Hao Xiaoyan, Zhang Huihui, He Honghai, Tao Liyuan, Tian Lei, Zhao Wei, Wang Peng
Medical Examination Center, Peking University, Third Hospital, Beijing, China.
Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China.
Postgrad Med. 2025 Jan;137(1):79-85. doi: 10.1080/00325481.2024.2436344. Epub 2024 Dec 1.
This study investigated the influencing factors of exercise systolic blood pressure response (ESBPR) by cardiopulmonary exercise test (CPX) in nonalcoholic fatty liver disease (NAFLD) in people aged 40-60 years.
A total of 603 adults were enrolled in this study. The inclusion criteria of this cross-sectional study were adults who underwent health checks and CPX.
There were significant differences in body mass Index (BMI) (26.80 ± 2.64 VS 23.31 ± 2.41, < 0.001) kg/m2, fasting blood glucose (FPG) (5.56 ± 0.94 VS 5.13 ± 0.55, < 0.001) mmol/L, alanine aminotransferase (ALT), aspartate transaminase (AST), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C) (1.13 ± 0.22 VS 1.43 ± 0.33, < 0.001) mmol/L, low-density lipoprotein-cholesterol (LDL-C) (3.21 ± 0.79 VS 2.99 ± 0.68, = 0.001) mmol/L, resting systolic blood pressure (SBP) (123.53 ± 14.73 VS 118.79 ± 14.79, < 0.001) mmHg, resting diastolic blood pressure (DBP) (80.29 ± 9.62 VS 75.27 ± 10.41, < 0.001) mmHg, peak SBP (184.01 ± 23.50 VS 172.81 ± 24.95, < 0.001) mmHg, peak DBP (87.47 ± 10.50 VS 84.01 ± 11.46, = 0.001) mmHg, oxygen pulse (VO2/HR) (0.88 ± 0.15 VS 0.92 ± 0.16, = 0.004) ml/beat, exercise maximum heart rate, carbon dioxide Ventilation equivalent (VE/VCO2) (25.84 ± 4.43 VS 25.12 ± 3.58, = 0.038), peak oxygen uptake (VO2 peak) (1.78 ± 0.45 VS 1.56 ± 0.46, < 0.001) mL/min between the NAFLD and control groups. VE/VCO2 (OR = 0.822, = 0.036) and oxygen uptake/work rate (VO2/WR) (OR = 0.517, = 0.021) mL/min/watt were associated with a lower risk of ESBPR in NAFLD subjects. Resting SBP was associated with a higher risk of ESBPR in NAFLD patients (OR = 1.059, = 0.003) and overweight NAFLD subjects (OR = 1.075, = 0.002). ESBPR (OR = 1.268, = 0.045), skeletal-muscle mass (OR = 1.305, < 0.001), and SMI (OR = 1.315, < 0.001) were linked to an elevated risk of NAFLD in individuals.
Our findings indicate that ESBPR is associated with an increased risk of NAFLD in individuals aged 40-60 years. Furthermore, in NAFLD subjects, VE/VCO2 and VO2/WR were found to be correlated with a decreased risk of ESBPR, whereas resting SBP was linked to an elevated risk of ESBPR. This will provide a research basis for the NAFLD subjects who have ESBPR at risk of adverse events during exercise.
本研究通过心肺运动试验（CPX）调查40 - 60岁非酒精性脂肪性肝病（NAFLD）患者运动收缩压反应（ESBPR）的影响因素。
本研究共纳入603名成年人。这项横断面研究的纳入标准是接受健康检查和CPX的成年人。
NAFLD组与对照组在体重指数（BMI）（26.80±2.64 VS 23.31±2.41，<0.001）kg/m²、空腹血糖（FPG）（5.56±0.94 VS 5.13±0.55，<0.001）mmol/L、丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL-C）（1.13±0.22 VS 1.43±0.33，<0.001）mmol/L、低密度脂蛋白胆固醇（LDL-C）（3.21±0.79 VS 2.99±0.68，=0.001）mmol/L、静息收缩压（SBP）（123.53±14.73 VS 118.79±14.79，<0.001）mmHg、静息舒张压（DBP）（80.29±9.62 VS 75.27±10.41，<0.001）mmHg、峰值SBP（184.01±23.50 VS 172.81±24.95，<0.001）mmHg、峰值DBP（87.47±10.50 VS 84.01±11.46，=0.001）mmHg、氧脉搏（VO₂/HR）（0.88±0.15 VS 0.92±0.16，=0.004）ml/次、运动最大心率、二氧化碳通气当量（VE/VCO₂）（25.84±4.43 VS 25.12±3.58，=0.038）、峰值摄氧量（VO₂峰值）（1.78±0.45 VS 1.56±0.46，<0.001）mL/min方面存在显著差异。VE/VCO₂（OR = 0.822，=0.036）和摄氧量/功率（VO₂/WR）（OR = 0.517，=0.021）mL/min/瓦与NAFLD患者ESBPR风险降低相关。静息SBP与NAFLD患者（OR = 1.059，=0.003）和超重NAFLD受试者（OR = 1.075，=0.002）的ESBPR风险较高相关。ESBPR（OR = 1.268，=0.045）、骨骼肌质量（OR = 1.305，<0.001）和肌肉质量指数（SMI）（OR = 1.315，<0.001）与个体患NAFLD风险升高相关。
我们的研究结果表明，ESBPR与40 - 60岁个体患NAFLD风险增加相关。此外，在NAFLD受试者中，发现VE/VCO₂和VO₂/WR与ESBPR风险降低相关，而静息SBP与ESBPR风险升高相关。这将为运动期间有ESBPR不良事件风险的NAFLD受试者提供研究依据。
