Chatur Dipali K, Pati Saroj K, Ghate Jayshri R, Nanda Rachita, Sinha Meenakshi, Kodapi Kalpana
Physiology, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Radiodiagnosis, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Cureus. 2024 May 19;16(5):e60632. doi: 10.7759/cureus.60632. eCollection 2024 May.
Introduction Nonalcoholic fatty liver disease (NAFLD) presents as a multisystem disorder, heightening the risk of developing type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs). Occupation emerges as a significant factor influencing the occurrence of NAFLD. Research indicates that individuals engaged in shift work face an elevated risk of NAFLD, alongside obesity and T2DM, attributed to disruptions in their circadian rhythm, which precipitate hepatic steatosis and inflammation. Remarkably, peripheral neuropathy has been observed in conjunction with advanced liver disorders and NAFLD in the general population. However, the correlation between NAFLD and peripheral neuropathy remains unestablished in shift workers. Objective To identify NAFLD in seemingly healthy rotating shift workers and assess any potential impact of NAFLD on nerve function in this demographic. Methods This cross-sectional study involved 73 apparently healthy nonalcoholic security guards (aged 35 to 60 years) working in rotating shifts. The study included a comprehensive assessment, beginning with a medical history, an evaluation of physical activity, and anthropometric measurements. Confirmation of NAFLD was achieved through abdominal ultrasonography (USG), followed by the analysis of biochemical parameters. Motor and sensory nerve conduction studies (NCS) were conducted on participants with normal vitamin B12 levels using the Aleron electromyograph (EMG) machine (Recorders and Medicare Systems Private Ltd, Budanpur, India). The evaluation encompassed the Median and Common Peroneal motor nerves, as well as Median and Sural sensory nerves. Recorded parameters for motor nerves included distal motor latency (DML), compound muscle action potential (CMAP) amplitude, conduction velocity (CV), and F-wave minimum latency (F-wave), while sensory nerve parameters comprised sensory onset latency (SOL), sensory nerve action potential (SNAP) amplitude, and CV. Results Among 73 healthy security guards working in rotating shifts, 76.1% were diagnosed with NAFLD through abdominal ultrasound. Following participant withdrawals and exclusions due to vitamin B12 deficiency, a comparison of NCS parameters between NAFLD (n=24) and Non-NAFLD (n=12) groups revealed no significant disparities in motor or sensory parameters, except for a slightly diminished CMAP amplitude in the peroneal nerve of NAFLD subjects (8.21±2.83mV vs ±10.22±2.30 mV, p< 0.040). However, these differences fell within normal ranges, indicating no notable impact on peripheral nerve conduction in the presence of NAFLD. Conclusion The results indicate a high prevalence of NAFLD among individuals working rotating shifts. Moreover, the investigation suggests that despite the presence of NAFLD, there is no discernible influence on motor and sensory peripheral nerve conduction, particularly in common peroneal, median, and sural nerves.
引言 非酒精性脂肪性肝病（NAFLD）是一种多系统疾病，增加了患2型糖尿病（T2DM）和心血管疾病（CVD）的风险。职业是影响NAFLD发生的一个重要因素。研究表明，从事轮班工作的个体患NAFLD、肥胖症和T2DM的风险增加，这归因于他们的昼夜节律紊乱，进而引发肝脂肪变性和炎症。值得注意的是，在普通人群中，已观察到周围神经病变与晚期肝脏疾病和NAFLD相关。然而，在轮班工作者中，NAFLD与周围神经病变之间的相关性尚未确立。目的 识别看似健康的轮班工作者中的NAFLD，并评估NAFLD对该人群神经功能的任何潜在影响。方法 这项横断面研究纳入了73名表面健康、从事轮班工作的非酒精性保安人员（年龄在35至60岁之间）。该研究包括全面评估，首先是病史采集、身体活动评估和人体测量。通过腹部超声检查（USG）确诊NAFLD，随后分析生化参数。使用Aleron肌电图（EMG）机器（印度布丹布尔的Recorder and Medicare Systems Private Ltd）对维生素B12水平正常的参与者进行运动和感觉神经传导研究（NCS）。评估包括正中神经和腓总运动神经，以及正中神经和腓肠感觉神经。运动神经记录的参数包括远端运动潜伏期（DML）、复合肌肉动作电位（CMAP）幅度、传导速度（CV）和F波最小潜伏期（F波），而感觉神经参数包括感觉起始潜伏期（SOL）、感觉神经动作电位（SNAP）幅度和CV。结果 在73名从事轮班工作的健康保安人员中，76.1%通过腹部超声被诊断为NAFLD。在因维生素B12缺乏导致参与者退出和排除后，比较NAFLD组（n = 24）和非NAFLD组（n = 12）的NCS参数发现，运动或感觉参数没有显著差异，只是NAFLD受试者腓神经的CMAP幅度略有降低（8.21±2.83mV对±10.22±2.30 mV，p < 0.040）。然而，这些差异仍在正常范围内，表明在存在NAFLD的情况下，对周围神经传导没有显著影响。结论 结果表明，从事轮班工作的个体中NAFLD的患病率很高。此外，该研究表明，尽管存在NAFLD，但对运动和感觉周围神经传导没有明显影响，特别是在腓总神经、正中神经和腓肠神经中。
