONCLUSIONS: In patients with NAFLD, HMF is independently associated with CRF and a model with GGT alone explained most of the variance in CRF.

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FINAL ACCEPTED VERSION BY LIVER INTERNATIONAL 05082020 revised - Accepted Manuscript
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Accepted/In Press date: 17 July 2020
e-pub ahead of print date: 24 July 2020
Published date: December 2020
Additional Information: © 2020 The Authors. Liver International published by John Wiley & Sons Ltd.
Keywords: cardiorespiratory fitness, cardiovascular disease, hepatic mitochondrial function, non-alcoholic fatty liver disease, serum γ-glutamyl transferase, type 2 diabetes

Identifiers

Local EPrints ID: 442784
URI: http://eprints.soton.ac.uk/id/eprint/442784
ISSN: 1478-3223
PURE UUID: 2579655d-47cf-485a-bbe1-adf31a218c49
ORCID for Paul Afolabi: ORCID iD orcid.org/0000-0002-0553-1578
ORCID for Philip Calder: ORCID iD orcid.org/0000-0002-6038-710X
ORCID for Christopher Byrne: ORCID iD orcid.org/0000-0001-6322-7753

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Date deposited: 27 Jul 2020 16:30
Last modified: 26 Nov 2021 06:57

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Contributors

Author: Paul Afolabi ORCID iD
Author: Eleonora Scorletti
Author: Philip Calder ORCID iD

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