Estudo do Condicionamento Físico na Doença Hepática Gordurosa Não-Alcoólica

Abstract

Introduction: Non-alcoholic fatty liver disease (NAFLD) is related to the presence of cardiovascular disease, as there is a combination of risk factors common to both conditions, such as habits and lifestyle, diet and socioeconomic factors, which can result in a sedentary lifestyle, obesity and metabolic syndrome (MS). Cardiorespiratory fitness is an important indicator of cardiovascular health. To measure the maximum aerobic capacity of an individual, tests are used that allow knowing the volume/maximum consumption of oxygen (VO2max), such as the treadmill test (ET) and the six-minute walk test (6MWT). Therefore, the objectives of this study were to evaluate the physical conditioning (FC) of patients with NAFLD using the ET and the 6MWT, and to compare the FC to clinical parameters, and the results of the ET to those of the 6MWT. Methods: Observational, cross-sectional and analytical study, with consecutive and prospective inclusion of 32 patients with NAFLD confirmed by liver biopsy, with indication for ET to practice physical activity, who have completed the aforementioned test. Patients underwent ET and 6MWT and the FC was subsequently determined. Clinical data were compared to FC, according to TE and data from the two tests were also compared. Results: In the ET, 20 (62.5%) patients had very weak or poor cardiorespiratory fitness and in 12 (37.5%) the cardiorespiratory fitness was fair or good. In the 6MWT, 13 (40.6%) individuals had poor cardiorespiratory fitness, in 12 (37.5%) this was classified as very poor and in seven (21.9%) as regular. NAFLD activity score (NAS) ≥5 was observed in 37.5% of the sample, NAS <5 in 62.5%. According to the International Physical Activity Questionnaire (IPAQ), 12 (37.5%) patients were sedentary, 11 (34.4%) were insufficiently active and nine (28.1%) were active. Obese patients were more frequent in the group with very poor or poor physical fitness, NAS ≥5 and sedentary lifestyle were independently associated with very poor or poor cardiorespiratory fitness by ET. Although the mean VO2max values determined by the ET and the 6MWT were similar, no correlation was observed between the VO2 values determined by the ET and the 6MWT as well as there was no correlation between the distance walked on the 6MWT and the MET values, determined by the ET. There was no reproducibility of the cardiorespiratory fitness determined by the ET and the 6MWT. Conclusion: A high proportion of patients with NAFLD had poor or very poor cardiorespiratory fitness. Obesity, sedentary lifestyle and severe liver damage (NAS ≥5) were associated with very poor or poor cardiorespiratory fitness, according to TE. No correlation or reproducibility was observed between the parameters determined by the ET and those determined by the 6MWT.